Normal TSH, Positive TPOAb and above range Ferr... - Thyroid UK

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Normal TSH, Positive TPOAb and above range Ferriitin

Wwwdot profile image
9 Replies

Hi Guys

I am new to this forum as PA was my first home!

I spotted B12D neurological symptoms in hubby, got him checked and B12 was 201 ng/L [145-914 ng/L]. Saw consultant and he is now on SI B12 for one year.

During blood tests, his:

TSH was normal 2.02 mu/L [0.38-5.33]

TPOAb was 188.86 IU/mL [Negative = <50]

Ferritin 394 ug/L [25-300]

Prior to blood tests he was not on any supplements so no idea why iron so high.

He does take dispersible asprin, Ramipril, Lansoprazole and Atorvastatin since 2018 when he had two stents fitted.

The Consultant says that high thyroid peroxidase antibodies (TPOAb) show he has auto-immune disease and that the auto-antibodies can attack the thyroid and also the stomach (causing B12 deficiency).

Hubby has had no thyroid issues in the past. I thought the 5 years on Lansoprazole was the culprit.

Went onto btf-thyroid.org/thyroid-ant... and I am more confused now because it says

"It is possible to test positive for thyroid antibodies without having thyroid disease".

It goes on to give examples where

TSH is low and TPOAb is positive, and

TSH is high and TPOAb is positive

but I cannot find anything where

TSH is normal and TPOAb is positive.

Please can anyone shed any light or point me towards more information?

Thank you in advance

🤗🤗🤗🤗🤗

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9 Replies
PurpleNails profile image
PurpleNailsAdministrator

Welcome to thyroid forum.

Assume you mean TSH (thyroid stimulating hormone) not (FSH Follicle-stimulating hormone?)

The TSH is a pituitary hormone which signal thyroid to produce, it’s assumed when the TSH is in range so are thyroid hormones but that’s not always the case.

You husband need FT4 & FT3 the free thyroxine & triiodothyronine. The auctual thyroid hormones tested.

Antibodies are cleaning up substances from thyroid which shouldn’t be released into body and it occurs after a autoimmune attack. but positive antibodies levels show it’s occurring not how long ago or how severe - so it possible to have positive antibodies but for the thyroid to still be functioning at a sufficient level -without testing FT4 & FT3 the function should be assumed based on TSH.

High ferritin can be a sign of inflammation. Might be good to Test CRP.

Many use private options as NHS do not test further if TSH in range.

lots of information here

thyroiduk.org/if-you-are-hy...

Wwwdot profile image
Wwwdot in reply toPurpleNails

Thank you corrected - no idea where FSH came from 🤦‍♀️

🤗🤗🤗

helvella profile image
helvellaAdministrator

My own contribution is my blog - and its pages and onward links to other of my own documents. More a way of finding things out than reading up!

helvella.blogspot.com/

Many wander through this page - and the linked document. To see what is available.

helvella's Links and References document contains many links to other organisations

A single document containing numerous links to relevant websites. With a focus on the UK it nonetheless includes many non-UK sites.

Rather than a simple list of links, there is a page (or more) per site. This is intended to provide some flavour of the site before you decide whether to visit.

helvella.blogspot.com/p/hel...

One site many find helpful is thyroidpatients.ca/

Pretty much one person has assembled many pages of detailed and well-researched information.

At this point, EVERYTHING is overwhelming. Don't be afraid to ask questions.

Wwwdot profile image
Wwwdot in reply tohelvella

Helvella

Or should I say Helluva thank you.

Completely and utterly overwhelmed at the moment.

But small mouthfuls- only way to eat an elephant!

🤗🤗🤗🤗🤗

greygoose profile image
greygoose

It goes on to give examples where

TSH is low and TPOAb is positive, and

TSH is high and TPOAb is positive

but I cannot find anything where

TSH is normal and TPOAb is positive.

If TSH is going up and down, at some point it has to go through 'normal' on it's way - and sometimes it even stays there for a while. But, that has nothing to do with the antibodies. There is no direct link. The antibodies just tell you that the cause of the thyroid problem is autoimmune.

Wwwdot profile image
Wwwdot

Greygoose

Thank you.

So basically TPOAb indicates a problem of autoimmune attack which is persistent.

TSH is a snap shot of the status quo of the attack at this moment in time.

So at the moment the Thyroid is able to achieve “business as usual”.

But in time, Thyroid will reduce in strength and autoimmune attack will win.

Is that a fair summary?

🤗🤗🤗

Is that is?

SlowDragon profile image
SlowDragonAdministrator

in reply to your comments on another post …..rather than hijack their post I have replied here

His ferritin was above range about 400 ish.

Ferritin range for men is typically 15-400

Get full iron panel test to see if iron is high too

Inflammation because of Hashimoto’s could be causing high ferritin

Iron may be normal/low

He is on B12 and Folic acid.

Retest at least annually

We usually recommend taking daily vitamin B complex rather than just folate

Low stomach acid can be a common hypothyroid issue

Thousands of posts on here about low stomach acid

healthunlocked.com/search/p...

Web links re low stomach acid and reflux and hypothyroidism

nutritionjersey.com/high-or...

stopthethyroidmadness.com/s...

thyroidpharmacist.com/artic...

How to test your stomach acid levels

healthygut.com/articles/3-t...

meraki-nutrition.co.uk/indi...

huffingtonpost.co.uk/laura-...

lispine.com/blog/10-telling...

Useful post and recipe book

healthunlocked.com/thyroidu...

Ppi Like Lansoprazole or Omeprazole will lower vitamin levels further

gov.uk/drug-safety-update/p...

webmd.com/heartburn-gerd/ne...

pharmacytimes.com/publicati...

PPI and increased risk T2 diabetes

gut.bmj.com/content/early/2...

Iron Deficiency and PPI

medpagetoday.com/resource-c...

futurity.org/anemia-proton-...

onlinelibrary.wiley.com/doi...

sciencedirect.com/science/a...

Interesting about celiac as I have taken him off bread and pasta and replaced with gluten free and he has less acid reflux and feels better.

Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels

Low vitamin levels affect Thyroid hormone working

Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances.

Most common by far is gluten. Dairy is second most common.

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

Ideally……While he was still eating high gluten diet GP should have done coeliac blood test first …..but not worth going back on gluten just to test

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

thyroidpharmacist.com/artic...

drknews.com/changing-your-d...

Non Coeliac Gluten sensitivity (NCGS) and autoimmune disease

pubmed.ncbi.nlm.nih.gov/296...

The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported

nuclmed.gr/wp/wp-content/up...

In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned

restartmed.com/hashimotos-g...

Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.

Similarly few months later consider trying dairy free too. Approx 50-60% find dairy free beneficial

Hashimoto’s and leaky gut often occur together

Post discussing gluten

healthunlocked.com/thyroidu...

Wwwdot profile image
Wwwdot in reply toSlowDragon

Slowdragon

How can I ever thank you ???

Thank you a millions times for your kindness. I will read and digest. Thank you again. M

🤗🤗🤗🤗🤗🤗🤗🤗🤗🤗🤗🤗🤗🤗🤗😂

SlowDragon profile image
SlowDragonAdministrator

Forgot to add about vitamin B complex

Low folate

As he’s on B12 injections it’s recommended also to supplement a good quality daily vitamin B complex, one with folate in (not folic acid)

This can help keep all B vitamins in balance

Difference between folate and folic acid

healthline.com/nutrition/fo...

Many Hashimoto’s patients have MTHFR gene variation and can have trouble processing folic acid.

thyroidpharmacist.com/artic...

B vitamins best taken after breakfast

Thorne Basic B recommended vitamin B complex that contains folate, but they are large capsules. (You can tip powder out if can’t swallow capsule)

Thorne currently difficult to find at reasonable price, should be around £20-£25. iherb.com often have in stock. Or try ebay

Other options

healthunlocked.com/thyroidu....

personally I prefer Igennus Vitamin B complex. Nice small tablets. Full dose is 2 tablets per day. Most people are fine with just single tablet

igennus.com/products/super-...

But many people find Igennus don’t give high enough results. I usually alternate between Thorne and Igennus

IMPORTANT......If taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

In week before blood test, when he stops vitamin B complex, might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg)

Post discussing how biotin can affect test results

healthunlocked.com/thyroidu...

if stopping B12 injections could try daily B12 supplement instead

If serum B12 result is below 500, (Or active B12 below 70) recommended to be taking a separate daily B12 supplement and a separate daily vitamin B Complex 

If serum B12 is over 500 (or Active B12 level has reached 70), may be able to reduce then stop the B12 and just carry on with the B Complex.

If Vegetarian or vegan likely to need ongoing separate B12 few times a week

Highly effective B12 drops

natureprovides.com/products...

B12 range in U.K. is too wide

Interesting that in this research B12 below 400 is considered inadequate

healthunlocked.com/thyroidu...

Low B12 symptoms

b12deficiency.info/signs-an...

methyl-life.com/blogs/defic...

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