High TSH and High Anti-TPO

[supertramp123]

I am 27 Male, My current TSH is 7.35 and it fluctuates between 5-10 since last 4 years. have High level's of Anti-TPO is 573.5. I have never take thyroxine regularly, taken them for a few days and then stopped. Recently a new physician that i am seeing, said 7.35 is not clinically significant and I don't need to take thyroid medication. I have fatigue, high blood pressure, and anxiety can they be the result of hypothyroid?

[SlowDragon Administrator]

Your antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).

About 90% of all primary hypothyroidism in Uk is due to Hashimoto's

Your results show you are hypothyroid and should be treated

Essential to test vitamin D, folate, ferritin and B12

Always get actual results and ranges. Post results when you have them, members can advise

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

Low vitamin levels can 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 gut connection is very poorly understood

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

Ideally 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...

thyroidpharmacist.com/artic...

[shaws Administrator]

If you are in the UK doctors and endocrinologists have been told not to prescribe thyroid hormones until the TSH is 10. However, worldwide, patients are diagnosed if the TSH goes above 3+.

I shall give you a list of clinical symptoms and I am sure you can tick off more than a couple. Due to you having thyroid antibodies you have an Autoimmune Thyroid Disease also called Hashimoto's. Due to these antibodies, regardless of your TSH you should begin levothyroxine. Usuall starting dose is 50mcg with a blood test every six weeks and a 25mcg increase until your TSH is 1 or below.

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

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

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

email Dionne at Thyroiduk.org.uk and request a copy of Dr Toft's Pulse Online article. Within it highlight the part where he states that if antibodies are present a prescription should be given.

All blood tests for thyroid hormones have to be the earliest possible, fasting (you can drink water) and allow a gap of 24 hours between last dose of levothyroxine and the test and take it afterwards. This helps keep the TSH at its highest and taking levo before the blood test will skew results and may mean doctor might adjust your dose down.

Also ask GP to test B12, Vit D, iron, ferritin and folate deficiences can also cause clinical symptoms. Everything has to be optimal not just somewhere in range.

[supertramp123 in reply to shaws]

Thanks Shaws for the reply, My Vitamin D level is 16.6 less than 20 is considered deficient, I work a desk job and do not go out in the sun often, I have started Vitamin D supplements. Vitamin B12 is within range. Will see another doctor and see if he will start levothyroxine. I have high resting heart rate (~105) and taking medication for anxiety and heart rate. Will see if levothyroxine can be taken with it.

[SlowDragon Administrator in reply to supertramp123]

You are severely vitamin D deficient, largely due to Hashimoto's

You need GP to prescribe you loading dose of vitamin D

Look up your local CCG guidelines for vitamin D deficiency

Eg Oxfordshire

oxfordshireccg.nhs.uk/profe...

[Clutter]

Supertramp123,

TSH 7.35 is why you are fatigued with high bp and anxiety. Why did you not take Levothyroxine daily?

Thyroid peroxidase antibodies are positive for autoimmune thyroid disease (Hashimoto's). There is no cure for Hashimoto's which causes 90% of hypothyroidism. Levothyroxine treatment is for the low thyroid levels it causes. Many people have found that 100% gluten-free diet is helpful in reducing Hashi flares, symptoms and eventually antibodies.

chriskresser.com/the-gluten...

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

healthunlocked.com/thyroidu...

[supertramp123 in reply to Clutter]

Hi Clutter, I have just been lazy and gotten used to fatigue and didn't think something was worng with me. I recently (a month ago) hit my head on a big door and after a week, I had nervousness, anxiety, high heart rate, and bp which completely changed my perspective towards life, now I want to be very healthy. I'll see an endocrinologist and see if I can resume Levothyroxine with my current medication (propranolol 20mg)

[shaws Administrator in reply to supertramp123]

Hypothyroidism is a fatal disease if untreated. Propropanol interferes with the uptake of levothyroxine. Only a few weeks ago a member had been admitted to hospital with a myxedema coma which used to be fatal.

Our brain and heart need the most T3 (liothyronine) and T4 (levothyroxine) converts to T3.

As you have been unwittngly neglectful I believe your palps was because your heart was struggling with insufficient thyroid hormones and your whole body too as it was trying hard to pump your blood round your body. T4 is inactive and converts to T3 so you wouldn't have had enough T3 in your T3 receptor cells.

I am not medically qualified but myxedema (the original name) was fatal and that is the reason why, if we are diagnosed as hypo, we no longer pay for any other prescriptions for any other illnesses we may develop.

Propropanol interferes with the uptake of thyroid hormones but you might find (hopefully) that as your levo is increased your palps will reduce and heart will becalm.

The proper name for hypothyroidism is Myxedema

[supertramp123 in reply to shaws]

Thank Shaws, what do you mean by "If we are diagnosed as hypo, we no longer pay for any other prescriptions for any other illnesses we may develop." ?

[helvella Administrator Thyroid UK in reply to supertramp123]

Most of what you need to know is here:

nhsbsa.nhs.uk/exemption-cer...

[shaws Administrator in reply to helvella]

Thanks for that link helvella.