My name is Liz. I would very much appreciate some help.
I have had Hashimoto's for 10 years. I don't have medication currently. I don't have flare ups that frequently (maybe every 3 months) so it has been ok, I can live around it, but I have having a very bad flare up that has lasted 3 weeks. I have the possibility of medication arranged but I am having a deep think based on recent results.
I had a blood test last week. and got these results.:
TSH: 8.65 (high above 5.5)
FreeT4: 17.8 (optimal 11.9 to 21.6)
FreeT3: 6.97 (high above 6.8)
AntiThyroid Peroxidase antibodies: over 600 (high over 34)
My symptoms are very hypothyroid.
i am exhausted. My body temperature is low (35.6 - 8C). I'm trying to think of other symptoms. The outer third of my eyebrows has been missing for years. Right now my face is puffy and my eyes are droopy all the time. I hope this is coherent. Like I said, I'm feeling full-on hypo today - the really awful type where you would do anything to change the situation. Yesterday I was like a machine, full of energy, Getting Things Done. The day before that I was like this. You'll know what I mean if you have Hashimotos!
I don't have a GP who will help but to an extent, I do see why. She says she does not prescribe (anything) based on antibodies, only on thyroid levels. My last blood test result, from about a two years ago, I believe, was similar to this one, only the antibodies were then about 420 and the thyroid hormone levels were lower but still normal. That was done privately, through a very well-known lab. My GP, bless her, reacts to these like they are horoscopes - about that level of trust in their legitimacy.
Re the results: I think it is unusual to have raised FT3 and FT4 with Hashimoto's isn't it? Its a bit of a bind then getting medication to improve the hypo symptoms I am experiencing, but I do see why the NHS says what it does for this reason: I had natural thyroid briefly when I returned to the UK. I developed a heart arrythmia which was briefly quite serious. I stopped taking the medication and the arrythmia instantly disappeared for good. Obviously, I was taking too much thyroid hormone. So, my GP and the NHS have that point.
Has anyone had similar test results? How can you be hypothyroid at the same time as having Hashis? I've had it for years so its not as if it is just developing. It could be i just measure it when the hormone is dumped in my system by destruction of my thyroid or when the feedback system decides to counteract the low thyroid but what are the chances that it would do that on two days in 2 years?
I'm finding your post very confusing, it doesn't really seem to add up. So, let's go through it point by point:
- You've probably had Hashi's for a lot longer than ten years. It doesn't develop over-night, it take years before you even notice the symptoms. .
- I don't have flare ups that frequently (maybe every 3 months)
Every 3 months would be very frequent! But it depends what you mean by a 'flare up'. No two people ever seem to mean the same thing.
- TSH: 8.65 (high above 5.5) Much, much too high. Should be around 1. You should be on thyroid hormone replacement (medication) with a TSH that high.
FreeT4: 17.8 (optimal 11.9 to 21.6) 60.82% 11.9 to 21.6 is the so-called 'normal' range, but that's not the same thing as optimal. Optimal is the point where you feel well. All the other numbers are sub-optimal or too high. Your FT4 is a little above what most people would call 'normal', but maybe that's 'normal' for you, or it's because of the Hashi's.
FreeT3: 6.97 (high above 6.8)Your FT3 is above range, so as you aren't taking any thyroid hormone replacement, we have to assume that it's due to the Hashi's.
- AntiThyroid Peroxidase antibodies: over 600 (high over 34)
The actual number is irrelevant. All you need to know with TPO antibodies is whether it's in or out of range. If it's over the top of the range you have Hashi's. If it isn't, you don't. Antibodies fluctuate all the time, but the fluctuations don't mean anything much. Yours are over-range, so you are positive for Hashi's.
Antibodies tend to be higher during and just after a Hashi's 'hyper' swing (what some people call a 'flare' or a 'flare-up', but that is confusing). Because it's then they have to do their job of cleaning up the blood - not in a crime-thriller way, but removing impurities from the blood. So, the antibodies themselves are nothing to worry about. They are the result of the disease, not the cause.
So, with your high antibodies and high-ish FT4/3 - but also high TSH - it rather looks like you're coming down from a 'hyper' swing.
- I don't have a GP who will help but to an extent, I do see why. She says she does not prescribe (anything) based on antibodies, only on thyroid levels.
I hope she doesn't count TSH as being a 'thyroid level' because it isn't a thyroid hormone, it's a pituitary hormone. And they usually like it to go over 10 before they will treat - which, given that a euthyroid TSH is around 1, is cruel and sadistic, leaving people to suffer. That said, right this minute, you do not need thyroid hormone replacement because your thyroid hormone levels are high. But that is only temporary. They will go down - probably quite low, judging by the TSH.
- Re the results: I think it is unusual to have raised FT3 and FT4 with Hashimoto's isn't it?
No. Not if you're on a 'hyper' swing. And you will be on and off until your thyroid has been destroyed.
- Its a bit of a bind then getting medication to improve the hypo symptoms I am experiencing
It's as well to be aware that a lot of symptoms can be the same with both hypo and hyper/under and over-medication. So, some of your symptoms could be down to that high FT3.
But you don't take 'medication' with the single aim of relieving symptoms. You take it to raise your thyroid hormone levels, which in turn will relieve your symptoms. But it's not like taking aspirin for a headache. And obviously you wouldn't take it with levels like yours - and if you had been previously prescribed it, we would advise you to stop it temporarily with levels like yours, until they came down again. So, what were your levels when you took the NDT? And how much did you take?
- How can you be hypothyroid the same time as having Hashis?
Because basically, Hashi's is hypothyroidism, with the occasional bout of 'hyper' levels. Or did you mean to say 'How can you be hyperthyroid...'?
What happens is, during an immune system attack on the thyroid, the dying cells release their stock of thyroid hormone into the blood, causing blood levels to rise to hyper-like numbers. And, incidentally, at the same time, traces of TPO leak into the blood, where it shouldn't be, causing antibody number to rise as they come along to supervise the removal. And all this is temporary. Eventually, FT4/3 and antibody levels with drop back to where they were before the attack.
- It could be i just measure it when the hormone is dumped in my system by destruction of my thyroid or when the feedback system decides to counteract the low thyroid but what are the chances that it would do that on two days in 2 years?
Not sure what you mean by 'when the feedback system decides to counteract the low thyroid'. How would it do that?
So, best thing to do now is to keep testing and wait until your thyroid hormone levels go down, as they eventually will. And during that time, get your basic nutrients tested - vit D, vit B12, folate and ferritin - and supplement any that are low. Your body needs optimal nutrient levels to correctly use the hormone you're going to eventually give it. And, if you could get your early morning serul cortisol tested, that would be a bonus.
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