Post partum thyroiditis. Help with blood test please.

[Ela_peraj]

15 months PPT and 16 weeks without levo (29th January 2021 readings). When should I have my next blood tests or would you guys say I've beat this and no need for more testing? I've had 4 endos. 1 diagnosed me with graves as in started in October 2019 being overactive. Within 2 months it went underactive and I was diagnosed with PPT by 2 endos and one said is permanent and need levothyroxine for rest of my life. I've had these tests done as well. The most levothyroxine I've been on is 50mcg. I stated in Jan/Feb 2020 and stoped October 2020.

Anti thyroid peroxidase >1022 IU/ML >9

TSH Receptor Anibody <0.3 IU/ML 0-0.9

Blood tests without levothyroxine since 7th October 2020.

12th November 2020

Tsh 2.73 range 0.3-5.

T4 14.4 range 7.9-16.

T3 5.7 range 3.8-6

11th Dec 2020

Tsh 2.85 range 0.3-5.

T4 13.8 range 7.9-16

T3 5.6 range 3.8-6

29th Jan 2020

Tsh 2.30 range 0.3-5

T4 14 range 7.9-16

Thank you

[Ela_peraj]

I feel much better being off levothyroxine and the last endo i spoke to he was determined that it was PPT but said to keep an eye do blood works. I am struggling will sleep, stress, hairloss, periods not in a regular cycle still and also have this like lump on my throat. Some days the lump goes away and some days is there. I can't lost any weight either and I am in a good diet and gluten free. God knows what's going on. Those antibodies scare me for sure. The highest my TSH has been is like TSH 20.50

[SlowDragon Administrator]

Important to also regularly retest vitamin D, folate, ferritin and B12

Have you had these tested?

[Ela_peraj in reply to SlowDragon]

Ferritin level 54 ng/mL [15.0 - 300.0]]Vitamin D level 75 nmol/L [50.0 - 150.0]

Serum vitamin B12 level 560 ng/L [120.0 - 900.0]

Serum folate level > 20 ug/L [2.5 - 9999.0]

Got tested 11th Dec 2020. What do you think?

[SlowDragon Administrator in reply to Ela_peraj]

Pretty good

Are these natural levels or are you supplementing?

[Ela_peraj in reply to SlowDragon]

I am on supplements for all of them since November 2020 also on magnesium, herbal teas and a gluten free diet. I've noticed my cortisol is at high end recently. It was dropping since I was on levothyroxine and now is increasing back up at the top end of the range. Should I be worried?

[Kalicocat in reply to Ela_peraj]

Yes, it sounds like you need to be on levothyroxine. High TSH stimulates the thyroid to grow and can eventually cause a goiter. And it sounds like you have the start of one. The reason why your T3 is high is because your body is converting more to compensate for your low T4. It happened to me when my thyroid started to fail. When I had PPT my antibodies were mildly elevated and then disappeared altogether and I was able to stop levothyroxine. With your high level of antibodies that is less likely to happen to you. The reason why your periods are irregular is because you are not making enough thyroid hormone for your needs. If you ever want to get pregnant again you would need to be on levothyroxine as you probably wouldn't be able to conceive otherwise.

[Ela_peraj in reply to Kalicocat]

I had the exact same problem after my 1st child and it went away. Now the same with my second child but taking longer to recover. I am not planning to have any more children. My gp and endo will not give me anymore levothyroxine as its within range. In the uk you have to gave a prescription to get levothyroxine. I was on 40mcg closer to the end as I was in the liquid levothyroxine. But the last 16 weeks I have not taken any. I was under the impression that the higher end of t3 and T4 is the place to be and lower Tsh. Why would you say I need to be on levothyroxine?

[Kalicocat in reply to Ela_peraj]

As SlowDragon said below, your adrenals are compensating for your thyroid problems. Your thyroid might be keeping up now, but if the antibodies stay high that likely won't last long. Also, hair loss is a HUGE factor, I lost my hair sooooo many times, I have about 6 wigs in the closet and even looked into hair transplants at one time. It's likely that your thyroid hormones are fluctuating alot if you are still having hair loss and missed periods. My antibodies went high again once I got into the late stages of perimenopause and they have stayed high, and my thyroid is now kapute. I'm currently on 75mcg levo and 6mcg T3 and I NEVER lose my hair now. If you google T4 and hair, you will find that hair is very happy if it has enough T4. You might want to see a private endo?

[Ela_peraj in reply to Kalicocat]

The endo I sow was private. I am fed up with tjem to be honest as I've now seen 4 and 2 of them diagnosed me with PPT and 2 with permanent underactive thyroids. I'll do some more reaserch and keep an eye on my levels. I fear I am doing damage to my thyroids not being on medication if that's the case of it being permanent.

[SlowDragon Administrator in reply to Ela_peraj]

Adrenals try to compensate for lack of thyroid hormones and this often causes cortisol to rise initially

If adrenals can’t keep that level of output up, then eventually results in cortisol dropping and adrenal exhaustion.

Suggest you wait a little longer to see how things go

[Ela_peraj]

Awww that's so kind of you. Thank you for your response and time this evening. 🙂

[greygoose]

Those antibodies scare me for sure.

Antibodies are nothing to be scared of. They are just a marker that you have the disease. They come along, after an immune system attack on the thyroid, and clean up the mess. They don't do any harm.

[Ela_peraj in reply to greygoose]

But does that mean that can show during PPT or does it mean I permanently have underactive thyroids?

[greygoose in reply to Ela_peraj]

I don't think anyone can answer that question with absolute certainty, only time will tell. But, I think the odds are that you have it for life. Remember that with Hashi's, you can have periods of remission - quite long periods, sometimes, when people start to doubt their diagnosis. But, the hypo systems will come back eventually. And, a TSH of over 2 does tell us that your thyroid is struggling. You need to keep a close eye on it, and on your thyroid hormone levels, and test regularly.

[tattybogle]

Hi there , you might find this post and the links in my replies to it interesting healthunlocked.com/thyroidu...

Short answer is that Post Partum Thyroiditis does seem to have antibodies in a lot of cases, but that in itself doesn't seem to mean it is always going to end up permanent.

But like a lot of thyroid stuff , the research is lacking to be definitive about anything, or even to be certain about differences between one kind of hypothyroidism over another.

And the only way to find out if it gets better by itself post partum is to come off levo if you've been put on it , and see what happens to your thyroid levels over time and how you feel.

...pretty much 'suck it and see', cos the medical profession are no surer about the differences than we are.

also ....some old history re Hashimoto's vs Ord's healthunlocked.com/thyroidu...