Antibodies keep rising, should I be concerned? - Thyroid UK

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Antibodies keep rising, should I be concerned?

YorkshireLass_1964 profile image

Hello lovely people I wonder if you can help, I was diagnosed with Subclinical Hypothyroidism in September 2019, started on 25 mg and have slowly been increased to 125mg. I'm trying to understand if my Antibodies which keep rising have a part to play with still feeling very tired, fatigued and bizarrely when out walking the tops of my legs feel like I have a ton weight attached to them, they are ok when walking on the flat or downhill.

I've attached a screenshot of my last 3 tests from Medichecks, hopefully for ease I've noted the date against the TSH result and as you can see my thyroglubuin has increased each time.

I also have an intermittent thick feeling in my throat, again not sure if this is due to the high Antibodies?

Doctors as normal only check TSH and I follow the advice on here regarding taking the test on an empty stomach, at the same time etc, I take Mercury Pharma 100 + 25 mg each morning 1 hour before anything to eat or drink.

I have a face to face doctors appointment on the 9th Feb to discuss hopefully getting them to test everything, not sure if I need T3?

Hope this all makes sense, thank you in advance for any help greatfully received.

4th March 21' TSH 3.4

17th March 22' TSH 1.5

23rd November 22' TSH 0.7

Many thanks.

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YorkshireLass_1964
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SlowDragon profile image
SlowDragonAdministrator

Welcome to the forum

Do you always get same brand levothyroxine at each prescription

High thyroid antibodies confirms autoimmune thyroid disease also called Hashimoto’s

About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high thyroid antibodies 

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis. 

Both are autoimmune and generally called Hashimoto’s.

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)

Have you had vitamin D, folate, ferritin and B12 levels tested

What vitamin supplements are you currently taking

Your Ft3 is very low

Suggests poor conversion rate of Ft4 to Ft3……very common when vitamins are low

I've attached a screenshot of my last 3 tests from Medichecks, hopefully for ease I've noted the date against the TSH result and as you can see my thyroglubuin has increased each time

Actually……..TPO and TG antibodies are slowly dropping

TG antibodies tend to drop as TSH reduces

TPO antibodies often reduce on strictly gluten free diet/dairy free diet

Have you had coeliac blood test done yet…..if not request GP do so (as per NICE Guidelines) BEFORE considering cutting gluten out

YorkshireLass_1964 profile image
YorkshireLass_1964 in reply toSlowDragon

Hello SlowDragon,

Thank you for you reply very much appreciated.

Its been a struggle but I do get the same brand, I now have it printed on my prescription that I have Mercury Pharma, I managed this through reading information on this site and a very helpful independent pharmacist who was sympathetic to my request as his father had Hypothyroidism, I know for the past year or so I have been very lucky.

I don't think I have a goiter or I certainly can't see one, I'm not sure if the feeling in my throat suggests there may be the start of one? I'm assuming a scan would have to be done to confirm one way or the other if its Hashimoto's or Ords?

**Latest results 22nd November 22

Vitamin D - 109 nmol/L [50 - 200]

Folate - 9.15 ug/L [3.89 - 19.45]

Ferritin - 313 ug/L [13 - 150]

B12 - 110 pmol/L [37.5 - 150]

Coeliac test was negative, so I am starting the transition to gluten free to see if that helps.

**Daily supplements

1 x Bimuno for gut health

1 x B complex

Better You Vitamin D MK2 at night

2 x Brazil nuts for Selenium

I also take 80mg of Propranolol for migraine prevention, this at least has been life changing after a 30 year struggle, been taking this since Aug 22.

As T3 indicates I'm a poor converter do I need to talk to the doctor regarding possible T3 supplementation?

Many thanks

SlowDragon profile image
SlowDragonAdministrator in reply toYorkshireLass_1964

You need to look at very slowly reducing propranolol and eventually stopping

Migraine is hypothyroid symptom

Propranolol significantly reduces uptake and conversion of Ft4 to Ft3. (It’s used to treat hyperthyroid patients)

I was stuck on propranolol almost 20 years ….more on my profile

Suggest you transition to strictly gluten free diet

Then SLOWLY start reducing propranolol

Are you taking slow release propranolol once a day …..or 20mcg 4 x a day

No one should ever stop propranolol suddenly

But thyroid patients need to reduce especially slowly

Maximum of 5mg reduction per day…..wait 4-6 weeks…..reduce by another 5mg etc etc

So it’s going to take 6-9 months perhaps to stop entirely

When down to last 5mg……cut one day week

Next week cut twice week etc

Meanwhile if not already supplementing magnesium, this can help generally and especially with reducing propranolol

Until you are off the propranolol completely you won’t be able to see how good a converter of Ft4 to Ft3 you are

YorkshireLass_1964 profile image
YorkshireLass_1964 in reply toSlowDragon

Hi SlowDragon,

I take 80mg slow release propranolol once a day, is there an alternative brand that perhaps doesn't affect the conversion that you know of, I've had migraines for nearly 40yrs and this medication has been a life changing event for me, the thought of having migraines again fills me with fear beyond belief.

Sorry I forgot to list it, I use Better You magnesium spray at night.

Thank you 😊

SlowDragon profile image
SlowDragonAdministrator in reply toYorkshireLass_1964

Migraine is extremely hypothyroid symptom

Now you are on levothyroxine you should find you don’t get them

Magnesium spray very unlikely enough

Suggest you try Thorne magnesium

uk.iherb.com/pr/thorne-magn...

Your thyroid levels are dreadful because of propranolol

GP can offer monthly migraine injection if necessary

But very likely you won’t need anything once thyroid levels are optimal

Are you on Gluten Free diet or dairy free diet

Both often give significant benefits….always worth trying

SlowDragon profile image
SlowDragonAdministrator

FT4: 29.4 pmol/l (Range 12 - 22) 174.00%

FT3: 3.8 pmol/l (Range 3.1 - 6.8) 18.92%

Most people when adequately treated will have Ft3 at least 50% through range…..and more usually 60-70% through range

And ideally Ft4 not over range

November test shows Ft4 too high and Ft3 far too low

Suggest you get thyroid and vitamins retested now

List of private testing options and money off codes

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

bluehorizonbloodtests.co.uk...

Monitor My Health now offer thyroid and vitamin testing, plus cholesterol and HBA1C for £65 

(Doesn’t include thyroid antibodies) 

monitormyhealth.org.uk/full...

10% off code here 

thyroiduk.org/getting-a-dia...

Only do private testing early Monday or Tuesday morning. 

Watch out for postal strikes, probably want to pay for guaranteed 24 hours delivery 

YorkshireLass_1964 profile image
YorkshireLass_1964 in reply toSlowDragon

Hello SlowDragon,

Thank you once again for the information, I will have the full range of testing done again as advised, I will also ask the doctor to do full testing when I have my appointment on 9th Feb, see how I get on with that one! although you never know I may be surprised and they'll agree to my request 🤞🤞

SlowDragon profile image
SlowDragonAdministrator in reply toYorkshireLass_1964

Vitamin D, folate and B12 look good

Low Ft3 and high Ft4 are both almost certainly due to propranolol

If on slow release propranolol, request changing to ordinary tablets….10mg - and start taking as 20mg 4 times a day

You might find you can reduce by more than 5mg at a time

Request full iron panel to check iron levels aren’t high

presumably you are post menopause

Slightly high ferritin is not unusual once periods stop

Ferritin can also be raised due to inflammation of Hashimoto’s

Ferritin range on Medichecks 

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

We have received further information the lab about ferritin reference ranges. They confirm that they are sex dependent up to the age of 60, then beyond the age of 60 the reference range is the same for both sexes: 

Males 16-60: 30-400 ug/L

Female's: 16-60: 30-150

Both >60: 30-650 

The lower limit of 30 ug/L is in accordance with the updated NICE guidance and the upper limits are in accordance with guidance from the Association of Clinical Biochemists. ‘

SlowDragon profile image
SlowDragonAdministrator

sorry forgot to add links about propranolol

 

pubmed.ncbi.nlm.nih.gov/168...

rejuvagencenter.com/hypothy...

labtestsonline.org.uk/tests...

Drugs that may decrease PTH include cimetidine and propranolol.

YorkshireLass_1964 profile image
YorkshireLass_1964 in reply toSlowDragon

Hi SlowDragon,

Thank you for the information, yes I am post menopause 58yrs old, I will discuss the low Ft3 and high Ft4 with the doctor and try and get her to accept its due to taking propranolol.

I did ask the doctor who prescribed it if it would affect anything and he said no, I shouldn't be surprised at that as I'm beginning to understand they know very little about the Thyroid and interaction with other medication!

I've also read your profile which is very interesting, I must write mine!

Thank you for all your help 😊

SlowDragon profile image
SlowDragonAdministrator in reply toYorkshireLass_1964

I saw numerous “thyroid specialists”

Including 2 Professors at leading endocrine “centres of excellence”

Not one of them considered propranolol was an issue

Yet a 5 second google search will bring up numerous research papers showing propranolol reduces conversion, slows uptake and lowers Parathyroid levels (leading to low vitamin D, low magnesium and poor bone health)

When I experimented with increasing propranolol dose to 80mg it was twice as bad…..like wading through treacle

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