Medichecks Results - TPOAB Levels Understanding Required

[Pinkroses]

Hi. I have symptoms consistent with under active thyroid the worst being fatigue and brain fog (I also have a family history of under active thyroid and B12 deficiency). Doctor tested TSH (4.4), Free T4 (13) and B12 (402) and said they were normal. Having read advice here I got a Thyroid test by Medichecks to include testing for antibodies and the results are below with the ranges in brackets.

TSH 4.6 (0.27 - 4.20)

TT4 90.1 (59-154)

FT4 13.8 (12-22)

FT3 4.32 (3.1-6.8)

TGAB 55 (0-115)

TPOAB 176 (0-34iu/ml)

Medichecks said that I have slightly elevated TSH and TPOAB antibodies which can be consistent with Hashimotos and to discuss the results with my GP. However, what I can't understand is that my Free T3 level is fine so why would I be experiencing under active thyroid symptoms, as although my thyroid is under stress my body still has the amount of Free T3 which it actually needs?

I am loath to go back to my GP (who thinks its either chronic fatigue or depression) as I have a one doctor surgery where the GP has recently retired and so I will see a different locum each time. Also, if the TPOAB results were so important why would my GP not have tested these in the first place?

I am thinking of self medicating with a small does of 50 levothyroxine daily to see if my symptoms get better?

[SlowDragon Administrator]

Would really suggest you take results to GP and get official diagnosis.

They may want to repeat the tests, if they don't trust private ones.

Sadly very common not to test antibodies.

You also really need vitamin D, folate, ferritin and B12 tested

Read as much as possible about Hashimoto's

Thyroid Uk home website

The Thyroid Pharmacist website has masses of info

Amy Myers, Chris Kreseer good too

[Mike374]

It's a combination of cost grounds & (false) belief that TSH & FT4 tests alone will give picture of any thryoid dysfunction, that means most doctors won't order a full thyroid panel (plus antibodies).

You rightly note you have thryoid inflammation (auto-immune disease) as indicated by the number of both antibodies currently present. Something that certainly needs to be addressed, & sooner the better. IMO (others may disagree) at this stage taking T4 alone is unlikely to address this, although might be helpful if hypothroid symptoms were to continue after other treatment options tried i.e. vitamin/mineral supplementation & diet changes.

Have you had any of your key vitamin & mineral levels checked? Deficiences in the likes of folic acid (b9/folate), Vitamin B12, Vitamin D, Magnesium, Iron etc... can cause all sorts of unwanted symptoms that are part & parcel of hypothyroidism. Having optimum Vit D levels is paricularly important for bringing any autoimmune disease like Hashimoto's under control.

So personally I'd look at checking & addressing any potential nutrient deficiences before looking at trialing any thryoid hormone supplementation. Adding some T4 supplementation may prove useful as a next step, though right now seems that your T3 & T4 levels really are not too bad (although of course potential to be improved to optimum levels).

Assuming your current diet is a good healthy (balanced) one, then any nutrient deficiences are likely to be caused by low stomach acid. Which in itself can reduce the efficient absorption of vitamin & mineral supplementations. So something to very much keep in mind. Therefore often preferable to use sublingual or and/or other more easily absorbed forms of supplementation if they're needed. And you can always aid digestive absorption by taking a little Betaine HCl if you believe low stomach acid might be a problem for you. Many that have successfully treated their Hashimoto's swear by modifications to their daily diet. I'm sure they will chime in & help on that front.

All the best.

[Pinkroses in reply to Mike374]

Thanks. yes my vitamin levels are all ok except perhaps B12 which was 402 so I am starting to take a sublingual B12 tablet. I would be interested in learning more about modifying my diet to control hashimotos. Is this on this site to?

[Mike374 in reply to Pinkroses]

Hoping your vitamin/mineral levels are better than ok! i.e. the aim should be to have them optimal & towards the upper end of blood test reference ranges and not just 'normal'. You'll find plenty of info regarding specific recommended diets on many of the main thyroid help websites & the better self help books.

[Pinkroses in reply to Mike374]

My vitamin levels (with the exception of B12) are all in the midway point of the ranges so yes could increase them all towards the upper end of the ranges.

[Treepie]

Your FT3 is less than half way up the range ,and FT4 is just in range.GPs will often only treat if TSH above 10 . With the high antibodies and likely Hashimotos why not ask for a trial on levo.