Gluten and antibodies

[redsquirrel68]

Thanks to the feedback here on my first post previously( posted as twodogas), I finally have an endocrinologist booked in next week. I’ve yet to be diagnosed officially but from my lab tests and feedback I’ve received, it appears I may have hashimoto Hypothyrodism.

I posted my first test results from August here previously. Few days ago, I did a second test just to have a snapshot before my doctor’s appointment and my results are the following, ref ranges in brackets:

FT3: 2.52 to 3.85 (3.1-6.8 pg/ml)

FT4: 12.87 to 15.6 (12-22 pmol/l)

TSH: 18.1 to 6.272 (0.55-4.78 uIU/ml)

TgAb: 344 to 286 (0-115 IU/ml)

TPOAb: 535 to >1300 (0-60 IU/ml)

I’m not on any medication and there are no changes made between the 2 tests. I’m on the same supplements throughout which is vitamin D, magnesium, zinc, selenium. Results for these are all mid range and my B12 and iron are on upper range as I’m on a high fat/protein low carb diet. I stopped my supplements 2 days before blood drawn for both tests. The only difference I noticed when I did my second test, I was inflammed from gluten as I’ve just returned from holiday. I discovered I was gluten intolerant only a few months ago and whilst going low carb was easy for me, the gluten free learning curve is more complicated!

Does anyone know if gluten inflammation can trigger antibodies the way mine spiked and what could cause my TSH to drop? Not even sure if I still have Hashimoto and hypo or if I’m suffering from something else. Any thoughts are appreciated, as I’d like to have some background before seeing the endocrinologist next week. Many thanks again.

[greygoose]

If you have an over-range antibody test it means you have Hashi's. And Hashi's doesn't go away, so yes, you still have it. And with Hashi's all levels can - and do - fluctuate due to the nature of the disease.

Antibodies tend to rise during/just after an immune system attack on the thyroid, when they come along in force to clean up the blood. And having an attack would explain the rise in your thyroid hormone levels. You don't need to do anything or change anything for this to happen. It just happens.

[redsquirrel68 in reply to greygoose]

Thank you for writing so quickly and clarifying hashimoto attack. Still trying to understand better and can’t seem to find any NICE guidelines ( especially on the October revision) on hashimoto thyroiditis. Is there one?

[greygoose in reply to redsquirrel68]

I'm afraid I don't know. But probably not as the NHS doesn't understand Hashi's.

[redsquirrel68]

Thank you. Could the elevated TSH from my first test be indicative of higher gluten in my diet and subsequently when I went gluten free, the lower gluten in my system could have dropped the level? Apologies if my question seem silly. I’m just so confused even with published studies that appear to conflict with what I experience. I’ve just come across a pubmed study which casts doubt over if gluten free diet is necessary for hashimoto sufferers thus my post. Do you know if NICE has any guidelines for hashimoto? The other abnormality I noticed from my lab is transferin which is not a normal bio marker mentioned in the group. On both tests, my transferin is 1.5 and 1.6 (ref range 2-3.6g/l). Not sure if there is any relevance to thyroid or could be just because my iron is on the high side.

[tattybogle]

hi redsquirrel .. no .... the NHs does not have any guidelines on hashimoto's

they mention checking TPOab ( Thyroid Peroxidase antibodies) in relation to diagnosing/ treating subclinical hypothyroidism ....they accept that high TPOab means patient is more likely to go on to develop 'overt' hypothyroidism at some point .

(they are more likely to start treatment for subclinical hypothyroidism if TPOab are over range.... as it gives them confidence it is a lifelong condition that will need treatment at some point anyway.

the NHS rarely use the term 'hashimoto's '.... it is usually referred to as 'autoimmune hypothyroidism' ... or quite often just 'hypothyroidism' (since the vast majority of hypothyroidism they deal with is caused by this)

( 'subclinical' hypothyroidism is when TSH is raised but fT4 is still within range.

'overt' hypothyroidism is when TSH is raised and fT4 has fallen below range)

[redsquirrel68 in reply to tattybogle]

Thank you tattybogle. That’s very helpful to know that it’s not a commonly used term with nhs. I will reword my Google search and try to understand this better.