thyroid profile

[PlatypusProfit8077]

hi, I’m trying to understand all this thyroid stuff after having my head buried in B12 all year.

can someone comment please?

- serum TSH 1.2 mIU/L (range 0.5-4.0)

- anti-thyroglobulin antibodies 10 IU/mL (range <4.5)

- anti-Throidl Peroxidase Antibodies 42 IU/mL (range <60)

anti-thyroglobulin antibodies are the ones that stand out to me, being higher than the range.

[greygoose]

Are you sure about those antibody ranges? They look a bit strange. But if they are correct then the Tg antibodies are saying you probably have Hashi's - which wouldn't be surprising because you have PA.

Just testing TSH gives you no information at all. It was noted in your last post that your TSH did not correspond to your low FT4, which could indicate you also have a pituitary problem. Your TSH is still about the same but you need to know what your FT4 is now - could be even lower. And, ideally, your FT3.

TSH is a pituitary hormone. When the pituitary senses that there is not enough thyroid hormone in your blood, in is supposed to increase its out-put of TSH to stimulate the thyroid to make more thyroid hormones - T4 and T3. Your pituitary doesn't seem to be reacting to your low T4. What time of day was the blood draw for this test? TSH is highest before 9 am, and at its lowest around midday. So, important to always test early morning.

[PlatypusProfit8077 in reply to greygoose]

Yeah that’s what was printed exactly. The tests were done in August but I always always fast for my blood tests and I always have them done in the mornings so 🤷🏻‍♀️

The neurologist ordered these but said everything came back normal (which is usually untrue but he had been good about everything else and I didn’t check).

So should I get all of these retested? TSH, FT3, FT4, and antibodies?

I’ve had an iron infusion in December, I’ve just started on vitamin D supps and still on frequent B12 injections.

And ask about pituitary?

[greygoose in reply to PlatypusProfit8077]

You can ask about the pituitary but your doctor is unlikely to have a clue.

Doctors tend to only know about their speciality, so a neurologist is highly unlikely to know about the pituitary - not many endos know about that. And he wouldn't really know how to interpret thyroid blood test results, either - he obviously doesn't know that just testing TSH doesn't tell you very much.

So, yes, a retest would be a very good idea. A lot could have changed since August. And you do need those FT4/3 results to get the full picture.

As for antibodies, your TgAB are positive, so no need to redo those. But might be a good idea to retest PTOab, just to see what they're up to. Antibodies fluctuate all the time so they could now be positive as well.

Are you taking the vit D co-factors: vit K2-MK7 and magnesium?

[PlatypusProfit8077 in reply to greygoose]

Yep, both of those supplements and the vitamin D with some healthy fats.

It’s exhausting when your body isn’t cooperating.

I’m seeing the GP next week (started the year off with a capsule swallow last week - will see if I get to the top level of Medicare again this year 🙄). I’ll ask about the thyroid and push for those blood tests and an endo referral.

Thanks so much!

[PlatypusProfit8077 in reply to greygoose]

Sorry, one more thing, when you say the TgAB is positive - does that without a doubt confirm autoimmune? Or am I going to have a fight on my hands? It’s ridiculously hard getting the PA one here so some advanced warning would be good.

[greygoose in reply to PlatypusProfit8077]

The thing with TgAB is that it can be high for other reasons, so not, it doesn't confirm without a doubt.

It can be very hard to get a hypo diagnosis, too. And they don't seem to care if it's Hashi's or not. What you really need is an ultra-sound but at the moment, that might not be much help, either, because it doesn't look as it the thyroid is badly damaged yet.

[tattybogle]

TGab not usually regarded as definitive for thyroid autoimmunity by doctors .

eg . TPOab :

southtees.nhs.uk/services/p... "Autoimmune thyroid disease is characterized by the presence of autoantibodies against TPO".

versus

TGab southtees.nhs.uk/services/p... "Thyroglobulin antibodies (TgAb) are often present in patients with autoimmune thyroid disease. Approximately 10% of healthy individuals have TgAb at measurable levels.

TgAb can be detected in 30% of patients with Graves’ disease and in 85% of patients with Hashimoto’s thyroiditis."