Can you add the reference ranges please. As they vary from lab to lab, we need the range from the lab that did the test to interpret results. They may be at the side of the result, maybe in brackets, eg
TSH 2.5 (0.2-4.2)
Do you have nothing more recent than august 2017? If not it would be a good idea to maybe do a private test to include the full thyroid panel plus vitamins and minerals -
The abnormal Thyroid Peroxidase antibodies (they will be over range) confirms autoimmune thyroid disease aka Hashimoto's
which where antibodies attack the thyroid and gradually destroy it. The antibody attacks cause fluctuations in symptoms and test results.
For results to be compared accurately, the tests need to be done under the same circumstances each time. We always recommend here that the test is booked for the very first appointment of the morning and fast overnight (just delay breakfast until after the test, water allowed) . This gives the highest possible TSH which is needed when looking for a diagnosis. TSH is highest early morning and lowers throughout the day. It can also lower after eating and coffee also affects TSH.
Unfortunately, in the UK guidelines say that TSH needs to be 10 for diagnosis. However, Dr Toft, past president of the British Thyroid Association and leading endocrinologist) wrote an article in Pulse Online magazine (the magazine for doctors) which says that if antibodies present then patients should be prescribed levothyroxine to nip things in the bud. Email Dionne at
tukadmin@thyroiduk.org
and ask for a copy which you can then show to your doctor. The information is in answer to question 2. Your daughter could take this to her doctor to discuss. She should also take a list of her symptoms, she can print off this list and tick any that apply
Even though the 2018 results have no reference ranges, TSH of 6.24 will be over range, and with confirmation already of raised antibodies then hopefully a decent GP will agree to start prescribing Levothyroxine.
Most doctors dismiss antibodies as being of no importance and know little or nothing about Hashi's and how it affects the patient, test results and symptoms. Your daughter needs to read, learn, understand and help yourself where Hashi's is concerned.
She can help reduce the antibodies by adopting a strict gluten free diet which has helped many members here. Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks. You don't need to be gluten sensitive or have Coeliac disease for a gluten free diet to help.
Supplementing with selenium l-selenomethionine 200mcg daily can also help reduce the antibodies.
Hashi's and gut absorption problems tend to go hand in hand and can very often result in low nutrient levels or deficiencies, so it's important that she has vitamins and minerals tested:
Vit D
B12
Folate
Ferritin
If GP is reluctant to do anything, then I would suggest she does the full thyroid and vitamin panel mentioned above. If she can do it at a time when she feels unwell, then chances are she may catch the antibodies when they are high which might hopefully persuade the GP to prescribe Levo.
Come back here with any new results, including the reference ranges, and we can comment and suggest a way forward with the GP.
OK, so if the last set of results is August 2018 then her TSH is definitely over range (they rarely go above 5) but no idea about FT4. My GP's lab range is 7-17 so your daughter's result would be very good, but we also see 9-19 and 12-22 so if it was a range of 12-22 it would be quite low in range. Maybe she can ring the hospital and get the ranges so we can interpret the results.
Or get the full thyroid/vitamin panel as suggested because TSH and FT4 alone don't tell us much about what's going on.
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