Subclinical

[Greta18]

Hello, I know this is a very knowledgeable site and I would really welcome your thoughts on my results. Thyroid disorder found 18m ago from blood drawn because of severe hives due to low DAO (the enzyme which breaks down histamine). Lack of the enzyme resolved by taking DAO (Histame capsules) before meals and working to repair my gut. Stopped prescribed antihistamine (Zirtec) with the help of the DAO. I went strictly gluten free, soy free, eat as organic as possible and avoid processed. Still have some gut inflammation - a work in progress. I use coconut oil to eat and cook. Symptoms I went to the specialist for were not just severe hives - I also had poor balance when walking, benign positional vertigo, poor mental focus, tiredness, blurred vision, ringing ears, acid reflux. Those symptoms cleared quickly after I saw a nutritionist and made diet changes. I no longer need DAO supplements but am careful not to eat very high histamine foods. My weight has been stable for 2 years.

I am still monitored for subclinical hypothyroidism by endo and GP despite feeling well. Results below are through my functional nutritionist Optimal ref ranges provided (endo and GP refuse other than FT4 and TSH).

Endo only interested in TSH high level. I don't want to start on levothyroxine unless I understand all this better and weigh up the pros and cons.

Endo is not interested in antibodies but I am!!! TPOAb resolved to optimal after I went GF. Am now considering going dairy free to see if TgAb will reduce any if I cut out casein. I can find very little literature on TgAb. I use HRT patches and wondered if Estrogen is blocking uptake of T3 but my Dr says there's no connection. Has anyone brought down TgAb by diet or is levothyroxine the only way?? Thank you for reading all this. Wishing you well!

TSH = 5.23 [1.30-2.00]

FT3 = 4.80 [4.61-5.38]

FT4 = 14.40 [12.87-19.30]

Total T3 = 1.60 [1.39-2.59]

Total T4 = 90.90 [77.22-153.15]

T3 uptake = 26% [ 27-35]

TPO Abs = 12 iU/L. [0-34]

Tg Abs = 544 iU/L. [0-115]

RT3 = 0.55ng/ml. [0.36-0.90]

Free Thyroxine Index (T7) = 1.83 Index [1.70-4.60]

D(25-OH) = 109.32 [125-225]

B12 = 562.20 pmol/L [332.01-590.24]

Folate = 28.99 nmol/L [33.99-56.65]

DHEA-S = 3.05 umol/L [7.42-10.80]

ESR = 20.00 mm/hr [3.00-10.00]

Fe Serum= 16.40 umol/L [15.22-23.27]

Ferritin = 84.00ng/ml [30-70]

% Transferrin saturation 26.40 [20-35]

I supplement with D3 and Selenium also B12. Have been taking Iodide for some months as an iodine loading test by the nutritionist showed a very low level.

[greygoose]

Thyroid hormone replacement - levo, T3, etc. - does not have any effect on antibody levels. All it does is replace the hormone your thyroid can no-longer make. However, keeping your TSH suppressed may keep your antibodies low. The less gland activity there is, the less likely the immune system is to attack. And it's after an attack that the antibodies come out in force to clean up the mess! But, levels fluctuate all the time, so there's no sure way of knowing if diet reduces them, either.

So, your TSH is much too high. And not really 'sub-clinical' at all. You are hypo when your TSH hits 3. But your Free levels don't indicate a conversion problem, because your FT4 is as low as your FT3. You need to start thyroid hormone replacement.

Your iodine may be low, but it is not what is causing your hypothyroidism, that's down to the destruction caused by the Hashi's. And taking iodine can exacerbate the problem, so it really isn't a good idea.

[bac_jac in reply to greygoose]

Subclinical Hypothyroidism is an actual diagnosis in which the TSH is above normal limits while the Thyroxine remains within normal limits. The letter writer is correct.

[greygoose in reply to bac_jac]

Yes, I know the OP is 'correct' in that that is what the doctors told her. But no, that is not the actual meaning of 'subclinical'. The TSH can be over ten, the limit that doctors deem to be overt hypothyroidism, but the FT4 still in range. However, subclinical actually means out of range results without symptoms.

I was not telling the OP she was wrong, I was saying her doctors were wrong because you are, in actual fact, overtly hypo as soon as your TSH is over three on two separate blood tests. And in some other countries you would be treated at that point. It's only in the UK that doctors insist your TSH should be over ten before they will admit you are hypo and do something about it.

[Nanaedake]

I don't have antibodies but my understanding is that levothyroxine in itself does not reduce antibodies although reducing TSH down to around 1.0 and optimising thyroid medication may prevent flare ups of Hashimotos thyroid antibodies and therefore help to prevent raised antibodies.

It sounds like you're doing all the right things and you may not be able to eradicate antibodies altogether. More importantly, it sounds like you're feeling well now.

Keep your B12 above 500 or at top of range, because some of your previous symptoms sound like they might have been related to low B12.

I agree with Greygoose, don't take iodine, it's not recommended when someone has Hashimotos.

[Starfish123]

Re iodine and hasimotos, there was an article of some kind on the Facebook page of stop the thyroid madness about taking it recently and why it was good for you.

[SlowDragon Administrator]

You would need an extremely experienced specialist in iodine, it's not generally considered a good idea with Hashimoto's

I have also read that the loading iodine test is unreliable

SeasideSusie possibly knows about that?

drknews.com/iodine-and-hash...

thyroidpharmacist.com/artic...

[magsyh]

Your gp is an idiot of course the estrogen is upsetting your thyroid function. If you are on estrogen did they check your hormones or did they just hand out the hrt? Are you getting progesterone? If not, why not? Hashis or not lack of progesterone will mess up your thyroid function? Have you had a hysterectomy at some point and they are telling you no womb so no progesterone needed? Makes my blood boil they are so stupid! If you are on combined hrt get off the progestin ask them for utrogestan and dont swallow it like they tell you to. If they wont give you it buy progesterone cream and protect yourself from cancer and thyroid problems. Im using 25mcg levo and utrogestan at moment to clear endrometrial hyperplasia. I burst the capsule and put the contents on my skin before bed. Hope this helps you if it sounds familiar to anyone out there xx

[SeasideSusie Remembering]

Yes, I have read that the loading dose test is unreliable

blog.zrtlab.com/flaws-in-th...

I have done the urine iodine test but the one where you don't take a dose of iodine before doing it - Genova Diagnostics END25 and it measures existing levels. I've done it twice, once before taking a multi supplement containing iodine (recommended by my practioner at the time) and again a few months later and the second one showed a big rise in the level so I believe the test is accurate.

[Angel_of_the_North]

You might want to get all your sex hormones looked at given your low DHEA-S level.

[klr31]

I would say that you need thyroxine!

Karen