I have positive TPOab (356 in a range of 0-9.0). After a few months of having low TSH, it has now gone up to 11 (0.3-5.0) and my T4 is 7.9 (7.0-20) so the transient hyper phase has abated. I also have a Thy3 nodule showing inflammatory cells.
…and yet my endocrinologist is still refusing to class it as Hashimotos Thyroiditis. I am still unmedicated and yet have classic symptoms.
At what level does TPOab, and TSH have to rise for confirmation in your experience?
He has said that the anxiety of the nodule is causing all my symptoms and that it is not my thyroid causing it. I’m sick of it always being attributed to mental health when clearly my thyroid is struggling.
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but for them to suggest 'anxiety about a nodule' is capable of causing an initially low TSh to then rise over 10, (and also magically create loads of TPOab )..... that is , er .... rubbish.
i very much doubt that being anxious could create TSH over 10 and TPOab of 300,... ask them to show you the evidence.
yes , 4 wksa bit too soon to know what tsh is after stopping carb , for same reason we have to wait 6 wks after changing dose levo ,,, because TSH takes a while to settle .
he's correct , fT4 /3 results are looking at what's in blood today,,, but TSH result is more like a window into the recent past , ie what sort of T4/T3 levels your pituitary / hypothalamus have been experiencing for the past few wks/ mths
I mean, anxiety doesn’t cause cold extremities, dry skin and a slow heart rate etc
It’s so infuriating. What makes it worse is that ENT are suggesting they don’t want to operate to remove nodule if tft are unstable but Endo is saying if it is Hashimotos (if!!) then it could be unstable for months/years.
Lazy doctoring! If all your symptoms come from anxiety he doesn't have to do anything. If he diagnoses you with hypo/Hashi's then he has to actually do his job! Quelle horreur ! He needs reminding of a few things:
- anxiety is a hypo symptom so you'd probably have it even if you didn't have a nodule.
- that's what ranges are for: to make it easy for him to diagnose: if you're in range you don't have it (debatable but for the sake of argument) if you're over-range then you do have it! Imagine that! Sooooo simple.
- ranges are not there for him to manipulate for his own convenience: i.e. to be ignored when you can't be arsed to treat the patient!
Of course, the NHS in general is guilty of N° 3 when they say that TSH has to be over 10 on two consecutive blood tests to get a diagnosis. But, anyone that knows their NICE would be able to tell him that with high antibodies you can over-rule that - if you so wish. But, I expect he's a diabetes specialist with scant knowledge of thyroid, isn't he? So, he'd probably just plead ignorance - or out-right deny it's true!
I think the only hope for you is a new endo - or at least a second opinion!
Oh my goodness, your last paragraph really hits home for me and what happened with my endo on Friday just gone! You could have been describing my circumstances to a tee!
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Is it hypothyroidism or just iron deficiency?
hashimotos 
I'm trying to find a doc who is willing to treat my symptomatic hypothyroidism when TSH is high but within UK 'normal' range, with low FT4.
Hashimotos or Vitamin Deficiency
