Hi if I have raised thyroid antibodies and high tsh and low thyroid hormones and symptoms of low thyroid like puffy eyes and ankles and goitre and feeling cold do I need medication thank you
TSH 33.7 (0.2 - 4.2)
TPOAB 275 (<34)
FREE T4 10.3 (12 - 22)
Written by
Zosiak
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Has your GP actually said anything about these, were the tests done by your GP?
Your TSH is very high, you obviously know that it should be within the range quoted. Your FT4 is below range. Both of these shout hypothyroidism, diagnosis is usually given when TSH reaches 10.
See NICE Clinical Knowledge Summary for diagnosing hypothyroidism:
◦ Blood tests for thyroid stimulating hormone (TSH) and free thyroxine (FT4):
◾Diagnose overt hypothyroidism (OH) if TSH is greater than 10 mU/L and FT4 is below the reference range.
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Also, your high antibodies confirm 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.
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.
Some Hashi's information so that you can understand what Hashi's is like, which your GP probably doesn't know or dismisses antibodies as being unimportant
OK, make sure you come away with a diagnosis and a prescription for Levo
Unless you are a child, elderly or have a heart condition, you can easily be started on 50mcg, maybe more.
You will need repeat tests/increases of 25mcg Levo every 6-8 weeks until your symptoms abate and you feel well. The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it needs to be for FT4 and FT3 to be in the upper part of their respective reference ranges when on Levo if that is where you feel well.
Always book the first appointment of the morning for your thyroid tests, fast overnight (water allowed) and leave off Levo for 24 hours. This ensures the highest possible TSH which is needed when looking for an increase in dose or to avoid a reduction. This is a patient to patient tip and your GP or phlebotomist wont necessarily agree with it, so we just don't discuss it with them.
Start keeping a diary/spreadsheet of tests/results/reference ranges/dose of Levo/how you fee/etc. It will come in very useful in future if your GP wants to adjust your dose and you know you wont feel good on the dose he wants to change you too.
Take your Levo on an empty stomach, one hour before or two hours after food, two hours away from other medication and supplements, four hours for some.
Prevous GP was ignorant and negligent then! Are you still on the antidepressants? Depression can be one symptom of hypothyroidism.
Your ferritin was below range. Was anything done about it? If not ask for it to be repeated now, along with Vit D, B12 and Folate. All these nutrients need to be at optimal levels (not just in range) for thyroid hormone to work, it's very important, and again doctors don't appear to know this as they don't study nutrition.
Thanks no nothing done about the ferritin and it was done a week ago. I had a complete blood count showing mcv 77.6 (80 - 98) and mchc 385 (310 - 350) haemoglobin 117 (115 - 150) iron 7.8 (6.0 - 26.0) and transferrin saturation 15 (10 - 30)
vitamin d was 25.5 (25 - 50 deficient) folate 4.1 (4.6 - 18.7) vitamin b12 198 (190 - 900) all done a week ago
not on antidepressants I didn't think I needed them I haven't thrown them away I just don't take them
Your results suggest iron deficiency anaemia so along with the low ferritin that needs addressing. Let us know what GP says and if necessary I will give further information.
Vit D needs loading doses.
You're folate deficient with low B12 which really needs further investigation.
I'm on my tablet and all my information and links are on my PC which isn't playing ball at the moment.
If you post what your GP says and what he's prescribing I'll comment later when hopefully PC will be working.
That's ok my phone has been playing up today which I was on before (now on laptop) and the phone got fitted with a dodgy screen. £35 that cost me I posted what doctor said and what he prescribed already
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