Multiple auto-immune problems and do I have Hashimotos (or not)?

[Cider_Woman]

I finally got to see an Endocrinologist this week and it’s left me feeling more confused. She believes that I have sub clinical Hashimoto's disease and do not need treatment, beyond take selenium for 3 (or 6 months), as a one-off.

She was a bit flaky as, in addition, to the selenium, she said I didn't need any further ultrasounds on my thyroid. I have two small noodles on the RHS so I am not sure that is the best advice really, IMHO.

One thing she did get excited about was the fact that I had very early menopause aged 32 and thinks it may be another auto-immune problem. Together with my RA (two markers in my blood) and, potentially, vitiligo/idiopathic guttate hypomelanosis, I am a bit of a walking autoimmune worried woman.

I take no medication at all, except ibuprofen for the occasional RA flair-up (mostly stress related).

Is there any way of determining if I am categorically sub-clinical Hashimotos or sub-clinical?

Many thanks

CW

TSH (0.27 - 4.20)

April 19 - 2.68

Mar 19 - 2.63

Feb 19 - 2.92

Jun 18 - 3.116

Jun 16 - 3.6

Dec 15 - 4.33

Jun 14 - 3.13

Apr 05 - 2.2

Oct 04 - 1.2

Free T4 (12.0 - 22.0)

Apr 19 - 10.0 (range here 6.8 - 18.0)

Mar 19 - 13.2

Jun 18 - 11.5

Jun 16 - 14.2

Dec 15 - 12.7

Jul 06 - 13.4

Free T3 (3.1 - 6.8)

Apr 19 - 4.82

Mar 19 - 4.25

Jun 18 - 4.4

Vitamin B6 (35 - 110)

Mar 19 - 131

Vitamin B12 (145 - 569)

Mar 19 - 301

Vitamin D25 (75 - 400) - done in Switzerland

Mar 19 - 63

Jun 18 - 69

Vitamin D25 total (25-120) - done in the UK

Jun 16 - 26

Dec 15- 19

Selenium (0.8 -1.8)

Mar 19 - 1.2

Ferritin (30 - 400)

Apr 19 - 63

Feb 19 - 90 - this result is not to be trusted as I had a one-off iron infusion in Jan 19.

Jun 18 - 40

Total cholestoral (less than 5.0)

Jun 18 - 5.95

LDL - Cholestoral (less than 2.6)

Jun 18 - 3.77

HDL - Cholestoral (greater than 1.29)

Jun 18 - 1.58

Endocrinology results (all February 2019)

Thyroid-stimulating immunoglobulin (TSI) (range: less than 1.8) – less than 0.3; Thyroid Peroxidase Antibodies (range: less than 34) – 42; Thyroglobulin antibodies (range: less than 115) – 220; Thyroglobulin (range: 3.5 - 77.0) – less than 0.1

[Cider_Woman]

Sorry, I don't know where my head was! All April 2019 dates should read as June 2019. The draw was on Monday afternoon.

Morning would have been better, I know, but that was all I could get.

[greygoose]

No, you don't have sub-clinical Hashi's, you have Hashi's with subclinical hypothyroidism.

Your antibody levels say you have Hashi's, but your TSH stays within range, but top of the range sometimes. So, you're not yet really hypo and don't need thyroid hormone replacement at the moment.

Nodules don't grow very fast, if at all, so doubtful you're going to need another ultrasound, unless they start causing problems.

However, your vit D and ferritin are low. You really should get vit B12 and folate tested.

[Cider_Woman in reply to greygoose]

Thank you. That's helpful.

It raises though, the central problem I have... I have many, many Hypo symptoms and I feel like the advice is to wait until my thyroid is further trashed before taking T4. If I didn't suffer from memory fog, weight gain etc, I would be happy to wait but I do and it's miserable, knowing I can only get worse

I started taking Ferritin, Folate, B and D vitamins in the past three weeks, since I initially posted here, and have found they've helped. The missing hair with the alopecia has started regrowing and I wake up properly now (the latter seems to be due predominately to Vit B).

[greygoose in reply to Cider_Woman]

Unfortunately, as I said, they're not interested in symptoms - most of the time, they don't believe us, anyway, after all, we are women! But, symptoms often start a long time before problems show up in blood test results. But doctors don't understand that, either.

I'm afraid the NHS does like your thyroid to get well and truly trashed before they will deign to do anything - TSH over ten! In some countries, you're treated when your TSH reaches 3. I don't know why the difference, but it's probably something to do with money. But, in any case, even with antibodies - which they often prefer to ignore - your TSH will have to be well over-range before they will treat. And/or FT4/3 below range. So, you do need to keep testing.

[SlowDragon Administrator]

Are you on strictly gluten free diet?

It might help

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

While still eating high gluten diet ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first

Assuming test is negative you can immediately go on strictly gluten free diet




(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially)




Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

thyroidpharmacist.com/artic...

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

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

restartmed.com/hashimotos-g...

healthcentral.com/article/t...

Other gut issues due to being hypothyroid

healthunlocked.com/thyroidu...

Low stomach acid common, leads to low vitamins

Getting vitamins all optimal by regular and continuous supplementing can help

Your FT3 is pretty low

And cholesterol high .....both suggest you are already hypothyroid

If you try strictly gluten free diet....get vitamins optimal and get thyroid levels retested as early as possible in morning and fasting....TSH may then be high enough to start Levothyroxine

If not you may need to consider self medicating

[Cooper27]

Do you have symptoms at the moment? There are some endocrinologists (though I don't know who these mythical decent doctors are), who may recognise that because you have antibodies, you will end up hypo eventually, and who may be willing to trial thyroxine if the patient has a lot of symptoms. As your results are borderline, and have been out of range on a couple of occasions, you could suggest this to your endocrinologist?

I do recommend reading information from Izabella Wentz, as she got some great advice on how diet can improve symptoms. It won't heal the damage that's already been done, but it will help symptoms.

[Cider_Woman]

HI everyone, thanks for your responses. I really appreciate it.

I may have made some progress. I saw my gynie yesterday and she's going to suggest a family doctor (GP) who will take more of a holistic approach to my AI problems; high cholesterol/blood pressure as well as the Hashi's.

I have started gluten free today. I hope it is successful as I am already missing fresh bread for breakfast

Thanks again

[Cider_Woman]

Thank you