My doctor has refused to include antibodies in my recent blood test, he said it is not necessary as it doesn't change the outcome/treatment anyway. I have been underactive for years, and receiving a combination of Levothyroxine and Armour, but feeling very poorly recently and I'm desperate to try and find out why.
Could anyone comment on my doctors comment please and maybe suggest what to do next?
he's right , they are helpful for confirming if the cause of the hypothyroidism (or subclinical hypothyroidism) is autoimmune destruction of the thyroid gland. This can help them decide if it is wise to start treatment when the TSH is only slightly raised and fT4 is still in range.
But once already diagnosed hypothyroid and prescribed thyroid hormone, knowing if the antibodies are high or low doesn't change anything about the treatment the Doctor gives.
Knowing if the cause is autoimmune does help with understanding why there may be unexplained variation in blood tests for thyroid hormone levels and symptoms , but that still doesn't change the treatment which is to monitor and adjust the thyroid hormone replacement by looking at blood levels and symptoms together .
It would be more useful to get hold of your recent blood results for fT4, fT3 ,[with the lab ranges] and TSH result and post them here for advice.
Thank you so much for your reply and I will be following your suggestion.
Were antibodies high when first diagnosed
You need FULL thyroid and vitamin testing
For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested.
Very important to test vitamin D, folate, ferritin and B12 at least annually
Low vitamin levels are extremely common, especially with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)
Low vitamin levels common as we get older too
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 and last dose levothyroxine 24 hours before test
On day before blood test, split NDT into 2 or 3 smaller doses, at roughly equal 8 hour intervals, taking last 1/3rd of daily dose approx 8-12 hours before test
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins
List of private testing options
thyroiduk.org/getting-a-dia...
Medichecks Thyroid plus antibodies and vitamins
medichecks.com/products/adv...
Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test
bluehorizonbloodtests.co.uk...
If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3
£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code
thyroiduk.org/getting-a-dia...
NHS easy postal kit vitamin D test £29 via
If TPO or TG thyroid antibodies are high this is usually due to Hashimoto’s (commonly known in UK as autoimmune thyroid disease). Ord’s is autoimmune without goitre.
About 90% of all primary hypothyroidism in Uk is due to Hashimoto’s. Low vitamin levels are particularly common with Hashimoto’s. Gluten intolerance is often a hidden issue too
Link about thyroid blood tests
thyroiduk.org/getting-a-dia...
Link about Hashimoto’s
thyroiduk.org/hypothyroid-b...
List of hypothyroid symptoms
Hello Longpod and welcome to the forum :
In essence your doctor is right as he has only T4 - Levothyroxine to work with, irrespective of what has caused your under active thyroid and he works to guidelines, blood tests and ranges to manage your health.
However if you are with a thyroid auto immune disease there is much you can do to help your immune system calm down, mainly through checking for possible food intolerances and life/ work choices
You might like to dip into the Thyroid UK who are the charity who support this forum and where you will read up on all things thyroid and likely start being your own best advocate.
You will also find details of private companies who can run a full thyroid blood test for you, to include TSH, T3, T4 antibodies, inflammation and ferritin, folate, B12 nd vitamin D as no thyroid hormone works until until your core strength vitamins and minerals are optimal.
Does your doctor know you are taking NDT as well as T4 - Levothyroxine as this will alter your blood test results and it seems many doctors are not aware of how a TSH, T3 and T4 present when the patient is taking anything other than T4 - Levothyroxine.
I take NDT and my TSH is low suppressed, under range, and my T3 at around the top of the range and my T4 at around 25% through. I am very well compared to how I was on T4 - monotherapy.
The bloods tests and ranges were introduced to be used alongside Big Parma's launch of Liothyronine -T3 and Levothyroxine - T4 in the middle of the last century.
NDT presents very differently in blood test and you treat to the relief of symptoms and not blood tests since NDT was successfully used for over 100 years prior to the science of blood tests and the complications of fitting into any of the medical tick box exercises.
Hello Longpod,
My Endo said the same, once the antibodies are there, that info is in us so to speak, which was why they dont usually retest once that has been confirmed.
I asked him why/what caused the antibodies......he said there was lots of research,thoughts, data etc non conclusive as yet. I said it would be interesting to know if anything I did diet-wise changed things...
For me via private testing, my antibodies reduced down to double figures from treble when I removed gluten, a slight change with removing soya and dairy, Endo was suprised ,but then he said we dont recheck to note changes.
We are all different, and our bodies then need the medication to make up for the loss due to antibodies.
I found Chris Kressor (think that how you spell his name) website very useful on the thyroid -gut connection.
Its tricky to find the balance of meds or brand of meds, its doable as so many on here have found and will give great support. I wish you all the very best, G
NHS rarely tests thyroid antibodies more than once
Many members use private testing to test Ft3, Ft4 and TSH, plus antibodies and vitamins
Thyroid antibodies testing included in many private thyroid and vitamin test bundles
Many members see TPO antibodies reduce on strictly gluten free diet
TG antibodies seem to reduce the lower TSH drops (ie the less own thyroid is required to work)
My endocrinologist was also astonished to see that my TPO antibodies started to reduce on gluten free diet
As they almost never retest antibodies, are as a result unaware what might influence changes in levels
Hi SlowDragon,
Yes its interesting what we find out for ourselves. I believe my Endo 'is' aware of the food connection, leaky gut, b12 etc , every now and then when I say im trying this or that, and this worked but that didnt, his guard comes down and he says 'some find this helpful, or why dont you try cutting a supplement in half' ...then the guard goes back up when I see the letters copied back to GP and then me....with no mention that there was improvement because....
That said, he has been very supportive when so many hadnt.
Every best wish SlowDragon, very grateful you are here. G
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