Positive antithyroglobulin abs, hypothyroid symptoms, tender neck/thyroid but normal tfts

[Lego1234]

Hi there,

I had a baby 4 months ago. Following my last pregnancy I had some issues with brain fog/weight gain (no matter what exercise I did), lethargy and some mood problems. About 10 months post partum, I had my TSH and T4 done and my TSH was raised at 5.6 (though T4 was normal). I eventually convinced my dr to give a trial of levo and felt so much better. Came off this about 15 months after the birth and felt ok on nothing; normal subsequent pregnancy.

However, once again post partum I have noticed similar symptoms; this time I also feel my neck area around the thyroid is very tender; I can't feel a lump or goitre really. I cannot loose weight no matter what I do; I've lost mental clarity; exhausted all the time (two kids don't help). Did a private thyroid panel including abs. These were the results:

TSH 3.09 mIU/L (0.27-4.2)

FT4 17.5 pmol/l (12-22)

FT3 5.7 pmol/l (3.1-6.8)

T4 (66-181)

TPOab 9.3 kIU/l (0.34)

TgAB 225.9 KU/L (0-115)

So thyroid function normal but positive TgAB's. My question is- does this mean anything? Do I have hashimotos based on this even though thryoid functions ok? I definitely feel I would benefit from treatment again but wouldn't like to go hyperthyroid. Planning to speak to GP but not sure they even routinely test TgAB on NHS so they are likely to dismiss these results?

Any guidance would be great if anyone has been in this situation/aware of the next steps? Many thanks......

[SlowDragon Administrator]

Request GP test vitamin D, folate, ferritin and B12

What vitamin supplements are you currently taking

Ft4 and ft3 are at good levels

Yes NHS won’t diagnose autoimmune thyroid disease with just high TG antibodies. High thyroglobulin antibodies doesn’t necessarily mean you have autoimmune thyroid disease

[Justnotcricket]

HiI have very similar thyroid results which have been like that for several years, although my TSH is getting steadily higher. I have raised TGAB levels but normal TPO levels. My experience with gps has not been great. I've taken private blood results to them which they say they won't take into account so they repeat the TSH test but they won't do any additional testing until my TSH is out of range. I also have pernicious anaemia which puts you at higher risk of developing Hashimoto's but can also itself be a cause of raised antibody levels I think. If you haven't already had your b12, ferritin, vitamin D checked, I would start there.

[greygoose]

But your thyroid function isn't ok. You need an abnormally high TSH to get your thyroid hormone levels to approx. mid-range. That suggests that your thyroid is failing. At the moment, it's managing to keep up, but as you do have Hashi's - shown by high TPO antibodies - it's not going to be able to keep up forever. It will be slowly destroyed by the disease until it is no-longer able to produce enough hormone to keep you well. And, as you have Hashi's, you are going to go false 'hyper' from time to time, anyway, because that's how Hashi's works.

Unfortunately, it's highly unlikely that you will find a doctor that knows enough about thyroid/Hashi's to understand that. They will just look at the TSH and see it's in-range and tell you there's nothing wrong with you, and antibodies are irrelevant. So, it's up to you to keep an eye on your levels, testing from time to time, until the TSH goes over-range. Then, with high antibodies, you should get treatment. However, if TSH goes low, and FT4/3 go high, do not consult a doctor or you will get the wrong treatment! As I said, they just don't understand how Hashi's works.

[Lego1234 in reply to greygoose]

That's interesting...I didn't know people could go 'hyper' with hashis but I know postpartum people can go high then low, so maybe I'm in that phase. So to be considered hashi's do you just need positive antibodies (be it TPO or TGAb?) I do have a family history of hashis so wouldnt be that surprised... thanks for your help.

[greygoose in reply to Lego1234]

Well, that can be complicated. High TPO antibodies is definitely Hashi's. But, with TgAB, it depends how high they are. Also, 20% of Hashi's sufferers never have over-range antibodies, and are diagnosed through an ultrasound, when the damage is bad enough to show.