The treatment for hypothyroidism is the same whether it is hashis, Ords, no known cause, due to thyroid removal or RAI. Over range antibodies are used to confirm autoimmune thyroid disease often called hashis.
If the treatment is the same for all hypothyroidism why do we need bother with antibodies? It is better to know if you have an autoimmune disorder as 1 can often make you more likely to have others. Hashis has spells of overproduction of hormones when the thyroid is under attack so it helps understand why your thyroid hormone levels are fluctuating and why you may need to alter your dose of levo temporarily. So knowing helps you to understand what is going on with your body
But as I said earlier the treatment a hashis patient gets offered will be the same as I get offered and my thyroid was destroyed by radio active iodine.
It isn't 'over-production' of hormones with Hashi's. What happens is, during an immune system attack, the dying cells deposit their stock of hormone (already made) into the blood. This causes FT4/3 to rise sharply, and therefore the TSH drops. With time, this excess hormone will be used up/excreted, levels of T4/T3 will drop, and you will become hypo again.
This is something doctors know nothing about and cannot understand. They will either accuse the patient of 'abusing' their thyroid hormone, or they will tell you you've 'gone hyper' and stop your levo etc. They have no idea that a) it is physically impossible to 'go hyper' if you are hypo, nor that you will eventually 'go hypo' again, so will need your levo again. But, if the patient at least knows what's going on - well, one of you has to! - then you might be able to sort it out without too much fuss. If you know, or suspect, that you're having a Hashi's 'hyper' swing, it's best to just stop your levo for a few days yourself, without involving the doctor.
To answer your question:
Have any of you had blood test with some antibodies but good TSH and later on TSH started rising but it wasnāt Hashi?
Meaning I want to know if some had antibodies but they had a different type of hypothyroidism in the end?
Over-range TPO antibodies don't 'grow into' Hashi's, they are the result of having Hash's. They are not the cause. When your thyroid is under attack, as explained above, some of the TPO contained in the cells leaks into the blood along with the hormones. So, because it shouldn't be there, the TPO antibodies come along and clean it all up.
That said, it is possible to have other hypothyroidism-causing conditions at the same time: Central hypo (pituitary/hypothalamus problem), whip-last, over-dose of endocrine disruptors, to name but a few. So, the odds are that you would go hypo anyway, even without the Hashi's. But the Hashi's certainly won't help!
I did make a previous (very long) post with some speculations.
But basically I have Type 1 diabetes which is autoimmune and Iāve recently discovered that my TSH had been quite elevated for a while and my last test was 5.63 (in March and it jumped from 4.41 in November).
But looking through old tests Iāve seen that I had a TPO antibody test and TSH done and the results were:
2018/2019
- TSH: 0.99 (0.27-4)
- TPO: <33 (0-60)
So some have told me that that TPO is negative or āin rangeā.
Now my assumption was that normal people donāt really have antibodies..
And although it was in range, it was more than 50% through and having other conditions, this may mean I may have Hashis.
Doc said based on previous results they can already class asSubclinical hypothyroidism but weāre waiting for more recent tests to know more as we tested TSH, FT4, FT3, TPO, TG and a load more.
I was getting ready to try for a baby and therefore trying to get my ducks in a row..
Slashed my a1C, and tried to improve my weight.. and bow Iāve discovered this whole new thing lol. (No, the doc didnāt let me know my Thyroid was elevated š).
So just trying to get versed on most likely Thyroid outcomes for me and what they really mean for my general health and trying to get pregnant etc.
With hashis the auto immune system attacks the thyroid. The attack damages the thyroid and causes it to dump a load of hormones. The antibodies come along to clean up the debris. So antibody levels go up and down.The thyroid is damaged by these attacks and gradually fails.
Well, opinions vary on that point - stopping the attacks. But, as far as I can tell, it's all theory and no concrete fact.
Levothyroxine, is the the thyroid hormone T4. It's Thyroid Hormone Replacement and doesn't have any effect on the thyroid itself, just replaces the hormone that the thyroid can no-longer make enough of to keep you well. Taking enough to suppress your TSH - if you can get away with it! - might possibly slow down the attacks. But, there again, theoretical opinions vary, but no hard facts. Possibly it varies from person to person, I don't know. But, that really isn't the point of taking levo. The point is to keep you alive and well.
As greygoose says, itĀ“s sometimes claimed that suppressing the TSH can stop or reduce autoimmune attacks. I did not work for me. I was diagnosed with HashimotoĀ“s in 1999, based on very high levels of anti-TPO, below range FT4, and above range TSH. An ultrasound sound showed the thyroid gland was of normal size. My doctor was unsual because he wanted a TSH between 0.3-0.05 in Hashi patients. He claimed the TSH is what causes autoimmune attacks so a very low TSH would reduce or even stop the attacks. Well, it didnĀ“t work for me. It took 20 years for the antibodies to end up in range. Last November, a new ultrasound showed an atrophied thyroid gland. So, it would seem the antibodies did not disappear until there was nothing left to destroy. My TSH has remained below 0 during all this time. I am not sure it would have made a difference either way as my hormone-producing tissue was already damaged at tihe time of diagnosis. Even if I need a higher dose of levo because there is no thyroid gland left, it hardly makes a difference if I take 100, 150 or 200 mcg a day because I still need thyroid hormone replacement. Some alternative doctors claim you can actually reverse autoimmune thyroiditis using supplements, but I donĀ“t know enough about it to tell if there is any thuth to it. I have the impression that, in most cases, the diagnosis isnĀ“t made until the patient is symptomatic, in which case there is already damage to the thyroid gland. Not sure how many are diagnosed before they develop symptoms, as most doctors donĀ“t seem to order anti-TPO/anti-TG tests until patients are already symptomatic.
Wouldnāt that be good but donāt be surprised if cortisol is normal if so keep asking each week for a repeat test many people it takes years for a diagnosis unfortunately. When I said urine testing I mean the 24 hour UFC hopefully youāre GP has arranged this one for you.
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