TPO results

[Taytay68]

Hiyas all, already posted this week regarding test results but these have come in today . Doctor has text me to say they want to speak with me and I’ll call them tomorrow And anyone advise on this please

[Nanaedake]

You have elevated thyroid antibodies. So you have the potential to develop thyroid disease that ultimately leads to hypothyroidism.

When people become hypothyroid as a result of destruction of the thyroid gland by autoimmune thyroid disease then Doctors call it autoimmune thyroiditis. It's popularly known as Hashimotos.

Looks like you're already on levothyroxine so you are already becoming hypothyroid. I see others have already given you lots of advice on previous posts.

[SlowDragon Administrator]

High TPO antibodies confirms autoimmune thyroid disease also called Hashimoto’s or Ord’s thyroidits

Ord’s is autoimmune without goitre

Hashimoto’s is autoimmune with goitre

Essential to test vitamin D (don’t think that’s been done yet?)

Also if still eating gluten, request coeliac blood test from GP at next test

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 coeliac 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.

hypothyroidmom.com/how-to-l...

Eliminate Gluten. Even if you don’t have Hashimoto’s. Even if you have “no adverse reactions”. Eliminate gluten. There are no universal rules except this one.

[Taytay68 in reply to SlowDragon]

Hi slow dragon thank you for all this information I did go gluten free some months ago but I’ll look at all the links you have posted to see if I can help myself more, I’m trying to post the Vit d results which came in today as well

Vit d

[SlowDragon Administrator in reply to Taytay68]

So vitamin D is 73nmol

Not bad

Are you currently taking vitamin D?

How much?

Aiming for at least around 80nmol and around 100nmol maybe better

[SlowDragon Administrator]

With autoimmune thyroid disease we frequently only feel well on higher doses of levothyroxine, so that TSH is very low. This ineffect stops your own thyroid constantly changing how much thyroid hormones you have

It’s the constant changing levels of hormones with autoimmune thyroid disease that can make us feel very unwell

Levothyroxine doesn’t top up failing thyroid, it replaces it, hence the reason the guidelines suggests that almost all thyroid patients need to increase dose levothyroxine SLOWLY upwards in 25mcg steps until on approx 1.6mcg levothyroxine per kilo of your weight

NICE guidelines on full replacement dose

nice.org.uk/guidance/ng145/...

1.3.6

Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.

Also here

cks.nice.org.uk/topics/hypo...

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

Traditionally we have tended to start patients on a low dose of levothyroxine and titrate it up over a period of months. RCT evidence suggests that for the majority of patients this is not necessary and may waste resources.

For patients aged >60y or with ischaemic heart disease, start levothyroxine at 25–50μg daily and titrate up every 3 to 6 weeks as tolerated.

For ALL other patients start at full replacement dose. For most this will equate to 1.6 μg/kg/day (approximately 100μg for a 60kg woman and 125μg for a 75kg man).

If you are starting treatment for subclinical hypothyroidism, this article advises starting at a dose close to the full treatment dose on the basis that it is difficult to assess symptom response unless a therapeutic dose has been trialled.

BMJ also clear on dose required

bmj.com/content/368/bmj.m41

bestpractice.bmj.com/topics...

Guidelines are just that ....guidelines.

Some people need more ….some less

healthunlocked.com/thyroidu...