I had Graves 13 years ago so have annual TSH/FT4 blood tests.
Over the last few years my TSH has been creeping up and my FT4 has been sitting low in the range.
In view of my history of Graves, the fact I have other autoimmune issues (pernicious anaemia and vitiligo) and because TSH was 4.3 six months ago I asked my GP to test my thyroid antibodies.
I’ve just had my results (which show that TSH is better than recent years) and these are
Thyroid peroxidase: TPO result is positive
263.8 (range 0-5.6)
TSH 3.05 (0.35-5.00)
Free T4 11.2 (9-22)
I do feel more tired than friends of a similar age but usually assume it’s a B12 issue (which I’m happy is being adequately treated). Otherwise apart from hair loss over the last 6-9 months I feel generally well and my weight is fine. (The test 6 months ago did show that Free T3 was near the top of the range despite T4 being near the bottom).
My GP has suggested that subject to the latest test results that it may be an idea to start me on 50mcg thyroxine and I’m seeing him soon to follow this up.
Do you think that starting on thyroxine is a good idea even though my TSH & T4 are in range?
Are there any questions I should ask my GP?
Incidentally I did have a test for coeliac a while back and this came back negative.
Thank you
Written by
JanD236
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Testing for Coeliac is largely irrelevant with autoimmune thyroid. Most of us still find gluten free diet helps
Yes if you have no thyroid function, did you have RAI or thyroidectomy? Either way TSH is too high (should be around one) and FT4 too low, should be nearer top of range
All thyroid tests should be done as early as possible in morning and fasting and don't take Levo in the 24 hours prior to test, delay and take straight after. This gives highest TSH and most consistent results
Also ask GP to test vitamin D, folate, ferritin and B12
Thank you SlowDragon. I didn’t have either RAI or thyroidectomy but was on carbimazole for 2 years and this seemed to sort out the overactive thyroid so I didn’t need further treatment. I’m not on thyroxine.
My latest blood test was at 8.30am and I hadn’t eaten or drunk anything beforehand.
My vitamin D levels were fine when last tested a year or so ago and the test last week showed folate and ferritin both in the top third of the ranges. (I refuse B12 tests as I have B12 injections so the result would be meaningless).
So.....should I take thyroxine if offered by the gp on the basis of raised antibodies, some tiredness and hair loss but no other symptoms?
Did you actually have your antibodies tested for Grave's? Or did your doctor just assume that you had Grave's because your TSH was low and/or your Frees high? It could very well be that you've never had Grave's, but were on a Hashi's 'hyper' swing, which then went back to euthyroid, and now you're slowly going hypo.
If you're having symptoms, I would definitely start the levo, if I were you. Hashi's doesn't go away by itself, you just get more and more hypo.
I thought the Graves was behind me as it was 13 years ago. But your comment has made me think maybe I should ask for an endo referral again. I had an endo managing my treatment of the Graves but since then blood tests (and PA) have been taken only at my GP practice.
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