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Help - GP won't diagnose Hashimotos based on elevated TPOAb

Hi folks, I wonder if anyone can help.

I posted my blood test results last week and while I currently have 'normal' thyroid results, my thyroid peroxidase antibodies are above range indicating autoimmune Hashimotos thyroiditis (which matches my symptoms).

I saw my GP yesterday and she refused to diagnose Hashimotos based solely on elevated levels of TPOAb (which considering I had to explain to her what the two types of antibodies were didn't hugely surprise me...). I'm really pushing for the diagnosis because I want to be regularly monitored, and may have to relocate so don't want to start the discussion all over again with another GP.

I'm sure that in the last few months I've read something 'official' recommending that Hashis can be diagnosed based solely on the presence of elevated antibodies even when the patient is euthyroid, but for the life of me I can't find the reference or link... :( I keep notes on everything so this is so frustrating!

Can anyone help at all, is there anything I can present to the GP to prove that she can diagnose based on elevated TPOAb? She's said that if I can prove it to her she'll consider putting the diagnosis on my record.

11 Replies

Thanks Clutter that's really helpful, I couldn't find anything specifically on TUK stating TPOAb levels could be used to make a diagnosis by itself, but the Medscape article was amazing!! It finally connected a dot for me about fertility issues and why I was misdiagnosed with PCOS!

What a strange and winding road this is.... :)

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If she wants NHS literature


If autoimmune thyroid disease is suspected, check:

Thyroid peroxidase antibodies (TPOAb) to confirm the diagnosis — repeat testing of TPOAb is not recommended.

Also in Risk factors associated with hypothyroidism

Autoimmune thyroid disease is associated with other autoimmune diseases such as type 1 diabetes mellitus, pernicious anaemia, vitiligo, alopecia areata, Addison’s disease, myasthenia gravis, coeliac disease, Sjögren’s disease, and rheumatoid arthritis [Weetman, 2010; Garber et al, 2012].

One UK-based cross-sectional multi-centre study (n = 495) found that the frequency of other autoimmune diseases was 14.3% in people with Hashimoto’s disease [Boelaert et al. 2010].

Rheumatoid arthritis was the most common coexisting autoimmune disorder (found in 4.24% of people with Hashimoto’s disease) and the relative risk for almost all other autoimmune diseases (including pernicious anaemia, systemic lupus erythematosus, Addison’s disease, coeliac disease and vitiligo) were significantly increased [Wiersinga et al, 2012].

If you don't have goitre and swelling it might technically be Ord's thyroiditis

Ask for thyroid scan


Hashimoto's link


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Thanks SlowDragon, this is exactly what I think she'll listen to. I'm going to send her this, the Medscape article, and a paper on early treatment, and hope that does the trick.

I don't think she'll give me a scan, as the guidelines say 'the recommendation that neck USS is not routinely recommended unless a clinical indication, such as goitre is present' and I don't have one currently. I went to a GP years ago with one, but when the scan came 8wks later it was gone and the consultant said I had imagined it (I did not)... Over the years now and again I get the same feeling but it's never lasted as long. I'm not sure if there are some lumps or enlarged areas in the thyroid which can resolve on their own or swell/shrink based on other factors... But I can try asking for one once I get over this hurdle with her. Thank you so much!

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PCOS and Hashimoto's are linked


Both seem to respond to strictly gluten free diet


For conception and pregnancy TSH should be below 2.5

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Thanks, I've been devoted to Wentz's website since I saw her linked on here, but not listened to this! She was also the final push for me to go gluten free :D When I told my GP I was doing this she did suddenly suggest testing for coeliac as my mother has it, but we'll see if that happens... she seemed a bit overwhelmed by the appointment!

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NCGS can be just as serious as coeliac, just no test available

I had two negative Coeliac blood tests and ambivalent endoscopy. Results of endoscopy strongly suggested coeliac, DNA testing said probably not coeliac. It's not always clear cut.

But avoiding gluten helps thousands


it's really frustrating there's no test, I suppose it's best just to listen to your symptoms and lean on the side of caution with gluten - at this point, I'm up for anything that helps!


I had absolutely no gut symptoms. Was astonished.

Silent coeliac is obviously vastly under diagnosed

Presumably sIlent NCGS is the same

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I hope GP prescribed correctly for your vitamin deficiencies

detailed supplements advice on low vitamins



She asked to see my B12 and ferritin results of her own accord to check for pernicious anaemia, so it seems to me her heart and head are in the right place, she was just a bit blindsided and unsure of what to focus on. She said her practice has it's 'own protocol' for loading doses of VitD (I had the NICE guidelines in my hand), so will get back to me and prescribe (hopefully). And while it was in range, she did think getting my ferritin up would be a good idea, although didn't offer anything.

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