Thyroid UK
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Normal T4-TSH --> Abnormal ultrasound and elevated antibodies no goitre.

Hello everyone!

After 2 months of a lot of wierd symptoms happening and a lot of doctors visits + no diagnosis i visited an endocrinologist.

She made an ultrasound and told me my thyroid has abnormal shape that looks like hashimoto. I already had a routine blood test that came back with normal TSH and T4 so she requested some other hormonal tests. Results were the following

ANTI TPO : 132 (normal rates <60)

ANTI tg :157 (normal <120)

VitD:10 (<11= severe deficiency)

After the results came back even though she told me i have a type of thyroiditis but she only prescribed vit d and selinium supplements,and told me to come back after 6 months to test thyroid hormone levels again. Im confused. Should i ask for another opinion ?

Symptoms: i have 180/300 of the symptons in the famous thyroid list.

12 Replies
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You have Hashimoto’s thyroiditis. Although she probably called it autoimmune thyroiditis - it’s the same thing.

She’s taking a very conservative approach but it is likely that over time you will develop full blown hypothyroidism I’m afraid.

Do you know what your TSH and FT4 results actually were (with ranges)?

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Hey jazzw , thnx a lot for the quick reply.

Yes . they are the following

FT4: 1.13 (0,75-1.7)

Tsh: 2.93 (0.38-5)

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Do you have the lab ranges? They’ll help. It looks like your TSH is only slightly elevated so I can see why she’s adopting a watch and wait approach but I’d recommend asking for repeat blood tests in a couple of months rather than waiting for 6 months.

What Vitamin D has she put you on? How much?

The other things that would be worth testing are Vit B12 levels and iron. Often both are low in folk with Hashimoto’s - especially untreated or undertreated Hashimoto’s.

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Personally I would get full Thyroid and vitamin tests

Your vitamin D was extremely low. How much were you prescribed

For full evaluation you ideally need TSH, FT4, FT3, TT4, TPO and TG antibodies, plus vitamin D, folate, ferritin and B12 tested

See if you can get full thyroid and vitamin testing from GP. Unlikely to get FT3

Private tests are available

thyroiduk.org.uk/tuk/testin...

Vitamindtest.org.uk - £28 postal kit

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.

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, lowest FT4 and most consistent results

Link about antibodies

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

Link about thyroid blood tests

thyroiduk.org/tuk/testing/t...

list of symptoms

thyroiduk.org/tuk/about_the...

Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels

Low vitamin levels affect Thyroid hormone working

Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten

According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

But don't be surprised that GP or endo never mention gut, gluten or low vitamins. Hashimoto's is very poorly understood

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies

Ask GP for coeliac blood test first

thyroidpharmacist.com/artic...

thyroidpharmacist.com/artic...

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

chriskresser.com/the-gluten...

scdlifestyle.com/2014/08/th...

drknews.com/changing-your-d...

Low vitamins are extremely common when untreated or due to under medication

Detailed supplements advice from SeasideSusie in these posts

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

1 like
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Thank you very much i will read them thoroughly!

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I ediited the lab ranges in the previus post so u can see them.

I also had lab tests 2 months before and tsh was 2,22. and in range t4 but dont know exact number.

B12 was 315 (197-771) i am taking b-complex supplements 3 pils everyday.

Iron and ferritin was not tested.

Funny thing is i was constantly gaining weight the last 4 years and for the past 2 years i was having a lot of vitamin deficiency symptoms. I should get tested for vit-a also because i noticed having diminished night vision and photophobia.

Thnx again for the interest !

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You need to stop any supplements that contain biotin at least 3-5 days before any blood tests

That would include nearly all vitamin B complex

Biotin can falsely affect test results.

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

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How much Vit D are you taking? (I’m hoping you’ve been given big doses...)

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25000 i.u /2.5 ml once a week

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Nowhere near enough. Check out Seaside Susie for dosing advice. I take 5,000 i u per day and I am not deficvent. You need a level around 100-150 !

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i will thanks

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My endo did not prescribed thyroid hormone replacement.

i have serius issues that signals something is wrong with my homeostasis

I believe i have several vitamin deficiencies since i am an R.D and i can recognise symptoms . Should i also seek 2nd opinion from another doctor along with the further testing for Iron, Feritin,Folate and vit a ?

Thnx again guys you are very helpfull.

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