I am a Hashimoto’s sufferer but have never been put on medication because, although my TPO levels are massively elevated and have been for over ten years, my thyroid blood results remain in the normal ranges. I had a baby 6 months ago and when he was 4 months old my thyroid suddenly swelled up huge and I was very symptomatic. I’ve had flare ups like this before. I contacted the GP and requested tests. My TPO antibodies came back as 128, my TSH was 0.6 and my T4 was 14 in a range of 12-22. The GP wanted to retest after six weeks to see what had happened.
I’ve just got my results and they are:
TSH 0.01
T4 16
TPO 700 ish
The GP is calling me on Friday but I just wondered what you all think is going on? A hyper phase? Although my T4 isn’t above range? Or something else? Should I be on medication? I’m scared the GP will say I’m hyperthyroid and try to medicate that even though my T4 isn’t hyperthyroid.
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Paolatello
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For full Thyroid evaluation you need TSH, FT4 and FT3 tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12
What vitamin supplements are you currently taking
Ask GP to test vitamin 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)
Is this how you do your tests?
Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins
Yes if your TSH is faulty - secondary hypothyroidism. My TSH doesn’t work -on diagnosis my TSH was 2 (0.5-4) but my T4 was 11(12-22) and T3 3 (3.1-6.8). I had lots of hypo symptoms but was fine having had Armour Thyroid for 15 years - a bit bumpy at the moment transferring to compounded T4/3.
You need fT3 measured. Maybe ask your doctor to do it or at least speak to an endocrinologist. If that fails you could get a private TSH, fT3, fT4 blood test.
While a drop in progesterone would indeed lead to a drop in thyroid hormone, that doesn’t explain why Paolatello’sTSH has dropped so low. Usually the pituitary would sense the drop in thyroid hormone and would prompt an increase in thyroid stimulating hormone (TSH) to get the thyroid to boost thyroid hormone production. But TSH is low here.
I think you might be at the tail end of a Hashimoto’s flare Paolatello . You’ve got Hashimoto’s—the raised antibodies confirm that, so I think in recent weeks your thyroid has “burned hot”, so to speak, put out a lot of thyroid hormone (which made your TSH drop dramatically) and your levels of thyroid hormone are now also dropping. Things may return to normal again soon—your FT4 certainly isn’t high. But it would be useful to know where your FT3 levels are at.
I suspect your doctor might want to watch and wait - I think if he does suggest treatment for hyperthyroidism (because of your low TSH) I’d suggest you say you want to wait to see what happens next. With a small baby the last thing you need is for your thyroid hormone levels to drop lower still because you’ve been put on carbimazole by a gung-ho doctor.
They can't medicate you against your will. You can always refuse the treatment, if offered. But, hopefully, your doctor has more common sense than that - even if he doesn't know much about thyroid.
Not dangerous as such but I think it could be like using a hammer to crack a nut - depending on what your FT3 levels are of course. Unless they’re very above the top of the reference range, carbimazole wouldn’t really be needed—and I doubt that they are above range because your FT4 doesn’t look high enough. You’ll know soon, so that’s good.
Putting you on carbimazole when it’s not needed would reduce your thyroid hormone levels and make you a bit hypothyroid. So it’s not dangerous as such—lots of people are walking around a little bit hypothyroid!—but it would probably be entirely unnecessary.
See what the results look like and go from there. x
Thank you. In that case, it looks like I don’t need anything even though my TSH is way out and I’m symptomatic plus have antibodies. I was just so excited when I finally got an out of range TSH as I thought this might finally be when they take me and my horrible symptoms seriously and help.
The problem is I’m not in the beginning, I was first diagnosed when I was 20 and I’m now 37. I’ve battled symptoms for that long with no help and I’m getting to a point where I’m running out of fight.
Hashimoto's 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 had a flare after my first baby. Definitely try managing your symptoms with these suggestions from slowdragon. Particularly trying strict gluten free diet. Good luck.
I have adhered to all of Slowdragon’s advice since I joined this forum years ago but I’m still suffering daily. I know having a baby has made it worse as I had a flare with my first too but this time is much worse abs the bloods are much more erratic.
Yes, good this doctor is listening to you. I hope you get some answers and a way forward which helps you. Feeling unwell is bad at the best of times, but must be even more difficult with a new baby. Fingers crossed for you
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