High TSH (between 8and10) normal T4 and T3, high thyroid antibodies (300)

[Bazza123456]

I’ve had high TSH normal t4/t3 for at least 10 years. I’m mid 50s. Antibiodies around 300.

I’ve no Symptoms. What should I do? Languish in sub clinical what and see land? Should I be worried as I get older? What can I take/do or stop doing?

[greygoose]

Can you give us the exact number, please: results and ranges? Because there's no such thing as 'normal' FT4 and FT3. When a doctor says normal, he means somewhere in-range. But, just being in-range is not the same as optimal, the ranges are too wide, so we need to know exactly where within the range, the result falls.

However, if your TSH is 10 and your antibodies are high, your doctor should be starting you on levo, because you are obviously hypo, and it's just going to get worse, not better.

You probably have got some symptoms, you probably just don't associate them with thyroid. There are over 300 known symptoms, so the odds are you have at least one of them.

I'm not sure getting older has anything to do with anything. Only trouble is, ignorant as doctors are, the older you get, the less likely they are to want to diagnose. So, time to start pushing now. Make a nuisance of yourself until you get what you want.

What can I take/do or stop doing?

The only thing I can think of is avoiding soy. All forms of soy: soy protein, soy milk, soy, oil, etc.

Make sure you have a nutrient-rich diet, don't cut your calories, and don't cut your salt. Get your nutrients tested: vit D, vit B12, folate and ferritin - being hypo can cause them to be low. Get just enough exercise to stop you rusting, but over-exercising can be detrimental at this point. Possibly try a gluten-free diet, but if you don't have symptoms, I don't see much point.

[Bazza123456 in reply to greygoose]

Thank you so much for your prompt reply. The only data I have atm is from April 2022: TSH 9.04, T4 15.4. Also the thyroid antibody was 300 (last week) down from 330 (2 years ago). I will implement your dietary changes and lifestyle advice. With a view to retiring in about 4 years I don’t want some sort of burnout? Letting things lie as they are doesn’t seem right either.

I’ll get on to my GP tomorrow. 👍🏻

[greygoose in reply to Bazza123456]

Your TSH is very high - technically, you're hypo when your TSH reaches 3. Your FT4 looks low, but without the range, it's impossible to tell.

Antibodies fluctuate all the time, so the drop doesn't mean anything. Once you have an over-range result, it means you have Hashi's, and Hashi's doesn't go away.

[Bazza123456 in reply to greygoose]

Many thanks.

[greygoose in reply to Bazza123456]

You're welcome.

[arTistapple in reply to greygoose]

“Just enough exercise to stop you rusting”. Yes that is excellent. Otherwise counter productive at the moment.

[SlowDragon Administrator]

Here’s a short list of symptoms

thyroiduk.org/wp-content/up...

High thyroid antibodies confirms autoimmune thyroid disease, and your high TSH shows that your thyroid is under attack and struggling

Always test thyroid levels early morning, ideally before 9am to get highest TSH

Was latest test done early morning?

Absolutely essential to test vitamin D, folate, ferritin and B12 at least annually

Being hypothyroid frequently causes low stomach acid levels and poor nutrient absorption and low vitamin levels as direct result

Have you had vitamins tested recently

Are you currently taking any vitamin supplements

GP should do coeliac blood test

Only 5% of autoimmune thyroid patients are diagnosed as coeliac, but a further 80% find strictly gluten free diet helps or is essential

But get tested for coeliac before considering trial on strictly gluten free diet

[Bazza123456 in reply to SlowDragon]

Thanks for reading my post and your comments. The blood draw was early morning as I was getting other checks.

I do take a range of vitamins and minerals including kelp!

I have found that when I don’t eat gluten I don’t have indigestion and acid reflux.

I enjoy the gym but struggle to lose weight unless I eat one meal a day Mon-Fri. BMI 27.

Thanks again.

[SlowDragon Administrator in reply to Bazza123456]

Kelp and iodine are not recommended for anyone with autoimmune thyroid disease

health.clevelandclinic.org/...

[arTistapple]

Bazza12345, I am confused “No symptoms”? Is it just curiosity on your part to follow this up or are you really not feeling quite well? I am intrigued because I went on for years knowing there was something wrong but was frankly unable to articulate it. I think that is one of the major stumbling blocks for your average GP for diagnosis of hypothyroidism. The patient can’t explain it and the GP can’t hear it. Have you begun to accept life at a shadow level as normal, it’s just your fault? If you can say more, I for one would be happy to read it!

[Bazza123456 in reply to arTistapple]

Hi thanks for your comment. Everything is much the same as before. If anything I exercise more and feel great!

Believe me if I had symptoms eg sluggishness, I’d be at the doctors door demanding levo!

[arTistapple]

Oooh you are in such a fortunate position. Keep going.

[CaptainBeOS]

Somewhere on thyroidpatients.ca I read this about failing thyroids...

It goes like this: If indeed you have an autoimmune thyroid disease then it doesn't mean that you will be immediately hypothyroid or ill. In fact I've come across someone who is a little hyper. This is because as your thyroid output weakens your pituitary gland produces more TSH to make what is left of your thyroid work harder restoring you to normal balance.

Your pituitary gland's primary role is to maintain the fT3 level that your body needs. Normal balance in this respect does not include TSH or fT4 (though GP's would have you believe this). This means that TSH and eventually fT4 will look abnormal (high TSH, low fT4), but your fT3 will look good... and you will still feel absolutely fine as long as your fT3 is good.

I don't know if there is anything dietary that can be done to slow the process, but eventually the thyroid of a person with autoimmune thyroid disease will be unable to keep up with the flogging it is receiving from the pituitary gland and the fT3 will start to drop to a sub optimal level for the individual. Often around this point the excess TSH causes the thyroid to develop a thyroid nodule, so you start to feel a goiter or a lump down by your clavicle.

So you are probably right, it is a case of watchful waiting until a clinical problem arises and being aware what you need to look out for. If you want to periodically retest your thyroid hormones then make sure to track your fT3, noting that it does cycle throughout the day, so be consistent with the time of day. GP's won't offer fT3 tests, only an endocrinologist can order one on the NHS, so most likely you will need to do this via the medichecks website or the like... knowing your healthy fT3 level ahead of any clinical problems will also be very helpful.

[Bazza123456 in reply to CaptainBeOS]

Thanks so much for your helpful comments. It’s becoming a waiting game that I don’t like playing!