Thyroid results questions

[Steve1997]

Hello everyone I'm a new user here. I'd just like some advice on my Thyroid test as some readings were abnormal range. Any help would be highly appreciated thank you. I'll attach a few pics showing my results as I don't know what it means.

[Steve1997]

And this one to

.

[greygoose]

The high antibodies are telling you that you have Hashi's - aka Autoimmune Thyroiditis. Did you not know that? Do you know what Hashi's is?

I don't understand why, in the second photo, they're saying the result is too high. Looks to me like it's right in the middle of the range. But, the photo is rather small, so I might be missing something. Can you type the result out, please?

[Steve1997 in reply to greygoose]

Hello tap on the 2nd picture it should show the full result. And no sorry I've heard of hashi's. Is this condition serious?

[greygoose in reply to Steve1997]

I did tap on the 2nd picture, but it doesn't magnify it enough to read the numbers of the range, which are very small.

Hashi's most certainly can be serious, yes.

A brief rundown of Hashi's:

OK, so Hashi's is an autoimmune disease, where the immune system attacks and slowly destroys the thyroid. It is diagnosed by testing Thyroid Peroxidase (TPO) antibodies and Thyroglobulin (Tg) antibodies.

Contrary to popular belief, it is not the TPO/Tg antibodies themselves that attack the thyroid:

"When lymphocytes infiltrate the thyroid gland, mistakenly taking it for a foreign bacteria invader, they damage the thyroid gland and release thyroid peroxidase &/or thyroglobulin into the blood stream. These don't belong outside of the thyroid gland so antibodies are developed to mop them up.

The antibodies are a result of the attack on the thyroid gland, the antibodies don't cause the attack."

thyroiduk.org.uk/tuk/about_...

After every immune system attack on the thyroid, 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.

(NB: A Hashi's 'hyper' swing is not true hyperthyroidism in that your thyroid is over-producing thyroid hormone. It's physically impossible to 'go hyper' if you are basically hypo. The thyroid cannot regenerate itself to the point of over production of hormones - or even normal production. Very few doctors appear to know that.)

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!

However, between the 'hyper' swing, and the descent back into hypothyroidism, there can be a phase - quite a long one, sometimes - of normality, where the person is neither hypo nor 'hyper'. This is where people sometimes start talking of having 'cured' their Hashi's, by whatever means. But, it doesn't last. Eventually, you will go hypo again.

But, there are things the patient can try for him/herself to help them feel a bit better:

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 were to get rid of the antibodies completely, you would still have Hashi's, because the antibodies are not the disease. It is not the TPO/Tg antibodies that do the attacking.

b) take selenium. This is 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 of 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, which 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.

[Steve1997 in reply to greygoose]

Thanks for all this information I'll definitely be making an appointment with my gp as I'm not on any treatments for this. And my TPO level is 129.1 hopefully this can be managed to some extent

[greygoose in reply to Steve1997]

Well, there's not much anybody can do about the Hashi's. It has to take its course. But, if your TSH/FT4/FT3 are suggesting you're hypo, then you should be on thyroid hormone replacement.

[Steve1997 in reply to greygoose]

My TSH is 3.81 which is considered just about normal. My FT3 was 4.8 which is normal and my FT4 is 17.7 again normal. Only (TgAB) and (TPOAb) came back abnormal. But I really do appreciate the information you've given me. No doubt it's more information then a gp could ever tell me

[greygoose in reply to Steve1997]

There's no such thing as 'normal' - it's a setting on a washing machine! And, one man's 'normal' is another man's abnormal, where thyroid is concerned.

I can tell you, for a start, that your TSH is nowhere near being 'normal'! A euthyroid TSH is around 1, never more than 2, and at 3 you are hypo. And, in some countries treatment would start when your TSH gets to 3. But, the NHS is a bunch of sadists that likes it to get to 10 before they will consider a diagnosis - probably because that way they have to diagnose less people, and it costs them less!

When a doctor says 'normal', all he means is 'in-range'. But, as the ranges are usually so wide, it's where in the range that the result falls that is important. You haven't given the ranges for those results - please do, because ranges vary from lab to lab. But, your FT4 would be about mid-range in most ranges we see. FT3 less so.

But, the good news is: with Hashi's it can only get worse! lol (Black humour) So, keep testing until your FT4 goes under-range, then, with the high antibodies, your doctor should diagnose.

[Steve1997 in reply to greygoose]

Ok that does it for me haha I'll definitely be making an appointment and hopefully they can give me something to at least manage it to an extent. Thanks for taking the time to educate me hehe

[greygoose in reply to Steve1997]

You're welcome. Now, all you have to do is educate your doctor! lol

[Gingernut44 in reply to greygoose]

Easier said than done 😀

[greygoose in reply to Gingernut44]

True.

[CLH_74 in reply to Steve1997]

Hi Steve, just to let you know that the full name is Hashimotos disease. Don't panic too much, it is treatable. You should be on thyroxine for your thyroid, which is underactive. You will have to keep on top of your GP with this because the initial dose they prescribe may not be enough for you and they go by whether you are "in range" rather than what is right for you as an individual. As others have said, your TSH should be around 1. A tip: young GPs tend to be way more educated on this in my experience and way more receptive if you need a change in dose.

[Steve1997 in reply to CLH_74]

It's just getting to the doctor that's the problem I tend to ignore my problems in the hope they go away.

[CLH_74 in reply to Steve1997]

Probably best not to do that, because as your thyroid function gets worse, your health will suffer more. We've all been there, so we know what it's like, but you definitely have to be strong on what's best for you.

[greygoose in reply to CLH_74]

Actually, the full name is Hashimoto's Thyroiditis. But doctors in the UK know it as Autoimmune Thyroiditis.

[Kazania in reply to greygoose]

😂 yes 2017 my TSH was 10.9 GP not overly bothered that I felt like death, generally treated me like a hypochondriac. It’s thanks to this forum and people like you that I now know what was going on. Thank you for your ongoing support.

[Holiday12345 in reply to greygoose]

Sorry to jump in ... with hashi how do you know when you are having a swing/flare.... would you have hyper symptoms? or could a bout Of extreme fatigue etc be a sign

[greygoose in reply to Holiday12345]

I would imagine it's different for everyone. Symptoms are such a personal think. You could have hyper symptoms, but it's often difficult to know if they're hyper or hypo symptoms. But, I don't think a bout of extreme fatigue would be conclusive, because that could be caused by so many things. The only sure and certain way to know is to have a blood test and see that your FT4 and FT3 are way, way over the top of the range, and the TSH is zero.

[KittyAO]

Hi Steve, welcome. The admins on here are incredibly knowledgeable and are able to help with good advice. Keep reading other posts on essential vitamins and other information which are important too. Good luck on your journey, this site has been really helpful in understanding and managing my thyroid health.

[Steve1997 in reply to KittyAO]

Thank you I've found this site to very helpful and informative

[Localhero]

Hi Steve

Welcome. What prompted you to have this test? Have you been having symptoms of hypothyroidism? The classic ones include fatigue, weight gain and depression. But there’s a full list here:

thyroiduk.org/if-you-are-un...

As well as blood test results, it’s useful to keep an eye on these while getting on top of this.

[Steve1997 in reply to Localhero]

I'm actually pretty skinny and seem to eat everything but it's like impossible for me to gain weight. I just like to check my health but I didn't expect this test to come back with any problems. I do suffer from low mood and I can't focus on anything

[SlowDragon Administrator]

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 as you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies

Did you get vitamins tested?

If not

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 did your tests?

As you have high antibodies this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).

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

healthcheckshop.co.uk/store...?

Assuming test is negative you can immediately go on strictly gluten free diet

(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially)

Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

thyroidpharmacist.com/artic...

drknews.com/changing-your-d...

restartmed.com/hashimotos-g...

Non Coeliac Gluten sensitivity (NCGS) and autoimmune disease

ncbi.nlm.nih.gov/pubmed/296...

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

ncbi.nlm.nih.gov/pubmed/300...

The obtained results suggest that the gluten-free diet may bring clinical benefits to women with autoimmune thyroid disease

nuclmed.gr/wp/wp-content/up...

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

restartmed.com/hashimotos-g...

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.

[Steve1997 in reply to SlowDragon]

I haven't had a vitamin test but I do take a multi vitamin every morning so I don't expect my levels would be low.

[Salukigirl1]

One important aspect to Hashimoto’s is that it’s very likely that your TSH and T4 will fluctuate as your thyroid struggles to cope with the attack. Your doctor is like you to say you don’t need treatment as your TSH and T4 are normal range. It will be very difficult to get him to change his mind unfortunately. If you won’t treat you and you have hypo symptoms keep going back and asking to be retested.

[Salukigirl1 in reply to Salukigirl1]

Sorry, I mean if he won’t treat you.

[Steve1997 in reply to Salukigirl1]

Thank you I'll phone my doctor. If he fails to treat me I'll just change doctors to someone that's willing to treat me

[McPammy]

Sometimes the quickest way to be treated is to go private. But make sure it’s private only as if the Endocrinologist works for NHS and privately too they’ll still go along with NHS rules and you’ll struggle to get anywhere on treatment. I agree fully with what Greygoose has said too.

I waited many years and suffered to finally even get Levothyroxine treatment. I still didn’t do very well as I’m a poor converter of Levothyroxine to the most important hormone T3. When you take T4 Levothyroxine it sits in your body waiting to convert to active T3. If you are a poor converter you will struggle. So when you get your thyroid bloods checked always check them all T4, T3 and TSH. However, some GP’s refuse to check T3. It’s much quicker and you won’t go through years of struggle to go private only. GP’s tend not to know anything about the thyroid. My old GP said I may as well be talking to a plumber on two occasions! He knew that little. It was only when I found this site and realised what could be wrong with me that I finally decided to go private. Within two consultations I was diagnosed and put on correct treatment. I struggled for 11 years previously. Oh boy what a huge difference it’s made to my life to be finally in correct treatment.

Your TSH needs to be around 1.00 even though the range is usually 0.35-5.50. My private only Endocrinologist explained to me that anything over a TSH of 2.5 is hypothyroidism and you feel best around 1.00.

This site has many people that can help you on this journey. It can’t be cured but when on correct treatment life can be good. Also check your vitamins D, ferritin, B12 and folate. These must be optimal for good conversion also. You mentioned you take multivitamins daily. It always good to check and ensure. I didn’t realise I was deficient in B12 and ferritin. Now I’m on treatment for those too and I do feel much better in every way.

My sister had high antibodies for a year or two and her GP wouldn’t treat her. She ended up with thyroid cancer. Which is very treatable too. All her GP would say was she was depressed. She was ill physically not mentally.

[jgelliss in reply to McPammy]

Your so right. My Dr's missed all my symptoms for years . Putting blames on everything . I ended up having papilary cancer and needed to have my thyroid removed.

[Steve1997]

Thanks I now know a little bit about this with all the information I've been given which has been very helpful. I have one question my resting heart rate is like 58-60 which seems pretty low does Hashi's causes a low heart rate?

[Stourie in reply to Steve1997]

Hi Steve I personally think that 58-60 is very good for a resting heart rate but everyone is different. Jo xx

[McPammy in reply to Steve1997]

Mine is about 58 resting. On times when I was admitted to hospital they’d comment and even joke asking how long had I been training to have such an athletic heart rate. They decided to check for bradycardia through tests. No bradycardia. They never joined up the dots as I had Hashimotos which can give you a low heart rate. Basically everything runs slower until you are properly medicated and stable. When I got very bad with my Hashimotos my heart rate was down to 48 bpm. It was at that point I was hospitalised but still no connection to my thyroid. When put on T4 and T3 combined thyroid medications my heart rate increased to 58bpm and every single symptom I had went. Plus I lost 4st.