Hi, I’ve been on levothyroxine since I was a teenager. I’m now 41and currently on 125mg. About 10 years ago I developed a goiter which had got much larger this past year. My latest blood test shows se thyroid peroxide of 600, tsh 0.46, t4 18.8, tsh 1.1.
My gp is saying this is all ok but from all the research I’ve done the thyroid peroxide is far too high. I was also diagnosed with fibromyalgia about 20 years ago but I’ve never felt this diagnosis fit and wondering if it’s more an autoimmune thyroid issue. I’m just wondering if anyone has any advice?
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Sarah2409
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Can you recheck your results and add reference range for each test? This is important as ranges differ between labs. You have 2 TSH results.
Antibodies dont actually cause symptoms as such. They are the result of an autoimmune attack on your thyroid. They will naturally fluctuate from high to low possibly for the rest of your life.
Many with autoimmune thyroid disease aka Hashimoto's benefit from a gluten free diet. A smaller percentage of those also need to remove dairy from their diet to feel well. These are intolerances and will not show up on any blood test.
So that our thyroid hormone works well we need to have OPTIMAL vitamin levels. Most hypo people have low or even deficient vitamin levels.
When hypo we get low stomach acid which means we cannot absorb vitamins well from our food, regardless of a great diet. For thyroid hormone to work well we need OPTIMAL levels of vitamins.
Have you recently or could you ask your GP to test levels of ferritin, folate, B12 & D3? Private tests are available, see link for companies offering private blood tests & discount codes, some offer a blood draw service at an extra cost. thyroiduk.org/testing/priva...
There is also a new company offering walk in& mail order blood tests in London, Kent, Sussex & Surrey areas. Check to see if there is a blood test company near you. onedaytests.com/products/ul...
Only do private tests on a Monday or Tuesday to avoid postal delays.
It's ideal if you can always get the same brand of levo at every prescription. You can do this by getting GP to write the brand you prefer in the first line of the prescription. Many people find that different brands are not interchangeable.
Always take Levo on an empty stomach an hour away from food or caffeine containing drinks & other meds. Many people find taking it at bedtime works well for them.
Do you do tests as per the protocol recommended here?
Recommended blood test protocol: Test at 9am (or as close as possible), fasting, last levo dose 24hrs before the blood draw & no biotin containing supplements for 3-7 days (Biotin can interfere with thyroid blood results as it is used in the testing process).
Testing like this gives consistency in your results and will show stable blood levels of hormone and highest TSH which varies throughout the day. Taking Levo/T3 just prior to blood draw can show a falsely elevated result and your GP/Endo might change your dose incorrectly as a result.
If your TPO antibodies are that high, plus a goitre, you undoubtedly have Hashi's - aka Autoimmune Thyroiditis. Unfortunately, doctors know nothing about Hashi's and do not understand the significance of high antibodies, so just ignore him.
There's not much you can do about Hashi's, but don't worry about the level of the antibodies, they are positive for Hashi's and that's all you need to know. The actual level is irrelevant. They fluctuate all the time.
The only 'treatment' for Hashi's is thyroid hormone replacement (levo) and you're already on that. Question is: are you taking enough? Doctors tend to rely solely on TSH for dosing, but that is totally the wrong way to do it. The FT3 is the most important number and they don't even test that! Your TSH is saying that your dose is adequate, but the TSH is often wrong. However, I can't comment on the FT4 because you haven't given the range. Please, always give ranges because they vary from lab to lab.
ESSENTIAL to regularly test and maintain GOOD vitamin levels
What vitamin supplements are you taking
When were vitamin levels last tested
Also if not already on gluten free diet
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
While still eating high gluten diet ask GP for coeliac blood test first as per NICE Guidelines
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
With loads of vegan dairy alternatives these days it’s not as difficult as in the past
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