TSH normal but antibodies present. What now?

[wakemeup]

Hello all,

This is my first post and am wondering if anyone can suggest a way forward. I've been suffering what I think are Hashimoto symptoms on/off for several years. I'm currently on sick leave. Here are my symptoms:

Extreme fatigue, headaches, tinnitus, dizziness all the time, muscle aches, horrible dry skin on torso and arms and most of all internal and extrenal shivers - like I'm living in the North Pole or something! Also, my voice goes croaky on and off and I have what feels like something stuck in/on my throat.

Ordered private blood tests. Here are the results:

Biochemistry

CRP 0.30 <5.0 mg/L

Ferritin 128.3 20 - 150 ug/L

Thyroid Function

TSH 1.52 0.27 - 4.20 mIU/L

T4 Total 66.7 64.5 - 142.0 nmol/L

Free T4 12.96 12 - 22 pmol/L

Free T3 3.96 3.1 - 6.8 pmol/L

Immunology

Anti-Thyroidperoxidase abs 13.9 <34 kIU/L

Anti-Thyroglobulin Abs 15 <115 kU/L

Vitamins

Vitamin D (25 OH) 72 Deficient <25 nmol/L

Insufficient 25 - 50

Consider reducing dose >175

Vitamin B12 666 Deficient <140 pmol/L

Insufficient 140 - 250

Consider reducing dose >725

Serum Folate 44.42 8.83 - 60.8 n

I've been taking 15,000 iud Vit D and 15 x spirulina tablets daily for several weeks now. But can anyone comment on the present of antibodies? I can't find the information I'm looking for online. Some say it's normal to have them present, some say I should go back to GP......ANY help at all would be most appreciated.

[shaws Administrator]

It's a pity that a patient with hypothyroidism is not given thyroid hormone replacements.

The reason for this is that the doctors only go by the TSH result alone and nothing else.

This is wrong.

Your TSH is within the 'normal' range so your GP is assuming that you are not yet in the range to be diagnosed as they have been directed that our TSH has to reach 10, even though the top of your range is 4.20.

Nevertheless, no notice has been taken whatsoever of the two main thyroid hormones, i.e. FT4 and FT3. both are too low for you to feel reasonably well and are at the bottom of the range and that's the reason you have clinical symptoms. T4 is inactive and converts to T3. T3 is the only Active thyroid hormone and has to get into the billions of receptor cells in our body in order that we can function as normal human being.

I shall give you a link from Thyroiduk.org.uk and make an appointment or phone your doctor and say you've taken advice from the NHS Choices for dysfunctions of the Thyroid gland and due to your very low FT4 and FT3 which should be towards the upper part of the range, you need to be prescribed thyroid hormones.

thyroiduk.org.uk/tuk/testin...

[wakemeup in reply to shaws]

Wow! Thank you so much for doing this for me. I will definitely do that. Do you think the antibodies are suggestive too? I'm still on the sick after 3 weeks and my sick note says 'dizzy' which as you can imagine is not really pleasing my employer. I'm getting stressed thinking I will have to go back but I really feel too poorly and when then doctors says you're 'normal' it just makes me really depressed thinking I must be a hypochondriac... Aww, I really appreciate you taking the time to do this for me. Thank you once again.

[Marz in reply to wakemeup]

You have anti-bodies - however they are still below the range - so fine for now. High in range can suggest inflammation somewhere - but your inflammation marker CRP is fine. So all a bit confusing.

Some may say you have Central Hypothyroidism where it is a Pituitary issue as all results are low in range. The TSH is often raised when the FT4 and FT3 are low. I am not experienced with this condition so hopefully others will comment or you can research it yourself

What supplements/medications are you currently taking ?

[shaws Administrator in reply to wakemeup]

If you are hypothyroid, it is classed differently from all other illnesses as, untreated, it can be fatal. So the quicker you get a proper diagnose on your sick note it will allow you a bit of time to get onto a reasonable dose. Also for any other illnesses you will never have to pay for any prescriptions. !!!

There's no quick fix but some, once on replacement hormones can pick up quickly and many do fine on levothyroxine but it as to be done gradually, i.e. about every six weeks an increase of 25mcg. Starting off at 50mcg of levo.

Blood tests should always be at the earliest, fasting (you can drink water) and allow 24 hours gap between your last dose and the test and take it afterwards.

(I am not medically qualified) I believe your antibodies are too low yet to be diagnosed as Hashimotos but others more knowledgeable will respond).

thyroiduk.org.uk/tuk/about_...

You should also get B12, Vit D,iron, ferritin and folate tested as everything needs to be at optimal.

[shaws Administrator in reply to wakemeup]

Just to pass your time ....

thyroiduk.org.uk/tuk/about_...

[wakemeup]

Thanks again all..... I'll book an appointment on Monday and see how it goes. xx