Chances of getting treatment for hashis?

[Cellocat]

Hello, it would great to have some advice, if possible.

I have a raised TPO result indicating hashis (result 10, ref range 5 and under). I also have an thyroid ultrasound giving the impression of hashis (according to the radiologist report).

But my TSH is within the reference range . Last result 3.2 (ref .27-4.2).

I am waiting to see endo for the 1st time, but with these results (plus all the standard hashi symptoms) can I expect to be prescribed medication that might help?

My non expert reading of the NICE guidelines was not reassuring. In the meantime I feel as if I am disappearing from the world.

Thank you

[SeasideSusie Remembering]

Cellocat

The guidelines (at least the old ones) used to say if TSH is over range but not reached 10 with raised antibodies then Levo may be prescribed. I don't think the new guidelines say that (but if any knows they do please link to it so I can save it ).

If your FT4 goes below range there's a good chance you'll be diagnosed and prescribed Levo.

[SlowDragon Administrator in reply to SeasideSusie]

See second flow chart

These guidelines say...

If TSH is over 5 ....and symptomatic.....can offer trial (regardless of antibodies)

gp-update.co.uk/Latest-Upda...

[SeasideSusie Remembering in reply to SlowDragon]

Thanks SD.

As that's GP Update rather than the NICE guidelines, will GPs be aware or more likely to follow the NICE guidelines do you think?

[Cellocat in reply to SeasideSusie]

Thank you and @SlowDragon

Think the main issue might be that my TSH is below 5. And my Medichecks T4 (not yet discussed with a dr) is within the ref range.

The 2019 NICE guidelines don’t seem offer treatment options, even with raised antibodies, a damaged thyroid and symptoms. Does that sound right?

Would an endo have more flexibility than a GP?

Thanks again!

[radd in reply to Cellocat]

Cellocat,

It all depends on the endo. Some are more sympathetic as have a better understanding of subclinical in terms of autoimmune disease. Others will stick by the book. It also depends how low your thyroid hormones are because they can't replace if there isn't a deficiency and unfortunately might not view FT4 half way through range as deficient enough yet, in spite of a rising TSH.

If you feel unwell, and it turns out this endo is going to leave you subclinical & wait for the disease to further develop before offering replacement, then you could ask for the ThyroidUK list of endos who have a better understanding so more likely to treat your symptoms.

Meanwhile, horrid symptoms might be more manageable if you can reduce inflammation and high immune response, ie going g/f, and looking into possible supplementation of selenium and zinc both required for good thyroid physiology. Also, science has shown adequate selenium levels to reduce TPOAb.

A good read for further understanding is The Root Cause by Isabella Wentz.

[Cellocat]

Thanks again radd . I been gf for a month, so still a way to go.

I have also broached daily brazil nuts but will look at zinc and selenium supplementation more systematically.

Which brands could be most effective here?

Fortunately I have managed to get a endo appt with someone on the TUK list.

Until then it’s hopes and prayers! 🤞thank you.

[Kisca]

Hello....one of the members recommended this to me xx

Purple.

[Cellocat in reply to Kisca]

Thank you!