Dr Google says Thyroid Peroxidase is indicative of autoimmune Hashimoto's or even Graves. Is this always the case?
Yes, it is.
Do the other more 'normal' results outweigh this?
I'm afraid not.
Hashi's is a disease where the immune system slowly destroys the thyroid, mistaking it for the enemy. With Hashi's, thyroid status can swing between hypo and false hyper, as the dying cells dump their stock of hormone into the blood.
Grave's is where the patient is permanently hyper with a suppressed TSH and very high FT4 and FT3. So, looking at your results, it's more likely you have Hashi's because the TSH is not suppressed and I would imagine the FT4 is low. However, as you haven't given the range for the FT4, it's difficult to say how low. Please, always give ranges with results, because they vary from lab to lab.
Your results are saying that you are not hypo or 'hyper' at the moment. But, it rather looks as if you have been 'hyper' recently, and your TSH hasn't yet recovered. Are these the first thyroid labs you've had? If you've had others, can you post the results and ranges for comparison? You can expect levels to jump around a bit, with Hashi's.
Although you have not posted ranges youd FT4 does look low - this is an inactive hormone which needs to convert into the Active T3. So that too could be low in the range. It is low T3 that can be the cause of symptoms and be linked to ME/CFS.
Vitamins and minerals need testing too - B12 - Folate - Ferritin - VitD. When low in range than cause you to feel unwell.
For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12
Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies
Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
About 90% of all primary hypothyroidism in Uk is due to Hashimoto’s. Low vitamin levels are particularly common with Hashimoto’s. Gluten intolerance is often a hidden issue to.
Noted about the vitamins and minerals - as per my reply to @Marz -
I had very severe Vitamin D deficiency diagnosed in January just after I first became ill.
Apparently B12 and folate were 'normal' 3 weeks ago (but I've been on a mixture of Dr Myhill and Nancy Klimas' vit and min supplements for 7 months and keto diet).
It was retested about 8 weeks ago and it had gone up significantly after a course of Vit D and some sunbathing - but I need to check what it had gone up to as I can't remember (I've just moved, changed GP and can't access records due to changeover ...)
It still wasn't where it needed to be though.
Don't know TPO result - I'm just recounting what was in the Clinic Letter which has taken me 3 weeks to extract from them - as mentioned in reply to Grey Goose, I need to chase this Rheumatologist ... and this was the first face to face appointment at a hospital since December due to the pandemic ...
I think what I'm getting from this forum is that I might have a thyroid problem and I need to press the NHS docs because they are being lax. Or go to a private Endo to get properly checked over.
First step is to get full thyroid and vitamin testing...either via GP or privately
Come back with new post once you get results
For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. EXTREMELY important to regularly test vitamin D, folate, ferritin and B12
Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies
Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .
This gives highest TSH, lowest FT4 and most consistent results.
Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins
This is a very common phenomenon for someone with ME/ CFS. In addition to Hashi's symptoms you may also have other problems which overlap with thyroid problems. These can include food intolerances, fibromyalgia, IBS, adrenal exhaustion, anxiety, yeast overgrowth in the gut, sensitivity to environmental toxins, noise and light sensitivity etc.
A useful resource for ME/CFS is Dr Sarah Myhill's website (if you have not already discovered her). She talks about the thyroid connection, essential vitamins, minerals and amino acids.
She's also pretty keen on promoting a paleo diet with as little processed food and added sugars as possible. Personally, I find this a tad too restrictive. Going gluten and (mostly) dairy free pretty much did the trick for my gut issues with the addition of some key vitamins and minerals. I also have about a third of the sugar I used to have (too much sugar leads to yeast overgrowth).
It's not unusual with CFS to have a 'misleading' TSH (it really cannot be trusted as a guide). Dr Myhill explains this. Be guided by your symptoms and your Free T4 and Free T3 levels instead.
Thank you. I need to go back and re-read Dr Myhill info.
I went on her regime (supplements and keto) in February and have recently fine tuned it with a few recommendations from Nancy Klimas.
I've recently come off the keto because I just moved and something had to give ... and after having enjoyed indulging a bit, I'm thinking of doing something similar to what you are saying. e.g serious moderation.
In terms of the ME-CFS, I've seen some improvements recently (less POTs, less fatigue) - able to leave the house in the last 6 weeks and stay upright, but other symptoms have come to the fore in their place - more brain fog, headaches, facial tremor, droopy eyelids, memory loss etc.
A lot of your current symptoms sound like Hashi's, so you must try and get this resolved asap with your GP. Dr Myhill also recommends adrenal supplements as well as thyroid to many of her patients. If you find you're not tolerating the Levo, you may benefit from adrenal support as well (too low or too high cortisol disrupts thyroid hormone conversion). Given your P.O.T.S diagnosis as well it'd be worth asking your Endo to investigate your cortisol and dhea levels.
P.O.T.S is often worsened by low electrolytes, so it's a good idea have some soluble minerals with vitamin C on hand to prevent those symptoms.
Low Vitamin D is very common, and as Slow Dragon says, you may find you're still low unless you've been prescribed proper loading doses with Magnesium and Vitamin K2. Have a look at Seaside Susie's responses on getting vitamin D levels up.
As well as being gluten free (actually I don't find it that restrictive really) do you take Selenium to reduce antibodies? It's worked for many here.
Memory issues or tremors could be low b12, so I hope your levels are not just 'in range'. The Myhill supplements are good, but with Hashi's you'll probably have low stomach acid and enzyme disruption. B12 is the hardest vitamin to absorb (it's a massive molecule) and some of us need injections. Double check your levels. Magnesium, Zinc and p5p are also required for good cognitive function. My son takes a tablet from Igennus that combines all three. It is both calming and helps focus.
The muscle twitching could also be low Calcium (due to low vitamin D). You could ask to get this checked as well.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Thyroid antibodies results advice please
Partner's results for thyroid peroxidase antibodies 
Antibodies for Underactive thyroid and test results
I'm new here, would like results explained.
New here - Thyroid Advice
