Thyroid UK
88,810 members103,410 posts

Worthwhile pursuing?

ResultAbnormal, but expected - No Further Action

Pathology Investigations

Serum thyroid peroxidase antibody concentration > 1300 u/mL [0.0 - 60.0]

Above high reference limit

ResultSatisfactory - No Further Action

Serum free triiodothyronine level 4.6 pmol/L [3.5 - 6.5]

Serum free T4 level 11.4 pmol/L [10.0 - 18.7]

Serum TSH level 2.56 mu/L [0.35 - 4.5

Symptoms: Very slow mind, poor memory, sleepy face, weight gain, sore throat

This was taken in February and I gave up. Have started running since then, to keep my weight in check.....

11 Replies
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S181LLE And are you keeping your weight in check? With a low FT3 that might be hard.

Serum thyroid peroxidase antibody concentration > 1300 u/mL [0.0 - 60.0]

Your high antibodies mean that you are positive for autoimmune thyroid disease aka Hashimoto's which is where antibodies attack the thyroid and gradually destroy it. The antibody attacks cause fluctuations in symptoms and test results.

Serum TSH level 2.56 mu/L [0.35 - 4.5]

Serum free T4 level 11.4 pmol/L [10.0 - 18.7]

Serum free triiodothyronine level 4.6 pmol/L [3.5 - 6.5]

TSH shows your thyroid is struggling, your FT4 is very low in range and your FT3 shows your body is doing it's best to provide some of the active hormone at the moment.

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

In America and some other European countries, they have reduced the TSH level to 2.5 which means that anyone above that figure will be treated if they have symptoms of an underactive thyroid.

The 'UK Guidelines for the Use of Thyroid Function Tests' state that, "There is no evidence to support the benefit of routine early treatment with thyroxine in non-pregnant patients with a serum TSH above the reference range but <10mU/L (II,B). Physicians may wish to consider the suitability of a therapeutic trial of thyroxine on an individual patient basis." If your TSH is above the range but less than 10, discuss a therapeutic trial of thyroxine with your doctor.

Subclinical hypothyroidism (where there are elevated TSH levels, but normal FT4 levels, possibly with symptoms) has been found in approximately 4% to 8% of the general population but in approximately 15% to 18% of women over 60 years of age.

Subclinical hypothyroidism can progress to overt hypothyroidism (full hypothyroidism with symptoms) especially if there are thyroid antibodies present.

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."

If you would like a copy of the article so you can discuss it with your GP then email louise.robers@thyroiduk.org

**

As for your Hashi's, you can help reduce the antibodies by adopting a strict gluten free diet which has helped many members here. Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks. You don't need to be gluten sensitive or have Coeliac disease for a gluten free diet to help.

Supplementing with selenium l-selenomethionine 200mcg daily can also help reduce the antibodies, as can keeping TSH suppressed.

Gluten/thyroid connection: chriskresser.com/the-gluten...

stopthethyroidmadness.com/h...

stopthethyroidmadness.com/h...

hypothyroidmom.com/hashimot...

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

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Thank you SeasideSusie. for your post over the last couple of months my thyroid symptoms have all returned, ie fatigue, aches, etc. I went Gluten free a couple of years ago and seemed to be OK, but a month ago i got the hankering for a some nice fresh Bread, pork pie then Gluten Free went of the menu. I have been trying to fathom out why i was back to all the old symptoms. A big clean out in the kitchen first thing tomorrow, I am due bloods test in two months fingers and every thing x for a good result. we can but try.Once again Thank You . Dave.

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just Add i have never been Tested for Coeliac disease I did the Gluten Free to help with Gut problems.

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72 kg and 172CM ....+ 6 kg in one year. I'm on my feet all day very active job. Run approx. 20 miles per week. On HRT (elleste solo)

GP says people often have these antibodies that is normal and no indication of Thyroid disease

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S181LLE When the range is 0-60 and your antibodies are greater than 1300, then there is no way that is normal and it is indicative of autoimmune thyroid disease.

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

The first group, the TPO Ab, are found raised in Hashimoto's disease - otherwise known as autoimmune thyroiditis. Here the cells of the thyroid gland are attacked and slowly destroyed. Patients with these antibodies present either have Hashimoto's, or are going to have it with subsequent reduction of thyroid function. (Elevated levels are found in virtually all cases of Hashimoto's disease and they will also be raised in 65% of patients with Graves' disease).

thyroidpharmacist.com/artic... -

In most cases of Hashimoto’s thyroiditis, blood tests will reveal one or two types of anti-thyroid antibodies. Thyroid peroxidase antibody (TPOAb) is the most common antibody present (in up to 95% of those with Hashimoto’s), and often antibodies against thyroglobulin (TGAb) are found as well (around 80%). These antibodies may appear decades before a change in TSH is detected.

Thus, TPO antibody screening is always crucial in suspected thyroid disease.

medicinenet.com/thyroid_per...

What does a positive thyroid peroxidase test mean?

•Most people with chronic thyroiditis display a positive TPO test. The test is also positive in lesser numbers of people with other thyroid diseases.

mayomedicallaboratories.com...

The determination of TPO antibody levels is the most sensitive test for detecting autoimmune thyroid disease (eg, Hashimoto thyroiditis, idiopathic myxedema, and Graves disease) and detectable concentrations of anti-TPO antibodies are observed in most patients with these disorders. The highest TPO antibody levels are observed in patients suffering from Hashimoto thyroiditis. In this disease, the prevalence of TPO antibodies is about 90% of cases, confirming the autoimmune origin of the disease. These autoantibodies also frequently occur (60%–80%) in the course of Graves disease.

Plenty more out there if your doctor would like to educate himself.

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Have you tested your vitamin D, folate, ferritin and B12. These are very commonly far too low with Hashimoto's

If these are too low then thyroid hormones can't work. So you feel hypo but tests say normal.

If you have these already, put on a new post

thyroidpharmacist.com/artic...

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

chriskresser.com/the-gluten...

Low stomach acid can be an issue

Lots of posts on here about how to improve with Apple cider vinegar or Betaine HCL

thyroidpharmacist.com/artic...

Other things to help heal gut lining

Bone broth

thyroidpharmacist.com/artic...

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Sorry, how rude am I. Thank you Seaside Susie and Slow Dragon for your replies :)

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A year ago

B12 AND FOLATES

Serum vitamin B12 level 519 ng/L [161.0 - 531.0]

Serum folate level 8.3 ug/L [2.9 - 16.9]

TSH 3.39 (0.36 - 4.5)

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Serum ferritin level 26 ug/L [22.0 - 332.0]

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This is much too low

Read up SeasideSusie posts on here about how to supplement

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S181LLE If this is from a year ago, like your B12 and folate, it would be best to get everything retested. Levels could be different now - better or worse - and I'd not like to suggest anything based on old results.

And if the TSH of 3.39 is a result prior to the result of 2.56 mentioned earlier, then it's of no significance now, it's the current result that matters.

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