TPO result.

[11Ananke11]

Hi, according to my test results, I have raised TPO antibodies.

Thyroid Peroxidase Antibodies 99.7 kIU/L 0 - 34

Am I right in thinking this is potentially indicating Autoimmune/Hashimoto's?

Thanks

[TiggerMe Ambassador]

Yep!

[11Ananke11 in reply to TiggerMe]

Thanks Eeyore

[SlowDragon Administrator]

High thyroid antibodies confirms autoimmune thyroid disease,

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.

In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)

Results from previous post

I am not medicated yet and my GP has no intention of prescribing Levothyroxine until my T4 drops more, even although it is hanging around at the lowest "within range". TSH was 6.9 last week down from 9.8 previously.

With 2 test with TSH over range, and high thyroid antibodies and symptoms you should be started on levothyroxine

Standard starter dose is 50mcg

Starting levothyroxine - flow chart

gps.northcentrallondonccg.n...

Hopefully you have stopped all iodine/kelp supplements as this will make Hashimoto’s worse

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease

ESSENTIAL to get vitamin D, folate, B12 and ferritin levels tested

Plus coeliac blood test

nice.org.uk/guidance/ng20/c...

Make appointment with different GP

[11Ananke11]

Thanks SlowDragon, your advice is appreciated.

I stopped the Sea Kelp and Ashwagandha immediately when you said, then stopped everything else two weeks before having a Medichecks test done a few days ago.

I've now re-started D3, K2 and B12 along with Zinc, Selenium and CoQ10.

Unfortunately the Folate test didn't work.

I've been gluten free for over 6 months, a Coeliac test would require me to start eating gluten for at least 6 weeks prior to a test. I'm not sure I want to do that.

I have seen two GPs in the same practice since my first test both are sticking to the "test again in one year". I did think at one point that it might be NHS Scotland's guidance but I'm not sure. I will hopefully be moving surgery in the near future but the locals don't rate this one very highly according to social media and these doctors may say the same thing so I don't know what to do for the best. I have some Tiromel here and I was considering taking a quarter tablet (6.25mcg) per day for a while to see how I feel but maybe I should try to buy some Levothyroxine instead.

text

[SlowDragon Administrator in reply to 11Ananke11]

Is this your first test with TSH over range?

Take results into GP

with two NHS tests with TSH over range or over 5, and high thyroid antibodies, and symptoms you should be started on levothyroxine

Starting levothyroxine - flow chart

gps.northcentrallondonccg.n...

Vitamin D is far too low

What dose vitamin D have you been taking

Only stop vitamin D day before test in future

Never START on T3

A) your results clearly show you are hypothyroid and should be treated on NHS

B) ALWAYS start on levothyroxine - standard STARTER dose is 50mcg and increase dose slowly up in 25mcg steps (retesting 6-10 weeks after each dose increase)

until on full replacement dose ……guidelines suggest for most people that’s around 1.6mcg Levo per kilo of your weight per day

…..once Levo dose is fine tuned, all four vitamins at optimal levels …..if after 3-4 months Ft3 remains low ……then if may be time to consider adding T3 …..but not sooner

Your ferritin is too high…..probably because you were supplementing without testing first

[11Ananke11 in reply to SlowDragon]

*Is this your first test with TSH over range?*

No, this is a test I had done last week by Medichecks. Before this I had 3 NHS tests 2 over range, one they didn't tell me the results, it was in between the other 2 tests so I would assume it was over range too.

*What dose vitamin D have you been taking* - 4000IU daily. I only have a week's worth left and need to buy more, should I stick with this strength?

*ALWAYS start on levothyroxine* - I'll see if I can get a hold of some.

Once again, thank you so much for taking the time to help me, I really appreciate it.

[SlowDragon Administrator in reply to 11Ananke11]

I would STRONGLY recommend you see different NHS GP or go see endocrinologist and get official diagnosis

It will be far, far cheaper in long run

[SlowDragon Administrator in reply to 11Ananke11]

List of thyroid specialists and endocrinologists

healthunlocked.com/thyroidu...

[SlowDragon Administrator in reply to 11Ananke11]

What dose vitamin D have you been taking* - 4000IU daily. I only have a week's worth left and need to buy more, should I stick with this strength?

with Hashimoto’s, improving to around 80nmol or 100nmol by self supplementing may be better

pubmed.ncbi.nlm.nih.gov/218...

vitamindsociety.org/pdf/Vit...

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Test twice yearly via NHS private testing service when supplementing

vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function.

There’s a version made that also contains vitamin K2 Mk7.

One spray = 1000iu

amazon.co.uk/BetterYou-Dlux...

It’s trial and error what dose we need, with thyroid issues we frequently need higher dose than average

Vitamin D and thyroid disease

grassrootshealth.net/blog/t...

Vitamin D may prevent Autoimmune disease

newscientist.com/article/23...

Web links about taking important cofactors - magnesium and Vit K2-MK7

Magnesium best taken in the afternoon or evening, but must be four hours away from levothyroxine

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Interesting article by Dr Malcolm Kendrick on magnesium

drmalcolmkendrick.org/categ...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

[11Ananke11 in reply to SlowDragon]

I'll go and work my way through those links SlowDragon, you certainly go above and beyond. Thank you.

[11Ananke11 in reply to SlowDragon]

Better you D K2 MK7 spray ordered

Interesting article by Dr Malcolm Kendrick on magnesium That was a great read.

Is there a particular type of Magnesium that is more suitable than the others?

I've also ordered some Levothyroxine and plan on taking 50mcg then doing another private test again in 10 weeks. This is not a sustainable route for me at all but if I can get myself through until the next NHS test I'll hopefully be registered with a different GP and will get it on prescription.

[SlowDragon Administrator in reply to 11Ananke11]

Do NOT start Levo or you will never get diagnosed

TSH would drop and they won’t ever diagnose you

Get vitamin levels optimal and get new thyroid test via new GP

Book early morning test, ideally just before 9am, only drink water between waking and test

Stop any supplements that contain biotin 5-7 days before test

Magnesium

If you suffer constipation, calm vitality magnesium powder is calming improves sleep too

Alternative

Thorne Magnesium citramate - large capsules. Empty powder into small glass water and drink.

[11Ananke11 in reply to SlowDragon]

Ah I see, so TSH would not rise again if I stopped taking Levo before the test?

[tattybogle in reply to 11Ananke11]

if you take levo for a while , then stop, the TSH would eventually rise again .. but you are talking 6- 8 wks minimum, more likely 6-8 months , and possibly a couple of years ..there's no way to know for sure.

if you already have 2 over-range TSH result with NHS , then you are already in a position to get an official diagnosis (and levo) on the NHS ... some GP's may want to wait until TSH is over 10 . but they ARE allowed to prescribe a trial of levo with 2 TSH over range but under 10 when symptoms of hypothyroidism are causing problems .and especially if TPOab are positive

I strongly suggest you ask GP's to follow guidelines below and push hard for 'trial' of levo since your TSH is now over 9

Taking self sourced levo before getting an NHS diagnosis will put a spanner in the works.... you would then have to make yourself unwell again, potentially for a very long time, in order to get an NHS diagnosis .

NHS guidelines: nice.org.uk/guidance/ng145/...

(NHS define 'sub clinical hypothyroidism' as TSH over range while fT4 is still in range)

"1.5 Managing and monitoring subclinical hypothyroidism

Tests for people with confirmed subclinical hypothyroidism

Adults

1.5.1Consider measuring TPOAbs for adults with TSH levels above the reference range, but do not repeat TPOAbs testing.

Treating subclinical hypothyroidism

1.5.2When discussing whether or not to start treatment for subclinical hypothyroidism, take into account features that might suggest underlying thyroid disease, such as symptoms of hypothyroidism, previous radioactive iodine treatment or thyroid surgery, or raised levels of thyroid autoantibodies.

Adults

1.5.3Consider levothyroxine for adults with subclinical hypothyroidism who have a TSH of 10 mlU/litre or higher on 2 separate occasions 3 months apart. Follow the recommendations in section 1.4 on follow-up and monitoring of hypothyroidism.

1.5.4 Consider a 6-month trial of levothyroxine for adults under 65 with subclinical hypothyroidism who have:

a TSH above the reference range but lower than 10 mlU/litre on 2 separate occasions 3 months apart, and

symptoms of hypothyroidism.

If symptoms do not improve after starting levothyroxine, re-measure TSH and if the level remains raised, adjust the dose. If symptoms persist when serum TSH is within the reference range, consider stopping levothyroxine and follow the recommendations on monitoring untreated subclinical hypothyroidism and monitoring after stopping treatment."

[11Ananke11 in reply to tattybogle]

Thanks for clearing that up for me tatty.

[Gingernut44]

I’m replying to you as SlowDragon wont know you’ve replied to her as you didn’t tap the blue reply button under her response, instead you replied to yourself !!

[11Ananke11 in reply to Gingernut44]

Thanks so much Gingernut, I often do talk to myself 😜

[dexter1973]

I was diagnosed with Hashimoto after a TPO test. results, THYROID PEROXIDASE ANTIBODIEs 498High