Hi all. So i have read on here that tsh over 3 suggests hypothyroidism and over 2.5 suggests thyroid is struggling. My gp is monitoring my levels every 6 months due to high tpo antibodies Aug 2019 tpo >1000)
Latest one is TSH 2.8 (0.20-4.50) Free t4 14 (9-21)
Previous one was TSH 2.5 Free T4 13 (same ranges as above) Both tests done at 8.10am with water only.
I know it's only a small increase in the last tests but I read on here that over 3 is classed as hypothyroidism and over 2.5 suggests thyroid is struggling. So do you think my thyroid is starting to struggle due to the high tpo antibodies?
Thanks
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Macey2009
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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
Ask GP to test vitamin levels NOW plus coeliac blood test too
Low vitamin levels tend to lower TSH levels
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)
Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins
Yes. I supplement vit d spray and igennus super b complex. Do you think my thyroid is beginning to struggle with these results? I know I still have a long way to go if I was to get any sort of diagnosis.
Previous test results on profile show B12 on low side
Hashimoto's frequently affects the gut and leads to low stomach acid and then low vitamin levels
Low vitamin levels affect Thyroid hormone working
Poor gut function with Hashimoto’s can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten. Dairy is second most common.
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
The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported
In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned
Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.
I read on here that over 3 is classed as hypothyroidism and over 2.5 suggests thyroid is struggling. So do you think my thyroid is starting to struggle due to the high tpo antibodies?
Yes, your thyroid is showing signs of struggling. A normal healthy person would have a TSH level of no more than 2, often around 1. But with autoimmune thyroid disease (Hashimoto's) the immune system attacks and gradually destroys the thyroid eventually causing hypothyroidism. TSH rises as you become hypothyroid. This takes time and you wont get a diagnosis and a prescription for Levo until your TSH goes over range with high antibodies. Primary Hypothyroidism with no antibodies requires TSH over 10.
Hi thank you for the clarification. I guess just wait and see in 6 months what that shows. Is it usually a long process? Or maybe that's a silly question like how long is a piece of string lol
Probably impossible to answer, most likely varies from person to person but overall I think it's a fairly long process. It's a case of catching an over range TSH with raised antibodies, and as antibodies fluctuate it's down to testing at the right moment. Even when results show raised TSH and raised antibodies, some doctors wont diagnose and prescribe, you'd need to find an enlightened one who understands this. Hang onto the following information as it might be useful in the future:
Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine (the magazine for doctors):
Question 2:
I often see patients who have an elevated TSH but normal T4. How should I be managing them?
Answer:
The combination of a normal serum T4 and raised serum TSH is known as subclinical hypothyroidism. If measured, serum T3 will also be normal. Repeat thyroid function tests in two or three months in case the abormality represents a resolving thyroiditisis.
But if it persists then antibodies to thyroid peroxidase should be measured. If these are positive - indicative of underlying autoimmune disease - the patient should be considered to have the mildest form of hypothyroidism.
In the absence of symptoms some would simply recommend annual thyroid function tests until serum TSH is over 10mU/l or symptoms such as tiredness and weight gain develop. But a more pragmatic approach is to recognise that the thyroid failure is likely to become worse and try to nip things in the bud rather than risk loss to follow up.
Treatment should be started with levothyroxine in a dose sufficient to restore serum TSH to the lower part of it's reference range. Levothyroxine in a dose of 75-100mcg daily will usually be enough.
If there are no thyroid peroxidase antibodies, levothyroxine should not be started unless serum TSH is consistently greater than 10mU/l. A serum TSh of less than 10mU/l in the absence of antithyroid peroxidase antibodies may simply be that patient's normal TSH concentration.
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