I had a thyroid blood test. While my tsh and t4 are within range (t3 borderline low) as I am for 7 months now on Levotyroxine that appears to work.The anti-tg antibodies are now high (at 570 IU/ml) and it is first time that they were tested.
I do not know how long I had the antibodies as my symptoms presented years ago, while tsh showed as normal.
Could that be hereditery meaning I was always predisposed to have tyroid issues? If so, how likely is the chance of first degree relatives to have it?
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I do not know how long I had the antibodies as my symptoms presented years ago, while tsh showed as normal.
Antibodies don't cause symptoms. Neither does the TSH. But antibodies would have been present long before the symptoms started because the antibodies are a sign that damage is being don't to your thyroid.
Autoimmune thyroiditis is a disease where the immune system mistakes the thyroid for the enemy and starts attacking it. Slowly, but surely it destroys the thyroid. At first, the thyroid can cope by increasing out-put by what is left of it. Then when that becomes difficult, the adrenals take over. So, it's a while before we actually even notice the symptoms, except mildly, and then we put them down to something else.
By the time our symptoms drive us to consult a doctor, we've probably been hypo for quite some time. But blood tests are a matter of pot-luck because with AIT, levels can jump around a lot. So, the hypo might not show up in bloods on that particular test - especially if the GP only tests TSH! TSH moves more slowly that the Frees, so it can look 'normal' - i.e. somewhere within the range, any-old-where will do as far as the GP is concerned - but the Frees could be low. And it's T3 that causes symptoms. Not the TSH. So, it can be very, very hard to get diagnosed. And, even if they do test antibodies - which they rarely do - and the antibodies are high - which they aren't always because they fluctuate all the time - doctors tend to dismiss them as of no importance.
So, take all these factors together and you can see why it's impossible to even guess how long you've had AIT except to say: it's been longer than you think!
As for your question about predisposed and other members of the family having it, the answer is: yes and no. It can be hereditary, sure, and other members of the family should get checked. But, there are other things that can trigger it in people with not family history of AIT, such as excess iodine for example. But you can't always know what it was.
Could that be hereditery meaning I was always predisposed to have tyroid issues? If so, how likely is the chance of first degree relatives to have it?
possibly, but not necessarily. Also sorts of things can trigger Hashimoto’s……such as glandular fever (EBV), Yersinia enterocolitica, H Pylori, smoking, etc etc
On levothyroxine when adequately treated TSH will be low, Ft4 towards top of range and Ft3 at least 50-60% through range
While my tsh and t4 are within range (t3 borderline low)
How much levothyroxine are you taking
Your comment suggests you are ready for next increase in dose
If Ft3 is low, highly likely vitamin levels may be low
You need vitamin D, folate, ferritin and B12 testing at least annually and maintain OPTIMAL levels by supplementing
Guidelines of dose Levo by weight
approx how much do you weigh in kilo
Even if we frequently start on only 50mcg, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or near full replacement dose
In the majority of patients 50-100 μg thyroxine can be used as the starting dose. Alterations in dose are achieved by using 25-50 μg increments and adequacy of the new dose can be confirmed by repeat measurement of TSH after 2-3 months.
The majority of patients will be clinically euthyroid with a ‘normal’ TSH and having thyroxine replacement in the range 75-150 μg/day (1.6ug/Kg on average).
The recommended approach is to titrate thyroxine therapy against the TSH concentration whilst assessing clinical well-being. The target is a serum TSH within the reference range.
……The primary target of thyroxine replacement therapy is to make the patient feel well and to achieve a serum TSH that is within the reference range. The corresponding FT4 will be within or slightly above its reference range.
The minimum period to achieve stable concentrations after a change in dose of thyroxine is two months and thyroid function tests should not normally be requested before this period has elapsed.
TSH should be under 2 as an absolute maximum when on levothyroxine
If symptoms of hypothyroidism persist despite normalisation of TSH, the dose of levothyroxine can be titrated further to place the TSH in the lower part of the reference range or even slightly below (i.e., TSH: 0.1–2.0 mU/L), but avoiding TSH < 0.1 mU/L. Use of alternate day dosing of different levothyroxine strengths may be needed to achieve this (e.g., 100 mcg for 4 days; 125 mcg for 3 days weekly).
Thank you for the information. So much to learn! I am on 100 μg/day x 5 days a week. Weight is 62kg.Vitamin D and ferritin are never optimal. I take 4000 a day (betteryou) and somehow it is stil low. B12 within range but not very high.
Poor sleep associated with being under medicated/poor conversion of Ft4 to Ft3
Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime and therefore may improve your sleep
No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.
Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away
(Time gap doesn't apply to Vitamin D mouth spray)
If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test
If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal
Thank you its very helpful.As for the dose, it is recommended by endo specialist reviewing my results. I can tell my sleep has slighly improved but can be better. I will follow your advice before my next test xx
I would look at reducing your anti-bodies if possible with diet & lifestyle choices. You will suffer further thyroid glad destruction with high levels of TPOab & TGab and your current Levothyroxine intake may have to increase over time.
No she won't. It's not the TPO/Tg antibodies doing they destroying. They just come along to clean up the blood after an attack by the immune system. TPO/Tg antibodies are the result of the disease, not the cause, and diet and life-style choices have nothing to do with it.
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