High tpo and ta

[Ralph1985]

I need help results just came in I see my doctor In 2 days I’m currently taking 112 mcg of synthroid

[greygoose]

The high antibodies say you have Hashi's.

The high TSH says you're under-medicated, if you take thyroid hormone replacement. And if you don't, it says you should be.

TT4 and TT3 say nothing much at all. They are the wrong tests. You need FT4 and FT3.

[Ralph1985 in reply to greygoose]

I also had scan of my thyroid I guess to check for nodules or stuff like that but haven’t gotten the results yet, the technician who did it told me on spot that it was looking normal since I asked out of nervousness. Would high antibodies like mine mean cancer or something? Wouldn’t I have to have my thyroid remove if I have high antibodies like that? I don’t know anything about this I’m literally freaking out right now.

[greygoose in reply to Ralph1985]

Please don't freak out, it frightens the horses.

No, nothing to do with cancer. You have Hashi's thyroiditis. Here's a brief run-down of how it works:

OK, so Hashi's is an autoimmune disease, 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 to 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. Worth a try. Some say that going gluten-free will reduce antibodies – I’ve never seen conclusive proof of that, 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.

There is no reason why you should have your thyroid removed. Those antibodies aren't doing any harm. They just keep your blood clean during an attack on the thyroid. If the technician told you it was looking normal, then you're only in the early days. So, the sooner you get treatment the better. I don't know if you'll be able to reverse it by healing your gut etc. but you stand more of a chance than people who have had their thyroid partially destroyed by the time they're diagnosed. Taking thyroid hormone replacement - levo, T3, NDT - will support your thyroid while you work on your gut. Yes, I know this all sounds very complicated, but it really isn't.

Are you in the UK? Because, if so, it's late, and you won't be able to take much in. If you like, we can talk more tomorrow. But, I suspect you're in the US, judging by those tests… Anyway, it's late for me, and I must go to bed. Have you talked to your doctor yet, about these results?

[Ralph1985 in reply to greygoose]

Yes I’m in the us. Thanks for explaining Hashimoto so well I hadn’t no idea what was happening to me! Wow. And yes I would like to talk tomorrow and learn more about healing the guy I know I need to do this so please any advice and info will help me. Thanks a thousand times 😃

[greygoose in reply to Ralph1985]

Good morning.

OK, so first of all, I see you say below that you are already being treated for hypo? Well, you're being undertreated - how much are you taking? And what? That TSH is way too high. Should be down to 1 or under. But, as I said, your doctor is doing the wrong tests…

There are two types of thyroid hormone in our blood: Bound and Free.

Only the Free - or unbound - is available for our bodies to use. The rest is bound to protein carriers that transport it round the body, and has to be unbound before we can use it.

So, there are two types of blood test: Free T4/3 (FT4/3) and Total T4/3 (TT4/3). The Total measures both the Free and the Bound, but doesn't tell you how much there is of each. The Free just measures the free hormone, which is what we need to know. So, ask him/her if he can do the right tests, please.

Now, when it comes to Hashi's, the belief is that it's all tied up with the gut. Although, to be honest, not an awful lot is known about it. So, let's go with the gut first.

How's your diet? What sort of things do you eat? I could be that you have a leaky gut, and that is affecting your immune system. So, the first thing to try would be to eliminate gluten from your diet. This can be tricky, because it's everywhere in processed foods. So, you need to cook everything from scratch. That will take a little getting used to. And, if you do buy anything ready made, you need to get used to reading all the labels. But, that should be your first step. It may help, it may not, but you really should try.

At the same time, you need to cut out all the soy from your diet. That's another sneaky one, because it gets everywhere: soy oil, soy flour, soy protein, etc. So, another reason to cook everything from scratch. Soy is very bad for hypos - well, it's very bad for everyone, really, it's not a health food at all - but especially for hypos.

And, then, you need to get rid of all artificial sweeteners and processed seed oils, like rapeseed oil. Again, these are everywhere, and destroying the health of everyone, but especially bad for hypos.

Get rid of all that, you your gut will have a chance to heal.

Do you take any other medications? Or supplements? Do you take iodine? Or kelp?

I know you're asleep right now - and I hope you're sleeping well. We'll chat later, when you're awake. That's a lot of questions, and a lot to take in, I know.

[Vxxxx in reply to greygoose]

Great hashis explanation. Did you get this from.a book? Or where as I'd like to learn more. And to OP I've got sky high antibodies and no cancer just hashis.

[greygoose in reply to Vxxxx]

No, I wrote it, summarising all I've read.

[carolinegodlonton in reply to greygoose]

That was the most informative post I've ever read, simply written and easy to understand. Thank you xx

[greygoose in reply to carolinegodlonton]

You're very welcome.

[Thulasi1 in reply to greygoose]

Hi greygoose,

Just a question. I have PA and being treated. My thyroid hormones are fine but I feel have antibodies which I need to test. The ultrasound was also fine. But can Hashi‘s cause tonsillitis I have chronic tonsillitis and there is no infection the cervical lymphnodes are enlarged from 8 months. Just wanted to know if it has any link to Hashi‘s

[greygoose in reply to Thulasi1]

No, as far as I know, TPO and/or Tg antibodies cannot cause tonsillitis. That's not their role.

However, being hypo can often cause symptoms in and around the throat: sore throat, lose of voice, voice changes, constant dry cough, difficulty swallowing, etc. But, that can happen whatever your reason for being hypo, not just Hashi's.

[Vxxxx in reply to Thulasi1]

Before I was diagnosed I had and still have palpable cervical lymph nodes. No tonsillitis. It was reassuring to eventually get the hashis DX. My thyroid hormones were in range (just) though rock bottom, my TSH at its highest was 2.4, I had florid hashis symptoms (I didn't know them that's what they were). My dx came after a ultrasound ofy thyroid which found hashis, later I developed positive antibodies. Thyroid replacement put right all my symptoms though my lymph nodes are still up, but that now doesn't worry me as I know why.

[Thulasi1 in reply to Vxxxx]

seems like I am in same condition as yours. As you mentioned thyroid replacement does it mean it’s removed or it’s medication?. Should i have to start the medication and what is the right dose as all the hormones are in good range

[Vxxxx in reply to Thulasi1]

I mean medication. I would never have mine removed. I take NDT armour. Every one is different. Best to post your bloods and get advice on here. Might be good idea to get a scan of your thyroid if that's not already been done. I'm relatively new to all this

[Thulasi1 in reply to Vxxxx]

Sure. I have posted my blood reports in previous post and adviced to get antibodies. Doctor in Germany doesn’t do the test. I have to do it when I travel to India. I have PA as well.

[Batty1 in reply to Thulasi1]

Thulasi1, do you have Psoriatic Arthritis?

[Thulasi1 in reply to Batty1]

Pernicious Anemia. I haven’t checked for psoriatic arthritis

[yesendi in reply to greygoose]

Well written info and easy to understand, so.....THANKS!!

[greygoose in reply to yesendi]

You're welcome.

[Ralph1985 in reply to greygoose]

Hey goodmorning thanks for replying and all this information you have share with me and now I have a better understanding of having Hashimotos. Well I’m currently taking 112 mcg of synthroid. The new Endo last time I saw him eso he wanted my tsh at around 2 he didn’t up my synthroid last time because he did not know where I was, I also believe he order ft4 and ft4 but I think the lab messed so I will have to talk to him abou those test. I see him tomorrow btw let’s see what he wants to do and I will post it here. On to my diet I try to eat healthy most of the time but I do consume vegetable oils some artificial sweeteners as well i will substitute all those now, I don’t take iodine or kelp idk what kelp even is 😳 maybe like spinach that’s what it sounds like. I take 5 mg of lisinopril and I’m also on trt.

[greygoose in reply to Ralph1985]

Oh dear. That's bad! An endo that wants your TSH around 2 has no idea about thyroid. A lot of us would be very ill with a TSH that high.

It's not vegetable oils that are bad - olive and avocado oils are wonderful - it's seed oils, like rapeseed, because they have to be highly processed to get the oil out, and that's very bad. Walnut oil is good, and hazelnut oil. And coconut oil, of course. The body does need good fats - animal fat, butter, etc.

The body doesn't need artificial sweeteners. They're very bad. Sugar isn't good, but it's better than aspartam!

Kelp is seaweed with a very high iodine content. Iodine supplementation of any sort is bad for hypos. Spinach is ok - if you like that sort of thing.

So, you're taking the lisinopril for high blood pressure? High blood pressure can be a hypo/under-medicated symptom. If you get onto the right dose, you might not need that anymore.

And, that brings me to the way we take our levo. Do you take yours on an empty stomach, leaving at least one hour before eating or drinking anything other than water? And at least two hours before taking your other medication? That's the way to do it for maximum absorption.

And, how do you do your blood tests? Do you have the blood draw early in the morning - before 9 am - after fasting over-night? That's the way to catch your TSH at its highest - which we need to do because doctors are so obsessed with TSH. And, do you leave a 24 hour gap between your last dose of levo and the blood draw? Otherwise, you will just be testing your last dose, and not what is normally circulating in the blood.

[Ralph1985 in reply to greygoose]

Oh wow I usually take my levo at 6 am and have the blood test at 8 am I did not know that I thought the test would be of what’s concentrated in your blood already next time I’ll take the Levi after the test. I do follow all guidelines of how to take Levi properly wait and hour before breakfast and I don’t take medication for at least 4 hours after usually at 10 is when I take my lisinopril which is a very small dose 5mg that’s it. Maybe my Endo has a different protocol for ppl with hashimotos when he said he wanted to keep my tsh at 2 was at our first visit he doesn’t know in hashis right now untill he sees me tomorrow with the results. Anyways I’ll try to see if he can keep me at a lower or suppressed tsh. I have a question, wouldn’t me having a suppressed tsh cause hyperthyroid symptoms I already suffer from anxiety that’s from being hypo idk what to expect

[greygoose in reply to Ralph1985]

Ah, so you've been getting a false high T4. But, even so, Hashi's or no Hashi's, keeping someone's TSH at 2 is just wrong. A healthy, euthyroid person has a TSH of around 1. It it gets to 2 and over, it means the thyroid is struggling. And, people taking exogenous hormone - as opposed to healthy people whose thyroid makes enough endogenous hormone - tend to need their TSH lower than healthy people.

The TSH, in and of itself, does not cause symptoms, be it high, low or suppressed. It is the thyroid hormones - T4 and T3 - that cause symptoms when they're too high or too low. So, having a suppressed TSH will not cause hyper-like symptoms if your FT3 is still within the range. Having a suppressed TSH dose not automatically mean that you are hyper/over-medicated.

Anxiety can be a hypo/under-medicated symptoms just as much as a hyper/over-medicated symptom.

[Ralph1985 in reply to greygoose]

Oh alright I will see if my Endo agrees to keeping my tsh below 1 I hope so! I been feeling bad for a very long time already really under medicated I guess

[greygoose in reply to Ralph1985]

I don't doubt it. Most doctors keep their patients under-medicated because of their lack of knowledge of thyroid, and hormones in general. In fact, most doctors are terrified of hormones.

[Ralph1985 in reply to greygoose]

I finally saw the endocrinologist and he said since I have hashimotos he wants to keep my tsh below 1. He also put my meds from 112mcg to 125 mcg and have me do labs again in 4 to 6 weeks

[greygoose in reply to Ralph1985]

That's a step forward, at least.

[jgelliss in reply to greygoose]

greygoose Great and Very Useful Informations . Very Well Put . Thank You .

[greygoose in reply to jgelliss]

You're welcome.

[AMG56 in reply to greygoose]

Thats brilliant information and very well explained. I too have hashi’s and to see everything so we’ll explained is a godsend. Thank you xx

[greygoose in reply to AMG56]

You're welcome.

[jgelliss in reply to greygoose]

greygoose *Spot On* .

[Greekchick]

Hi Ralph,

First, I understand your upset and why you are “freaking out”. This is likely new to you. I’m sorry that you are so distressed. So ... take a deep breath and let’s analyze this so you can feel a little better.

High antibodies for Hashimoto’s do not mean you have cancer and certainly not that you need surgery to remove your thyroid. Even if you had a nodule, 98% of them are benign. I do not have Hashimotos, I have Graves, but I had numerous nodules for 25 years and didn’t need to have my thyroid out until this year. None of my nodules were cancerous, and that was not why my thyroid was removed - so I hope I can allay your fears about that.

Secondly, even in the worst possible case, if it was cancer, there is recent research that suggests that a “watch and wait” approach to even cancerous or suspicious nodules is recommended. Thyroid diseases tend to move very slowly for the most part, so there are not too many “emergencies” in thyroid disease.

Finally, thyroid disease is treatable with medication, lifestyle change and proper diet. Many people on this forum have managed to control their disease by making changes. People live for years with thyroid disease and manage. So all is not lost!

It will help if you browse the posts and do some research about thyroid disease in general so that you don’t worry so much. Talk to your doctor when you see him/her and have questions ready to ask. That may also help to allay your fears. Stress and anxiety are very bad for the thyroid.

I just saw greygoose’s reply and she has given you some great advice.

I’m sending you good wishes today and hope I have made you feel a little better. All the best.

[Ralph1985 in reply to Greekchick]

Thanks 🙏 I do feel a lot more calm now. I jut had zero clues of what that meant and I’m prone to anxiety my head was everywhere.

I was being treated for hypothyroidism but my last endocrinologist wasn’t too good alll he did was give me pills he never check me for any of this stuff. I change him because I never felt good in that year and my dr order this test.