Sub Clinical Hypothyroidism, TSH/T4/TPO antobodies

[HRH8591]

Hi can anyone help please? Not been on here long and just getting to grips with what I should expect from my GP/Endo.

My most recent test results are TSH 8.7 (0.3 -4.2), T4 15.7 (12.0-22.0). No other tests been done despite asking but at my previous GP's TP antibodies were 72.4 (with other results similar). Since then I have had two scans that confirm I have a multi-nodular goiter.

My tests seem to be viewed in isolation by my GP of the fact that I have a goiter and disregard that I have previously had elevated TP Antibodies . I have also been suffering with below normal levels of B12, Folate and Ferritin which I am finally having treatment for. Felt absolutely terrible from November to end March, now a little better.

Really concerned that I feel ill a lot of the time after I eat, pressure in the chest, bad headache, dizziness lasting between half an hour upt a few hours. Heart seems to beat erratically now and them and takes my breath. I think it is something to do with insulin but they keep telling me my HBA1c is fine but trend has been going upward for 18 mths. I have weeks where I am ok... then bang it starts again. Anyone else have this? Also started this really odd gasp for air out of nowhere about 4 mths ago.

What should I expect/understand from my results? They haven't been repeat testing since my TSH went over the high of 5.3 until I pushed following info from here but I could only get them to add T4 to TSH.

As a background I also have Primary Hyperparathyroidism and Osteoporosis (since I was 41 (not post menopause). Thanks in advance.

[SlowDragon Administrator]

Your results are subclinical, but as TSH is above range and you have antibodies and symptoms, guidelines say treatment should be started

gp-update.co.uk/files/docs/...

So you are now presumably starting on 50mcg Levothyroxine. If not ask GP to do so

NHS guidelines saying standard starter dose is 50mcgs

beta.nhs.uk/medicines/levot...

How low were folate, ferritin and B12. What supplements are you taking and have they been retested since to see if improved?

Can you add the actual results and ranges

Essential to test vitamin D as well. Low vitamin D is strongly linked to Hashimoto's

holtorfmed.com/vitamin-d-au...

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, sometimes significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

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 plus vitamin D

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

chriskresser.com/the-gluten...

thyroidpharmacist.com/artic...

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

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

thyroidpharmacist.com/artic...

[HRH8591 in reply to SlowDragon]

Many thanks for all this info. I'll get the rest of my results and get back to you with more info but Vit D last tested about a year ago and was highest it has ever been (about 97) - used to be 25 and 30. Have been Gluten Free since 2012 . No treatment planned by GP - he's waiting for the Magic 10 on TSH and seems disinterested in past TPO Antobodies and my multi nodular goiter.

[Nanaedake]

I presume you have you been treated for hyperparathyroidism? Don't know what gasping for breath is, just wondering if it's connected to calcium levels?

[HRH8591 in reply to Nanaedake]

Hi, thanks for your response. No, not treated - seems GP is waiting for the magic 10. Elevated calcium is a feature of Primary Hyperparathyroidism but I'm sure all medical professionals will tell me it is nothing to do with my condition/s. Same story with all my symptoms.

[Nanaedake in reply to HRH8591]

How were you diagnosed with primary hyperparathyroidism? And why haven't you been offered treatment for it? Doesn't make sense, sorry.

[HRH8591 in reply to Nanaedake]

Diagnosed end of last year via two scans. They need to see more tests. Watching and waiting is de rigueur in the UK within the NHS/Endo's for this disease. My surgeon (private) wants to be sure it is not genetic, an,d if it isn't, surgery is the only option. The debate is how long I have had it and, if it's in early stages, they like to wait for PTH and/or calcium to rise more. In the USA they say it is nonsense and that if it is damaging your body they need removing. I have two parathyroid adenomas, one each side. Quite a rarity I am told. I think I have had it for at least 8 yrs as my calcium levels made no sense.

[Nanaedake in reply to HRH8591]

Do you think Dr is reluctant to treat thyroid as thyroid hormone may make parathyroids more active?

[HRH8591 in reply to Nanaedake]

Think he is reluctant to diagnose in general but to be fair I am under one of the most prominent Endo's in the country so I think he wants to leave it all for him I wouldn't mind so much if he was more thorough in his testing or referred to the Endo in between appointments. I have no idea whether treating the thyroid affect parathyroids... is that fact?

[Nanaedake in reply to HRH8591]

I have no idea how it affects parathyroids, I've no medical background, I'm just asking the question as I think these might be areas you need to find out more on, see SlowDragon's link below.

[SlowDragon Administrator in reply to HRH8591]

Presumably you have read all the info on this website

parathyroid.com

And bought the app?

calciumpro.com

[HRH8591 in reply to SlowDragon]

Thank you yes, read it over and over, not bought the app though. My surgeon has worked in America and appointments with him are very informative (like American drs) and he thinks they need to be sure I don't have one of the MEN syndromes. Thanks SlowDragon will get back to you with my test results.

[SlowDragon Administrator in reply to HRH8591]

App is only £2-£3