Not sure what to do next

Two months ago TSH - 8.5, T4 - 10.5, Ferritin - 33, B12 206 - Antibodies not done

Two weeks ago TSH - 5.2, T4 - 11, Ferritin - 34 B12 not done

Antibodies - 550

Symptoms - low body temperature, vitilgo slightly raised diastolic blood pressure.

The GP and the Consultant told me that I do not have Hashimoto's - also told me that I do not need medication. I have read somewhere that hormone theraphy at this stage can help with the inflammation of the thyroid. The consultant stated that "the jury is out."

Any suggestions or sign posting would be great,

thank you

9 Replies

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  • KarlNorge I think that just about everyone here will agree that you do have autoimmune thyroid disease aka Hashimoto's. Your high antibodies confirm that, and you have had an obvious over range TSH at 8.5 but no idea if 5.2 is over range (always quote ranges when posting results as they vary from lab to lab). FT4 looks low but again no range.

    Dr Toft (ex president of British Thyroid Association and leading endocrinologist) wrote an article in Pulse Online magazine which says that if antibodies are present then patients should be prescribed levothyroxine to nip things in the bud. Email louise.roberts@thyroiduk.org.uk and ask for a copy which you can then show to your doctor.

    From thyroiduk.org.uk/tuk/about_... > Guidelines for the Use of thyroid Function Tests

    .......

    If thyroid antibodies are found, then you may have Hashimoto's disease. If there are thyroid antibodies but the other thyroid tests are normal, there is evidence that treatment will stop full blown hypothyroidism from occurring.

    Dr A Toft, consultant physician and endocrinologist at the Royal Infirmary of Edinburgh, has recently written in Pulse Magazine, "The combination of a normal serum T4 and raised serum TSH is known as subclinical hypothyroidism. If measured, serum T3 will also be normal. Repeat the thyroid function tests in two or three months in case the abnormality represents a resolving thyroiditis.2 But if it persists then antibodies to thyroid peroxidase should be measured.

    If these are positive – indicative of underlying autoimmune thyroid disease – the patient should be considered to have the mildest form of hypothyroidism.

    In the absence of symptoms some would simply recommend annual thyroid function tests until serum TSH is over 10mU/l or symptoms such as tiredness and weight gain develop. But a more pragmatic approach is to recognise that the thyroid failure is likely to become worse and try to nip things in the bud rather than risk loss to follow-up."

    **

    Ferritin and B12 look low and probably need supplements. Please add the ranges. Was Folate tested, this works alongside B12.

  • Hello there Seaside Sue,

    This is exactly what I need - I just could not understand what the consultant was talking about and I did not want to say that I thought I had Hashimoto's because he would probably think that I was being over reactive. I will certainly try and get hold of this article to take with me. Just one question - is it possible to have the antibodies without having Hashimoto's?

    Thank you so much for your time in replying

  • is it possible to have the antibodies without having Hashimoto's?

    Not sure about that. I'm not Hashi's so can only go by what I read and I've not come across that, sorry. Might be a good topic for a new question/thread to catch the attention of those more experienced with Hashis/Antibodies.

    It's important that all your vitamins and minerals are optimal and the recommended levelsl are

    Vit D - 100-150nmol/L according to the Vit D Council

    B12 - very top of range, even 900-1000 for us Hypos

    Folate - at least half way through range

    Ferritin - half way through range

    Thyroid hormone, replacement or own own, can't work properly without optimal levels.

  • Okay - is there a reference that I can use that demonstrates that these optimal levels are recommended because the Doctor will just say that it is in the normal range so; "it's okay."

  • Unfortunately, I don't know of any that will be acceptable to doctors. As they're not taught nutrition, as long as they see a number that falls somewhere within the range then they're happy. And as they tend to ignore numerous under range results, it would appear they don't understand, have no knowledge or couldn't give a toss!

    We've had a spate posts showing under range ferritin/B12/folate and severely deficient Vit D recently which have been ignored by GPs, and my suggestion has always been to point these deficiencies out to the doctor and insist on appropriate treatment as shown in the guidelines, also to change to a doctor who actually cares and to make an official complaint against the one who has ignored the results.

  • Yes probably don't give a toss!! Where can I find the guidelines? On the web site?

  • NICE Clinical Knowledge Summary easy to find on Google for certain deficiencies

    Vit D - cks.nice.org.uk/vitamin-d-d...

    Iron deficiency anaemia - cks.nice.org.uk/anaemia-iro...

    B12/Folate - cks.nice.org.uk/anaemia-b12...

    Those give us a nice big clue as to how we are supposed to be treated for those deficiencies. However, local area health authority guidelines can differ slightly from the NICE CKS Summary so we need to search for our own particular area's guidelines.

  • I can guarantee that if your consultant physician had your symptoms and test results himself he'd be pushing for treatment.

  • Email Louise at Thyroid Uk for list of recommended thyroid specialists. You do have Hashimoto's

    Getting vitamins optimal and trying strictly gluten free diet may help, but if your TSH remains high then you need starting on Levothyroxine

    If you go gluten free early enough in Hashimoto's a few people have managed to get it under control without Levo, but it's unusual

    Louise.roberts@thyroiduk.org.uk

    amymyersmd.com/2017/02/3-im...

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