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.
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.
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.
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.
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
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
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
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
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
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
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
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TSH \"Normal\" F****** Range!
Low FT4 - FT3 and TSH in normal range
Over range FT4 and normal TSH (no medication) 
High TSH~normal range Free T3, T4
