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New to all of this! Any help appreciated. High TPO antibodies and high TSH

Amyflood246 profile image
74 Replies

Hi! Could anybody please help me with these results please? I have uploaded pictures. My TSH has always hovered between 1-2! I paid for a full thyroid with antibodies panel a few months ago and my TPO antibodies had come back raised at 68 but the rest of my thyroid panel was in range TSH was 1.6. My TPO antibodies were tested again as part of a full antibody panel a month later and they had raised to 87, TSH wasn’t checked at this time… however I have just had another thyroid panel tested and my TSH has jumped to 4.24 when it has never ever been higher than 1-2 so my questions are…

Is it possible to get symptoms at these levels?

I know that hashimotos doesn’t always mean you have hypothyroidism but if my TPO antibodies are high does this automatically mean I have hashimotos?

Do I need to be on medication?

how fast does hashimotos progress because in the space of 5 months my TPO antibody level has raised and my TSH has gone from being well within range to out of range but on google it says that it takes years to progress? So I’m confused?

Are there any other thyroid related or non thyroid related conditions that I need to be looking in to that could be mimicking these results?

Thank you so much and Any help is much appreciated!

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Amyflood246 profile image
Amyflood246
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74 Replies
Jaydee1507 profile image
Jaydee1507Administrator

Definitely you can get symptoms at your current blood result level. Even with a TSH within range you can have symptoms. Many doctors do not realise this.

In the earlier stages of Hashi's your TSH can vary quite a lot so it may be going in and out of range all the time. For diagnosis you need 2 NHS TSH results above range. Its unlikely that any doctor would treat you at this point and as TSH varies you need to replicate this twice on the NHS.

Can I just ask what time of day you took this test, did you fast and stop any biotin containing supplements 3 days before it?

Free T4 (fT4) 15.9 pmol/L (12 - 22) 39.0%

Free T3 (fT3) 5.4 pmol/L (3.8 - 6.8) 53.3%

Your thyroid is clearly struggling and its really just a matter of time as to how long it can continue.

I know that hashimotos doesn’t always mean you have hypothyroidism but if my TPO antibodies are high does this automatically mean I have hashimotos?

Yes in my book you automatically have Hashi's if you have positive TPO abs.

Its really highly variable as to what time Hashi's takes to progress. I don't think anyone could put an accurate estimate on that as so individual. It may just be that your levels are fluctuating and next time you test your TSH will be back at 2 or 3. Alternatively it could be above range again.

Are there any other thyroid related or non thyroid related conditions that I need to be looking in to that could be mimicking these results?

As your antibodies are positive then you need to look no further.

What were the vitamin results and are you supplementing levels?

Amyflood246 profile image
Amyflood246 in reply to Jaydee1507

Hi! Thank you for replying to me! I took the test at around 10am, I hadnt eaten for about 10 hours before the test and yes I did take a very very small dose of biotin that was in my b-complex but it was no more than 120mcg so a very very small dose. How long are you not supposed to eat for before the test? And did I take it at the right time? Can I ask what the percentages mean that you have put next to the test results?

I also noticed that my antibodies don’t seem as high as what most people have so does this mean that I haven’t had hashimotos/present antibodies as long as they have?

My vitamin levels aren’t too bad at present, I was deficient in vitamin D so I have been working on getting that up and I have been diagnosed with b12 deficiency so I’m on every other day injections for that. Folate is a good level it’s just iron that’s a little low so going to ask for iron tablets. The thing I’m going to struggle with is trying to work out whether I have symptoms from the hashimotos because my b12 deficiency causes horrendous symptoms and I already feel dreadful but now I’m thinking what if some of those symptoms are actually hasimotos? How do I tell?

They only other thing I’ve been worried about is thyroid cancer because I’ve read that TPO can be elevated with it, how likely is this? Xx

Jaydee1507 profile image
Jaydee1507Administrator in reply to Amyflood246

The studies that implicate biotin as interfering with thyroid test results did involve quite large amounts of the substance. In my B complex there is 400mcgs biotin. Even so, as good practice and for consistency and to be absolutely sure every time its best tostop it for 3 days. Something to remember for next time.

Fasting just that day is good enough. Just skip breakfast and coffee/tea before the blood draw.

10am is close, but 9am is when TSH is highest.

The percentages just give a better feel of where your results fall within the range. Your thyroid is probably putting up a huge effort to keep your FT3 up at the moment. Your FT4 is low but may yet drop lower.

Antibodies do vary a lot over time. I think some people never get antibodies in the thousands. Perhaps those people with super high antibodies progress faster but I am just guessing!

If you have several health conditions it can be hard to know what symptom is a result of which condition. All you can do is assess symptoms based on blood results.

Exactly what were the numbers of your vitamin results?

Are you taking vit D with K2 to help it go to your bones?

How low is your ferritin? Less than 30 is deficient by NICE guidelines. It's not recommended to supplement with iron unless you have done a full iron panel and know that you need it. Iron is quite complicated as you can have low ferritin yet iron can be high. Also the same in reverse.

Suggest you get a full iron panel run.

Its highly unlikely in my opinion that you have thyroid cancer because your TPO antibodies are elevated. It's extremely common with thyroid disease to have raised antibodies and only a tiny percentage of the many millions will have thyroid cancer.

Amyflood246 profile image
Amyflood246 in reply to Jaydee1507

so because my antibodies are lower does that mean that I still could have had it for years?

I thought it was t4 that dropped in hypothyroidism not t3?

My vit D was 25 but it now gone up to nearly 90, I’m taking 10000iu along with k2 and magnesium…. My folate is at 34… my vit b12 was at 192 before injections and I’m taking folic acid and b-complex to support them

My iron is the tricky one because I think my ferritin is raised due to inflammation but my saturation is slightly low. My hs-CRP was 10. I have included a picture of my iron panel xx

Iton
Jaydee1507 profile image
Jaydee1507Administrator in reply to Amyflood246

Honestly I wouldn't over think the antibodies. The main thing is that you know you have them and therefore its a good idea to try a strictly gluten free diet to see if it helps symptoms. Dairy can also be an issue for some so once you have strictly gluten free taped then move on to eliminating dairy from your diet.

Both T4 & T3 can drop in hypothyroidism.

I would discuss your iron results with your GP who will likely want to run their own tests. As you have raised inflammation it is clouding the picture but your serum iron is low.

Amyflood246 profile image
Amyflood246 in reply to Jaydee1507

I will do thank you! Xx

greygoose profile image
greygoose

Hi Amyflood246, welcome to the forum.

Is it possible to get symptoms at these levels?

Absolutely. Symptoms often proceed whacky blood test results. But, it's not the TSH or the antibodies that cause the symptoms. It's low FT3. Your FT3 in that photo looks ok, but there is obviously some damage done to your thyroid because it takes an abnormal amount of TSH - Thyroid Stimulating Hormone - to get it to that level. And, levels tend to fluctuate with Hashi's, so it could have been lower at some point.

I know that hashimotos doesn’t always mean you have hypothyroidism

Actually, it means that you don't have hypo YET. But the disease is eating away at your thyroid so you will go hypo eventually.

but if my TPO antibodies are high does this automatically mean I have hashimotos?

Yes, it does.

Do I need to be on medication?

The 'treatment' for Hashi's is not medication as such. It is thyroid hormone replacement, to replace the hormone that your thyroid can no-longer make enough of. It's not any sort of drug. And, there is not treatment of any kind for the Hashi's itself.

Do you have symptoms? If not, you don't need hormone replacement yet. And, in any case, with your results you would not find a doctor to give you any. They like the TSH to be at least over-range on two consecutive blood tests and/or high antibodies and/or under-range FT4 or 3.

how fast does hashimotos progress because in the space of 5 months my TPO antibody level has raised

Impossible to say. And, I should imagine, it's different for each individual - most thing thyroid are.

TPO antibodies are not a measure of the progression of the disease. The antibodies do not attack the thyroid. It is your immune system that is doing that, and during/after an attack, the antibodies come along to clean up the resulting debris in the blood. So, they are highest just after an attack. But, they fluctuate all the time.

and my TSH has gone from being well within range to out of range but on google it says that it takes years to progress?

Like all the other levels with Hashi's, TSH can fluctuate a lot. Also, did you know, that TSH fluctuates throughout the day? So, your level depends largely on the time of the blood draw.

Years to progress? Well, depends on your definition of 'progress', doesn't it. It takes years to completely destroy your thyroid, but it can make you ill a long time before that happens. And neither antibodies nor TSH can accurately tell you how much it has 'progressed'.

Are there any other thyroid related or non thyroid related conditions that I need to be looking in to that could be mimicking these results?

Well, any sort of illness will have an effect on your TSH/FT4/FT3 levels, which is why, when you suspect a thyroid problem, you have to keep testing to see how it pans out. But, there is nothing else that will affect your antibodies except autoimmune thyroid disease. TPO antibodies can be raised with Graves' Disease as well as Hashi's. But, Graves' is hyperthyroidism so your TSH would be suppressed, not raised. So, you really do have Hashi's, I'm afraid. :)

Amyflood246 profile image
Amyflood246 in reply to greygoose

hi! Thank you for replying to me! Do you mean my TSH could have been lower? I thought that it caused high TSH? sorry if I’m misunderstanding

Does the actual hashimotos cause symptoms or is it when it only when your thyroid function becomes abnormal that you get symptoms? I have been struggling with infertility for years but my thyroid has only just started going out of range so could I have still been the hashimotos causing this or is it unlikely?

So like I was saying to the other poster who commented, my antibody level doesn’t seem as high as most people so does this mean that I haven’t had hashimotos as long as them or that my case isn’t as severe? Just confused as to why some have higher levels than others? Could these antibodies been there for many years and I’ve not known?

can someone with no antibodies have had hasimotos for years and not know about it?

When you say any illness will affect my thyroid does that mean if I have the flu or a simple cold my TSH could be out of whack until I’m feeling better? Xx

greygoose profile image
greygoose in reply to Amyflood246

Do you mean my TSH could have been lower? I thought that it caused high TSH? sorry if I’m misunderstanding

Well, I'm misunderstanding, now. lol Not sure what you're referring to here.

The TSH level should be the reverse of the thyroid hormone levels - T4 and T3.

If T4/3 are high, TSH will be low. If T4/3 are low, TSH should be high to stimulate the thyroid to make more T4/3. So, if you are hypo, your TSH will be high, and if you're hyper your TSH will be low. But, it doesn't always work out that way with Hashi's, because levels can fluctuate, and the TSH moves much more slowly than the T4/3.

Does the actual hashimotos cause symptoms or is it when it only when your thyroid function becomes abnormal that you get symptoms?

It's the lack of thyroid hormone, T3, that causes symptoms. Hashi's is just the cause of low T3 because it is destroying your thyroid's capacity to make T3.

I have been struggling with infertility for years but my thyroid has only just started going out of range so could I have still been the hashimotos causing this or is it unlikely?

It is highly likely. Hashi's and hypothyroidism in general are often the cause of infertility.

So like I was saying to the other poster who commented, my antibody level doesn’t seem as high as most people so does this mean that I haven’t had hashimotos as long as them or that my case isn’t as severe?

It doesn't mean either of these things.

Look at it this way, you're planning a party and hiring cleaners to clean up the next day. The number of cleaners you need depends on the size of your venue. If you are just having a few people in the front room, you're only going to need one or two cleaners to clean up. But, if you're inviting thousands to the Albert Hall, you're going to need a heck of a lot of cleaners!

Your immune system is having a party in your thyroid. Sometimes it's just a small bash, sometimes it's the whole hog. The antibodies are the cleaners that come along and clean up afterwards. If it was just a small party, you only need a few antibodies. But, if it was a full-on attack, destroying many cells, you're going to need a lot of antibodies to clean up. That's why I said the antibody levels can fluctuate. The fact that there weren't many around the day you had your blood taken doesn't mean that next week there won't be a lot more.

Antibody levels do not reflect the severity of the disease in any way. In fact, Hashi's is Hashi's. One case is no more or less severe than any other.

It's true that over time, antibody levels can decrease. That is because there is less thyroid left to destroy, so the mess after the party requires fewer and fewer cleansers. But, that's looking a long way ahead. If I were you, I would just take it that antibodies have no meaning except to confirm that you do have Hashi's.

Could these antibodies been there for many years and I’ve not known?

Absolutely, yes. It's rare to catch Hashi's in the early stages due to the reluctance of doctors to test and diagnose. And, by the time symptoms of hypo have driven you to the doctors, a lot of damage will have been done. You don't notice the lowering levels of thyroid hormone to begin with because the adrenals take up the slack. So, yes, you could have been hypo for a long time without noticing something was wrong, just putting your increasing symptoms down to advancing age, or stress at work, or something else.

When you say any illness will affect my thyroid does that mean if I have the flu or a simple cold my TSH could be out of whack until I’m feeling better?

Not just your TSH. For complicated reasons I won't go into, illnesses like flu, or even a cold, or a medical intervention or whatever can down-grade your conversion of T4 to T3. That causes your TSH to rise. Once the bug has died off, or your healing is complete, conversion will pick up again, and your T3 will rise, so the TSH will drop.

BUT, this is not your case. Your TSH is rising because you have Hashi's, confirmed by the presence of high antibodies. :)

Amyflood246 profile image
Amyflood246 in reply to greygoose

hi! Sorry for only just getting round to replying so if the hashis could be a likely cause of the infertility how would that work because I thought you only had symptoms once your t3 became out of range?

What’s the likelihood that the hashis won’t progress to complete hypothyroidism? Xx

greygoose profile image
greygoose in reply to Amyflood246

The Hashi's will progress to complete hypothyroidism. There's no doubt about that. What is unknown is how long that will take. Some people get knocked down by a bus or swallowed by a whale before that happens. Others live a quiet, uneventful life and eventually go hypo. I wouldn't say my life has been uneventful, but my thyroid has been completely destroyed by the disease. I have no idea when it started by I wasn't diagnosed - at the age of 55 - until my thyroid was on its last legs. I expect it's completely dead by now.

I thought you only had symptoms once your t3 became out of range?

If only things were that simple. But they aren't. Thyroid problems are very, very complicated because there are so many body systems involved.

Besides, the majority of 'ranges' for T3 are so wide that you can be hypo long before the level drops below the bottom of the range. The problem is, if the FT3 is anywhere within the range, even scraping along the bottom, a doctors will say 'normal, no action' because they do not understand that it is not just about being in-range, it's about where within the range the result falls. So, if the bottom of the range is 3.1, and your level is 3.2, technically it is 'in-range', but you will be hypo and having symptoms. Add to that the fact that everyone is different and will develop symptoms at different levels, and you have a conundrum that doctors decline to unravel, and stick to their blinkered ideas that 'one size fits all'. It doesn't. Hypothyroidism is a very individual disease.

Amyflood246 profile image
Amyflood246 in reply to greygoose

ok I understand you! How come it took so long for you to be diagnosed were your lab results not budging from the ranges? X

greygoose profile image
greygoose in reply to Amyflood246

I was never tested. I was just told I was lazy (fatigue), greedy (weight-gain) and slightly dim (brain-fog). No-one ever thought to test my thyroid until I was 55 - and then it was by mistake! And I didn't even know what a thyroid was, in those days, so couldn't even suggest a test.

Amyflood246 profile image
Amyflood246 in reply to greygoose

I’m kind of going through the same thing at the minute with my b12 deficiency. NHS are telling me it’s anxiety and it’s all in my head, that I just need to loose weight! Even though my b12 was only 190 and NICE guidelines clearly state that anything under 200 is a deficiency and what’s more you can be completely in range with serum b12 and still have a functional b12 deficiency! I have so many neurological symptoms and it has severely impacted my quality of life. I gave up in the end and seen a private specialist and he diagnosed me but I have to admit that I am wondering now that I’ve found out about the hashimotos are some of the symptoms related to that?! Who knows x

greygoose profile image
greygoose in reply to Amyflood246

Low B12 symptoms and hypo symptoms are very similar. And, you can have both at once.

So, is your low B12 being treated now? Have you been tested for Pernicius Anemia?

Amyflood246 profile image
Amyflood246 in reply to greygoose

Yes my instrinsic factor is negative but I believe 40-50% of people don’t have the instrinsic factor antibodies so it is still a possibility! I am being treated for the b12 now with every other day injections. I just do my own as couldn’t keep affording the private script

So my symptoms are-

Cuts in the corners of my mouth… sore tongue… rapid heart rate… breathlessness…. Excessive sweating…. Constantly watery eyes…. Bladder issues…. Muscle twitches…. Muscle weakness…. Body feeling heavy like lead…. Occasional problems swallowing…. Memory loss…. Irritability….. brain fog…. Muscle cramps especially feet…. Occasional involuntary movements like my arm or leg will jerk….. intermittent pins and needles especially if the slightest bit of pressure is applied

Which ones of those could possibly be thyroid? Sorry for picking your brain. I just feel a little stuck now as I won’t know what’s causing what x

jade_s profile image
jade_s in reply to Amyflood246

How are your folate levels ? B12 needs good folate levels to work, and folate deficiency can also lead to neurological symptoms despite well treated B12.

It's always difficult to differentiate between the two. And one can affect the other, so until you've stabilized the B12/folate situation, it may be impossible to tell what's what. For example, when i'm low in folate or b12, thyroid symptoms get very wonky.

Are you keeping a daily symptoms log? Although you're still in the early days of SI, you should hopefully start to notice some small changes / improvements soon.

Amyflood246 profile image
Amyflood246 in reply to jade_s

hi! Yes my folate is at a good level of 37. I take 5mg folic acid daily x

helvella profile image
helvellaAdministratorThyroid UK in reply to Amyflood246

All too many times I have read of people taking 5 milligrams of folic acid daily and feeling terrible on it.

5 milligrams is usually prescribed for people who are definitively low in folate in order to return them to adequate levels. Not for long-term use. (A few might need long-term use of such a product. But not usually.)

Too much folate can cause lots of issues.

Quite a few who have switched from 5 milligrams to, say, 200 or 400 micrograms a day find they improve noticeably.

Amyflood246 profile image
Amyflood246 in reply to helvella

To be honest everytime I stop taking the 5mg my levels plummet to deficient again so it’s a tricky one x

helvella profile image
helvellaAdministratorThyroid UK in reply to Amyflood246

When you stop 5 milligrams do you quit taking any? Or take a lower dose?

Maybe somewhere between 5 milligrams and whatever you take (lower dose or none) you'd find a happy balance point? You wouldn't be the only person who needs a bit more than 200 or 400 micrograms. But I don't notice many who need 5 milligrams forever.

greygoose profile image
greygoose in reply to Amyflood246

Well, all of them could be hypo symptoms. Especially problems swallowing. Thyroid symptoms are non-specific because T3 is needed by every single cell in your body to function correctly. So, if you don't have enough to go round, symptoms can occur anywhere and everywhere, they aren't just limited to the area round your thyroid. When a doctor says that symptoms are 'nothing to do with your thyroid', he's talking rubbish. There's absolutely no way of knowing if a symptoms is due to low thyroid except by taking thyroid hormone and seeing if the symptom goes away. There are no symptoms that are exclusive to hypothyroidism, they could all be caused by 'something else'. But, when you have a whole bunch of them... Which is the most likely scenario: you have 20 diseases with one symptom each? Or you have one disease with 20 symptoms. I know which sounds the most likely to me.

But, it doesn't really matter which is which in this situation. You know you have Hashi's and you know you have deficient B12 - probably Pernicious Anemia, given that you have Hash's, as autoimmune diseases tend to hunt in packs - so you need to treat them both. Well, you will need to treat the hypo eventually. In the meantime, you need to continue working on the B12. When your B12 has improved, the symptoms that are left will more than likely by hypo symptoms.

Amyflood246 profile image
Amyflood246 in reply to greygoose

I have only just see. This reply for some reason! I am sorry! Is there any point me going to the GP with the results from my thyroid panel yet or will they just ignore it? X

greygoose profile image
greygoose in reply to Amyflood246

I'm afraid they will just ignore it at the moment, because they just don't know enough about thyroid to recognise the signs. Your TSH would need to be at least over the top of the ranges for them to take any notice because they believe that the ranges are solid bounderies and that if your result is within the boundery you have to be alright. As I said, they just don't know enough about it to understand.

Amyflood246 profile image
Amyflood246 in reply to greygoose

ok and sorry just one more question! Is it impossible to get your cholesterol down with hashimotos? X

greygoose profile image
greygoose in reply to Amyflood246

Not at all. Raise your FT3 level and the cholesterol will drop.

But, even if it doesn't, high cholesterol is not a disease, it's a symptom. It won't do you any harm. It doesn't cause heart attacks or strokes, as doctors want you to think. They just want to prescribe statins. But statins are not what you need. You need higher FT3.

Amyflood246 profile image
Amyflood246 in reply to greygoose

so even high cholesterol caused by bad lifestyle choices doesn’t cause strokes or heart problems? X

greygoose profile image
greygoose in reply to Amyflood246

Bad life-style choices - if there is even such a thing - does not cause high cholesterol.

Cholesterol is made in the liver. The liver tries to keep the level even so that the more you consume, the less it makes, and the less you consume, the more it makes. But, when T3 is low, the body cannot process cholesterol correctly, and it tends to build up in the blood.

And, on that subject, do not let anyone tell you you should be eating a low/no-fat diet. Cholesterol and fat are two entirely different substances and do not magically turn into each other when consumed. The body needs fat and low-fat diets are dangerous.

jade_s profile image
jade_s in reply to greygoose

What's worse, "low-fat" processed foods often have added sugar/carbs to make up for the lack of flavor. High blood sugar/Diabetes is a well known cause of cardiovascular disease - increasing the risk of heart disease by 2 to 3 times over the general population. The cholesterol naturally floating around just gets caught on the blood vessels already damaged by high blood sugars (or smoking).

diabetes.org.uk/guide-to-di...

heart.org/en/health-topics/...

greygoose profile image
greygoose in reply to jade_s

Well, I don't think it just gets caught. It attaches to the damaged area to fomr a sort of sticking plaster while the woundss heal. When they are healed, it is absorbed into the cells walls, which are made of cholesterol, anyway.

jade_s profile image
jade_s in reply to greygoose

Ah that could very well be, it makes sense! Most sites just gloss over the mechanism. Thank you for the explanation. :)

greygoose profile image
greygoose in reply to jade_s

You're welcome. :)

Amyflood246 profile image
Amyflood246 in reply to greygoose

sorry I’m really confused? But I thought you could lower cholesterol by eating healthy? And I’m not even in full blown hypothyroidism yet so why is my cholesterol high? X

greygoose profile image
greygoose in reply to Amyflood246

As I said, cholesterol levels have little to do with your diet. What is 'eating healthy', anyway? One man's 'healthy' diet would have another man crossing himself with horror! So many people think a 'healthy' diet is low fat. It most certainly isn't. Nor low salt, nor low carb, nor low calorie. The healthy diet is the one that keeps you well, and we're all different when it comes to that. They did some research in Israel some time ago about healthy diets and found that we all have very different needs. Sorry, can't remember the details, but the findings were very interesting.

As for not being 'fullblown hypo', that is just medical tosh! They say that because they don't want to treat you. Doctors hate treating thyroid patients - probably because they know they're out of their depth - and will say and do anything to avoid it. Therefore the medical community has decided it will ignore the ranges for TSH and insist that it be over 10 before they will diagnose, leaving the patient to suffer. And there is absolutely no logic in it or scientific fact in it.

A euthyroid (i.e. no thyroid problems) TSH is around 1. FT4 around mid-range, FT3 slightly lower. TSH is never over 2 in a thyroid-healthy person. And, when it gets to 3, you are hypo. Yours is over 4. Seems pretty 'full-blown' to me. You cannot be a little bit hypo, just like you cannot be a little bit pregnant. Either you are or you aren't.

So, if we look at your FT3 - and, remember, it's the T3 that causes symptoms like high cholesterol - It is 62.16%, is a little on the high side. Your FT4 is only 39.00%. That in itself is abnormal and should tell us there's something going on. The FT4 should be higher than the FT3. But, when the thyroid is failing, for whatever reason, it tends to make more T3 at the expense of the T4, to keep you functioning. T4 being basically a storage hormone that doesn't do very much.

Also, it is taking an absnormal amount of TSH to get your FT3 to that level. Now, when you have a blood test, you are just looking at a snapshot in time. And just because your FT3 was that level on that day doesn't mean it's always that level - especially not with Hashi's, because levels tend to fluctuate. And, if the FT3 drops, it takes time for the TSH to catch up and bring the level of the FT3 up again. Meanwhile, that cholesterol is building up in your blood and gives you a raised level in the blood test.

So, your high cholesterol is not due to the liver making too much, nor is it due to you getting too much in your diet, it's due to the body no-longer being able to get the cholesterol to where it's needed and excrete any excess, etc. because of low T3.

I hope that is understandable, and that I haven't confused you further. :)

By the way, where have you been reading about thyroid? You seem to have absorbed a lot of false ideas.

Amyflood246 profile image
Amyflood246 in reply to greygoose

so having high cholesterol doesn’t cause heart attack/stroke/heart disease? So what does then because I thought that these things were caused by cholesterol narrowing the arteries?

Why is my T3 too high? With what you have just said surely I shouldn’t be getting symptoms until my T3 drops if it’s the low T3 that causes symptoms?

Also I thought hypothyroidism was characterised by high TSH and low T4 not T3?

Before I made this thread I was looking the condition up on google but since posting here I have just been speaking to you about it xx

helvella profile image
helvellaAdministratorThyroid UK in reply to Amyflood246

Cholesterol is quite runny and wouldn't itself block an artery.

There are several ideas including that the plaque builds up due to inflammation in the walls of the blood vessels.

Amyflood246 profile image
Amyflood246 in reply to helvella

so it’s not dangerous to have high cholesterol?

What causes inflammation in the walls of the blood vessels? X

helvella profile image
helvellaAdministratorThyroid UK in reply to Amyflood246

That is a major question. Lots of ideas and suggestions but absolute proofs are simply not yet available.

Note that we only take in a small amount of cholesterol from our diets. Most is made in our own bodies.

Low thyroid hormone levels result in higher cholesterol levels. Treating low thyroid levels usually sees cholesterol go down. Even if high cholesterol isn't quite the demon it has been claimed to be, if it is indicating low thyroid hormone levels then it is the thyroid which needs treatment rather than the cholesterol.

Amyflood246 profile image
Amyflood246 in reply to helvella

but surely it can’t be good for the body to live off fast food and soda? X

helvella profile image
helvellaAdministratorThyroid UK in reply to Amyflood246

I don't quite get why you are asking/saying that?

I basically never consume soda. And rarely eat "fast food" in the senses usually meant (KFC, McDonald's, Domino's, etc.) So I agree it would be wrong to live off that.

Even if your diet has a lot of cholesterol in it, little is absorbed.

But lots of sugar results in production of cholesterol within you.

Amyflood246 profile image
Amyflood246 in reply to helvella

I’m just trying to make sense of it all. I drink a lot of coke and don’t have a great diet. Greygoose said we shouldn’t follow a low fat diet x

helvella profile image
helvellaAdministratorThyroid UK in reply to Amyflood246

Ah - right. Sorry I might have missed some bits as I read through.

I agree with her!

Fat and protein are vital.

All too many low fat products use various starches, gums, low chain substances, in order to approach the mouth feel, taste carrying and body of foods that are not low fat. These are almost certainly all bad to consume - at least every day and in larger quantities.

Do bear in mind that switching from an ordinary diet to low fat can reduce fat intake a huge percentage. Take a simple example of yogurt which might have 5 to 10% fat in standard versions. Low fat might have 0.5 to 1%. So a reduction of fat by 90%. (Indeed some yogurts actually claim a true 0% fat.)

We tend not to do that sort of massive reduction in consumption of other foods/constituents of foods. Carbohydrates and sugar? Protein? Vitamins? Fibre? We'd be very ill if we did.

Amyflood246 profile image
Amyflood246 in reply to helvella

so what would be the best kind of diet to eat?

Also as greygoose was saying when it comes the hypothyroidism it’s the low T3 that causes symptoms but my T3 is no where near low yet so why do I have the high cholesterol and other symptoms? X

helvella profile image
helvellaAdministratorThyroid UK in reply to Amyflood246

I am not a good person to ask - I have my own oddities in what I will and won't eat!

Your FT3 might not be very low within the reference interval, but your TSH is distinctly raised. Which suggests it isn't quite high enough for you.

Amyflood246 profile image
Amyflood246 in reply to helvella

my T3 seems to be right at the top of the reference range though?

And I’m confused because I thought that hypothyroidism was characterised by high TSH and low T4 not low T3? X

helvella profile image
helvellaAdministratorThyroid UK in reply to Amyflood246

To a large extent, T4 is a reservoir. It is the T3 that actually does something.

In many, they see TSH rise and FT4 fall before they feel too bad. The body appears to do everything it can to defend the level of T3 precisely because it is what is important.

That is, it raises TSH to try to make more thyroid hormone. And we see T4 fall. With T3 remaining not too bad.

When it can't achieve that, that is when we see people relatively suddenly become very much worse.

And none of us knows for sure where is best for our T3 level - unless we had a test before having a thyroid issue.

Amyflood246 profile image
Amyflood246 in reply to helvella

so is it possible to be having symptoms with my levels?

I also have a b12 deficiency and I’m starting to think that some of the symptoms that I attributed to that may actually be my thyroid but I just can’t see how when my T3 is the level it is x

helvella profile image
helvellaAdministratorThyroid UK in reply to Amyflood246

I had my first TSH test which returned just over 2 due to symptoms. And had further tests until they accepted I was hypothyroid.

If your TSH had been 1 for years, then went up to 2, that indicates an issue. Going up to 3, 4, 5 - each step further cranks up the severity. And the time for which you have been hypothyroid.

Amyflood246 profile image
Amyflood246 in reply to helvella

so when you had symptoms with a TSH of 2 were your T3 and T4 in normal ranges? X

helvella profile image
helvellaAdministratorThyroid UK in reply to Amyflood246

Like so many, they did not do FT4 or FT3 - so I don't know.

When my TSH went over range, they did FT4 and that was right at the bottom of range.

LucyYoga profile image
LucyYoga in reply to Amyflood246

I agree completely with FancyPants54 . Cut out the junk and sugar and eat a real/wholefood diet- meat, fish, fruit, veg and good fats. Drink water. No-one is going to be/feel well drinking loads of coke and processed junk. You wouldn't put diesel in a petrol car and the same goes for what you fuel your body with.

FancyPants54 profile image
FancyPants54 in reply to LucyYoga

Ah, except, being a side-tracked idiot I have put petrol in my diesel car. Twice!!! And no, it didn't feel well until I had drained it out.

LucyYoga profile image
LucyYoga in reply to FancyPants54

🤣….. I almost put diesel in my petrol car the other day… so I hear you!!

FancyPants54 profile image
FancyPants54 in reply to LucyYoga

Don't do it. It's a very expensive mistake.

FancyPants54 profile image
FancyPants54 in reply to Amyflood246

You certainly shouldn't follow a low fat diet. That's not the problem. Sugar is a major problem and so are artificial sweeteners, but for different reasons. The best thing you could do for yourself diet-wise is to stop drinking lots of Coke, don't swap to the awful artificial sweeteners, just find something else to drink. Water is a good start. And improve your diet by not buying processed foods and instead eating basic meat, veg, fish and fruit which you cook for yourself. That's the best diet.

FancyPants54 profile image
FancyPants54 in reply to Amyflood246

Where did that statement come from?! Of course fast food and soda is a bad diet. But not because it will damage your cholesterol levels. Just because highly processed foods are not what our bodies are designed to eat and make proper use of.

GreyGoose is an excellent explainer of hypothyroidism and she's spot on about cholesterol too. Before the days of blood tests for TSH to diagnose hypothyroidism, doctors diagnosed a patient with hypothyroidism when their cholesterol rose above the normal. It's a very reliable indicator of hypo. Modern doctors haven't been taught this.

I've read all through this thread and I can see a mounting kind of panic in your responses and questions. You need to take a deep breath and not panic. You have Hashimoto's thyroiditis. It's not curable. You wait until you have obvious symptoms or your TSH is consistently out of range and then you start taking replacement hormone. There are issues along the way for some of us. But that's the basics.

If you have struggled with weight and pregnancy and have higher cholesterol, then you have been struggling with a thyroid condition for years probably.

Low fat diets are very harmful to us. Our brain is made up of fats, a high proportion of which are cholesterol. The cholesterol myth has been a major medical scandal over the past 30 years or so. I hope to goodness that one day soon they will acknowledge their mistake and stop prescribing statins to all and sundry. Cholesterol won't cause you to have a heart attack or a stroke. You always need to treat the root of the problem and for you it seems that is thyroid.

Don't google. But I do recommend the book -

amazon.co.uk/Your-Thyroid-H...

It's an excellent primer in thyroid health. It was the second book I read about it all back in the day and it's one of the best to give you a basic good factual understanding.

What you need now is the book and a cup of tea and some time to relax and read it. You can't solve all this at once, so please don't panic. At least you know you have this condition now.

Amyflood246 profile image
Amyflood246 in reply to FancyPants54

Hi thank you, yes I am starting to panic and I can’t seem to make sense of it all. The bit that I’m struggling with is how I have had symptoms for years such as high cholesterol and infertility etc if my T3 is at a good level?

What causes heart attacks and strokes if it’s not high cholesterol?

My sister has no health conditions but she is very overweight and has high cholesterol so what would be the cause in cases like that where there are no underlying medical conditions?

I will definitely purchase that book! Thank you x

FancyPants54 profile image
FancyPants54 in reply to Amyflood246

You don't know what level your free T3 was back then. It will have fluctuated. We can't see in to our past. It's a shame we don't record baselines when well, but we don't.

What causes heart attacks and strokes? That's a huge question with no clear cut answers. All sorts of things cause both. There has been and still is great controversy over the pushing of cholesterol as the root of all evil. Forget about it. It's another worry you don't need. You have to not let doctors gaslight you into doing what they want in every case. They are great at treating infections and mending broken bits. But they are pretty rubbish at hormones of any kind. I first started learning about cholesterol 30 years ago! Long before I became hypo. At that point I decided I wasn't going to worry about it because the evidence just isn't there. My dad had open heart surgery when he was 80. They were discharging him and a consultant was talking to him and checking his medications. He saw that dad had been put on a statin for the first time. He said "what have they given you that for?! You don't need that." and promptly took it off the prescription list.

You won't make sense of it straight away. That's why I said don't panic, don't google but get a nice calming book to sit and read. It will help. You have Hashimoto's. It's not negotiable and you can't cure it. In this day and age it won't kill you. Sometimes people can seem to put it into remission for years with strict diet, but that's not guaranteed. And that needs a very fresh food, home cooked diet. So I'd not worry about that at this stage. But fertility is affected by a poor diet because it's more hormones that can go wrong when not properly nourished.

If your sister also consumes a lot of Coke or fizzy drinks, and eats a highly processed diet with not enough fresh food, or if she over-eats then that can account for the weight. But autoimmune diseases often run in families. I wonder when her thyroid was last properly checked. It might be that she has the same issue as you, she just doesn't know it yet because it hasn't come to the fore.

It took many of us years to learn enough about this subject to be able to help ourselves. The good thing is that with this forum, that experience can be passed on to the new patients so they can get up to speed more quickly. But we are all learning all the time because we are all different.

Amyflood246 profile image
Amyflood246 in reply to FancyPants54

will the book that you have recommended to me explain everything including cholesterol?

I would really like to understand the cholesterol because I’ve always worried that I might have coronary heart disease because mine is high!

I was just saying to a lady on the other thread, how do I know it’s for sure hashimotos because I have been reading that TPO antibodies can be raised in silent painless thyroiditis too so how do I know which category I’m in? X

FancyPants54 profile image
FancyPants54 in reply to Amyflood246

Cholesterol has nothing to do with hypothyroidism apart from if you are hypothyroid your cholesterol level will go up until you are on adequate treatment when it should drop again. The book I recommended is about thyroid issues. If cholesterol is mentioned it will be to say what I and others have told you here. It goes up when you are hypo and drops when you have adequate hormone. It used to be how they diagnosed hypothyroidism, by testing the blood for cholesterol.

You almost certainly do not have coronary heart disease. You are 33 years old! And coronary heart disease is not caused by cholesterol. You don't need to understand the cholesterol issue at this point. You need to relax and learn more about Hashimoto's thyroiditis and how to treat it.

Hashimoto's Thyroiditis, thyroiditis, it's the same thing. UK medical institutions don't usually give it the full title of Hashimoto's. They just call it thyroiditis. It's the Americans who tend to use it's full title. You have an autoimmune condition. You can't change it. It doesn't matter what you call it.

One thing is very clear from this thread and your responses, which are all on the verge of panic, is that you do have hypothyroid symptoms. Anxiety and endless circling worrying about things you don't understand are classic symptoms. Your body is under stress. It's stressing your brain and making it anxious. You need to learn to relax and rest rather than constantly asking the same questions in different places. It won't help you.

Amyflood246 profile image
Amyflood246 in reply to FancyPants54

yes I have severe anxiety which is mainly about my health at the minute because of how dreadful I feel! I also have depression, borderline personality disorder and autism so when you throw physical health in the mix too it gets quite a lot to handle and if I’m completely honest at the moment I’m that drained physically and mentally I don’t want to be here at all just to make it all stop x

SlowDragon profile image
SlowDragonAdministrator

My vitamin levels aren’t too bad at present, I was deficient in vitamin D so I have been working on getting that up and I have been diagnosed with b12 deficiency so I’m on every other day injections for that. Folate is a good level it’s just iron that’s a little low so going to ask for iron tablets. The thing I’m going to struggle with is trying to work out whether I have symptoms from the hashimotos because my b12 deficiency causes horrendous symptoms and I already feel dreadful but now I’m thinking what if some of those symptoms are actually hasimotos? How do I tell?

How low was vitamin D

How much vitamin D are you currently taking

How low was ferritin

Have you had full iron panel test for anaemia

Next step get vitamin D, folate, B12 and ferritin levels retested 2-4 months after working on improving

Plus get coeliac blood test and cholesterol

High cholesterol levels linked to being hypothyroid

A trial of strictly gluten free diet is always worth doing

Only 5% of Hashimoto’s patients test positive for coeliac but a further 81% of Hashimoto’s patients who try gluten free diet find noticeable or significant improvement or find it’s essential

A strictly gluten free diet helps or is essential due to gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and may slowly lower TPO antibodies

While still eating high gluten diet ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first

Assuming test is negative you can immediately go on strictly gluten free diet 

(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially) 

Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse

Approx how old are you?

Amyflood246 profile image
Amyflood246 in reply to SlowDragon

I am 33. vitamin D was 26 and it’s rose to nearly 90, I am taking 10000ui along with magnesium and k2… I take folate and b-complex to support my b12 injection.

I have high cholesterol, I have already had this tested

Have also had celiac tested and I was negative

Yes I’ve had a full iron panel and that is the one I am struggling with to be honest. Because my ferritin is high but I think that is due to inflammation as my ha-CRP is raised at 10. Haemoglobin is fine, It’s just my saturation that is slightly low so don’t know whether to request iron tablets or not. I have included a picture of my iron panel!

Do you know why some people have higher TPO antibodies than others? Mine are quite low at 86 does this mean that I haven’t had hasimotos for long? Xx

Iron
SlowDragon profile image
SlowDragonAdministrator in reply to Amyflood246

Antibodies vary day by day, hour by hour

They are the Hoovers tidying up after an autoimmune attack

Have you also had Thyroglobulin (TG) antibodies tested

Some people with Hashimoto’s only have high TPO, some only have high TG antibodies…..some have both TPO and TG at high levels

It’s also possible to have Hashimoto’s and never have high thyroid antibodies

Generally members find that adopting gluten free/dairy free diet may reduce TPO antibodies over time

Keeping TSH low tends to lower TG antibodies

SlowDragon profile image
SlowDragonAdministrator in reply to Amyflood246

Looks like you are “on the case” sorting vitamins out

Yes Ferritin likely false high if CRP is high

Amyflood246 profile image
Amyflood246 in reply to SlowDragon

yes I have had the other antibodies tested and they are not out of range. Do you think I need iron tablets or not? X

tattybogle profile image
tattybogle

a 'one off' high TSH can be due to all sorts of temporary things ..other illnesses etc. the body naturally adjusts thyroid function when it's ill .so a one off is nothing to worry about ~ which is why GP's always need to retest the TSH after about 3 months before they can consider diagnosing hypothyroidism.

Your raised thyroid peroxidase antibodies indicate that you have autoimmune thyroid disease and therefore are likely to become hypothyroid 'at some point' ... may be decades away .. may be weeks away .. there is no way to tell.

How high the thyroid peroxidase antibodies are has no relation to how long you have had autoimmune thyroid disease . the level of antibodies goes up/ down/ up again etc over time.

TPOab ( Thyroid Peroxidase antibodies) are like 'clean this up please' labels, that are stuck onto any thyroid peroxidase that has been spilled from the thyroid when it has been damaged. we always have a few of them , but if they are raised and raised persistently , then it usually indicates the immune system is gradually damaging the thyroid.

If you see very high levels of TPOab (eg many hundreds /thousands) then it suggests that the thyroid has fairly recently been attacked and a lot of thyroid peroxidase was spilled .

If it hasn't been attacked and damaged 'recently', then you will find a lower TPOab level , but with autoimmune disease , the thyroid has already been damaged , and will be damaged again in the future , so finding lower antibodies at any point doesn't mean your thyroid is any 'better' .

you have no particular reason to be concerned about thyroid cancer .. thyroid cancer doesn't usually cause any hypo or hyper thyroid symptoms, and doesn't usually cause abnormal TSH / fT4 /fT3 results.

if concerned about thyroid cancer, an ultrasound scan to look for nodules that look suspicious is the first way to investigate for it ,(most nodules are harmless)..... ask GP , they can arrange one if they feel any lumps that are concerning .

The TSH is naturally highest around the middle of the night .... it then falls gradually to it's lowest every day between about 1-3pm , then gradually rises again.

So if you test first thing in the morning you will see a slightly higher result than if you tested at lunchtime .

Eating breakfast can lower the TSH in some people , but not all ~this is why we suggest 9 am /fasting test .. so we can get properly comparable results each time , and which show the TSH at it highest point in the 'daytime'

Hope some of that helps a bit :)

Amyflood246 profile image
Amyflood246 in reply to tattybogle

so does that mean that at some point my antibodies could have been the 1000’s and have dropped back down?

Could my TPO antibodies be raised as just one off then they never come back or once it has happened it will be lifelong? Xx

tattybogle profile image
tattybogle in reply to Amyflood246

so does that mean that at some point my antibodies could have been the 1000’s and have dropped back down?

Theoretically yes , but realistically i don't think it's very likely that they were that high ..... i doubt they would go from 1000's to just over range .... but, i wouldn't be surprised if you'd had eg. 100 or 150 at some point previously .

The thing with thyroid antibodies is they are tested so infrequently that we just don't have enough data to know what they are getting up to , either in ourselves, or even from looking at research because they haven't got enough data for doing large long term population studies antibodies either, because the doctors so rarely test them.

i had >3000 20 yrs ago when i was diagnosed hypo and and prescribed levo ......then about 5 yrs ago i had 195 ~ i assume they got less over time (with presumably some up's and down's along the way) because over time i've probably got less healthy thyroid gland left now to be attacked . so less thyroid peroxidase to get spilled .. and as a result, i then get less TPOab.

But of course i don't know because i've never had an ultrasound of my thyroid, so no idea how damaged it actually was / is now .. because they don't so ultrasound unless you've got a lump ,,,, and most of us don't , so again~ not enough data collected for anyone to learn anything.

i assume we all had autoimmune disease starting to attack our thyroid for a long time before we noticed any problems with hypothyroid symptoms .. eg it's possible if you had difficulty conceiving. that could be an early symptom of you developing slightly lower thyroid hormone levels as a result of some damage starting to happen to the thyroid .. just a guess though .. but you'll never know for sure .

al you know is you have more than a normal amount of antibodies that show something (usually your autoimmune system ) has damaged your thyroid .... and some symptoms that made someone keep checking your thyroid hormone levels for a few yrs ... and now your TSH has gone up .. all of which is exactly what you'd expect to see in the early yrs of the autoimmune system damaging a thyroid.

But you have to wait to see if your TSH does actually stay high/ go higher .. or if it goes lower again.

GP's won't consider starting replacement thyroid hormones unless TSH remains over range at a repeat test in a few months time

Amyflood246 profile image
Amyflood246 in reply to tattybogle

thank you! So if it’s not my immune system attacking my thyroid what else could it be? X

tattybogle profile image
tattybogle in reply to Amyflood246

it almost certainly IS your immune system attacking your thyroid ... i'm not aware of any other definite causes of raised thyroid peroxidase antibodies ...

i suppose it's possible you may get a temporary rise in them after a strangulation type injury / seat belt in car accident etc .. but have no idea if that is true, i'm just guessing

I'm off out for the rest of the day ...., but if you're interested in understanding antibodies start here :

thyroidpatients.ca/2020/04/... the-spectrum-of-thyroid-autoimmunity/

healthunlocked.com/thyroidu... different-varieties-of-hashimotos-every-thing-you-ever-wanted-to-know-about-antibodies-lots-youll-never-get-your-head-round

sciencedirect.com/topics/im... immunology-and-microbiology/thyroid-peroxidase-antibody

Amyflood246 profile image
Amyflood246 in reply to tattybogle

thank you very much. I will have a read through those x

tattybogle profile image
tattybogle

tagging greygoose so she sees your reply .:)

you replied 'to yourself' there ~ you need to use the reply box directly underneath the comment you want to reply to if you want that person to get an 'alert' other wise they may not notice that you have replied .

Amyflood246 profile image
Amyflood246 in reply to tattybogle

thank you! I don’t know what I’m doing haha xx

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