Very confused with blood test results, please help

[evasofi]

Hi,

My T4 was high and I was on carbimazole for several month. T4 came to normal, I stopped the medication and in 2 weeks did the blood test.

The result came with very normal T3, T4, but TSH soared from 0.06 to 4.57 (norm is: 0.30 - 4.20).

I'm not too bad apart from regular tiredness and throat pain as usual. Please if you have similar experience, can you advice what should I do, go back to medication, will it help?

[greygoose]

Did you have any antibodies tested?

[evasofi in reply to greygoose]

Yes, antibodies were in norm, never up or down.

[greygoose in reply to evasofi]

But, which antibodies were tested?

You are no-longer hyper, you are now hypo, so going back onto carbi would make you worse, not better. It would make you more hypo.

[evasofi in reply to greygoose]

antibodies was for TSH receptor, it was in norm 0.4 U/L. Yes, that's what I thought - hypo now! I must admit - feels is better than hyper. So is this treatable, will I now need to ask for different medication then?

Thank you so much for your very helpful answers, much appreciated.

[greygoose in reply to evasofi]

When you're hypo, you don't take medication as such. You take thyroid hormone replacement - levothyroxine.

So, if your TSI was negative, you don't have Grave's. Therefore, you need your TPO antibodies tested, because you more than likely have Hashi's. In which case, you shouldn't have taken carbimazole at all, because the levels would have come down by themselves.

[evasofi in reply to greygoose]

Is Hashi the same as De Quervain's thyroiditis?

[greygoose in reply to evasofi]

No. As far as I know, De Quervain's thyroiditis presents like Hashi's to begin with : hyper, then hypo, then euthyroid with no treatment and no antibodies. But with Hashi's, the euthyroid phases are only temporary, and the disease does not resolve by itself, like De Quervain's thyroiditis.

Hashi's is an autoimmune disease, with high TPO and/or Tg antibodies, where the immune system attacks and slowly destroys the thyroid.

After every attack, the dying cells release their stock of thyroid hormone into the blood stream, causing the levels of the Frees to shoot up - FT4 around 30 something, FT3 around 11/12 - and the TSH therefore drops to suppressed.

There is no knowing how long these high levels will persist, but eventually, they will drop by themselves as the excess hormone is used up or excreted, and not only will you become hypo again, but slightly more hypo than before, because there is now less thyroid to make hormone.

Therefore, it's very important that your doctor does not reduce your prescription, because you’re going to need it again! If you start to feel over-medicated at that point - some do, some don't - the best thing is to stop levo for a few days, then, when you feel hypo again, start taking it again. It's very important to know one's body, and how it reacts.

There is no cure for Hashi's - which is probably one of the reasons that doctors ignore it - apart from the fact that they know nothing about it, of course! But, there are things the patient can do for him/herself.

a) adopt a 100% gluten-free diet. Hashi's people are often sensitive to gluten, even if they don't have Coeliac disease, so stopping it can make them feel much better, and can possibly reduce the antibodies. Worth a try. But, you should be aware that even if you get rid of the antibodies, you will still have Hashi's, because the antibodies are not the disease.

b) take selenium. This not only reputed to reduce antibodies, but can also help with conversion of T4 to T3 - something that Hashi's people often find difficult.

c) the best way to even out the swings from hypo to 'hyper' (often called Hashi's Flares, but that doesn't really sum up the way it works) is to keep the TSH suppressed. This is difficult because doctors are terrified by a suppressed TSH, for various false reasons, and because they don't understand the workings of Hashi's. But, TSH - Thyroid Stimulating Hormone (a pituitary hormone) - tries to stimulate the thyroid to make more hormone, but it also stimulates the immune system to attack. So, the less gland activity there is, the less immune system activity there will be, meaning less attacks, gland destruction slowed down and less swinging from hypo to hyper and back.

[evasofi in reply to greygoose]

thank you very much, vitamins and dietary advices are much appreciated. I have just booked another session with my endo, to see how to start with levoteraxin. I still hope that it will disappear one day without medication or as you said additional hormone supplement. But I also believe in christmas magics, so not sure how if I can rely on that...

Again, you and couple of other people do an amazing job in this forum, thank you so much for your time.

[greygoose in reply to evasofi]

You're very welcome. Don't hesitate to come back and ask questions, as and when necessary.

[SlowDragon Administrator]

So if TSH receptor antibodies were normal, it was not Graves. But more likely early stage Hashimoto's, which often starts with hyper swings before going hypo

For full Thyroid evaluation you need TSH, FT4, FT3 plus TPO and TG thyroid antibodies and also very important to test vitamin D, folate, ferritin and B12

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies

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

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 ideally be done as early as possible in morning and fasting.

If TPO or TG antibodies are high this is most likely Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).

About 90% of all hypothyroidism in Uk is due to Hashimoto's. Low vitamins are especially common with Hashimoto's. Food intolerances are very common too, especially gluten. So it's important to get TPO and TG thyroid antibodies tested at least once .

Link about thyroid blood tests

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

Link about antibodies and Hashimoto's

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

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

List of hypothyroid symptoms

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

[evasofi in reply to SlowDragon]

Thank you very much for the links. I went to private blood test in nearest hospital, I wouldn't say they are better than NHS. I will see what I can do again. Many thanks for the links and for detailed info

[SlowDragon Administrator in reply to evasofi]

Literally thousands on here use Medichecks or Blue Horizon for testing

See link above

[evasofi in reply to SlowDragon]

thanks will check it out