Thyroid antibodies positive and within normal range for TSH & FT4 but other bloods abnormal too but still no treatment

Got nearly all symptoms of been Hypothyroid, mostly tired all the time, aches and pains in different parts of body, feeling cold or find it hard to warm up after been out in cold, brain fog, heart palps, carpal tunnel and menstrual problems.

My bloods keep coming back abnormal especially Liver function and Inflamation markers. Asked doctor to try a trial of thyroid tablets but saying no because TSH within normal range. 24 hour heart monitor came back normal. Doctor now wants me tested for sleep apnea because I am so tired all the time !

Blood Results

CRP

12/3/13 10.0

5/2/13 11.0

15/1/13 9.0 (range <5.0)

8/1/13 14.0

Gamma GT

12/3/13 115

5/2/13 134 (range <40.0)

15/1/13 94

8/1/13 118

ESR

12/3/13 26

5/2/13 30

15/1/13 28 (range 4.00-12.00)

8/1/13 33

Cholesterol 5.8 (range <5.2)

Thyroid

8/1/13 TSH 3.41

FT4 14.7 (range 12-22)

Peroxidase antibodies 317 (range <49)

26/10/12 TSH 3.7 (fasting test) (range 0.4-4.0)

FT4 15.1

Any advice on above would be great.

11 Replies

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  • This is what Dr Toft, ex President of the British Thyroid Association says about antibodies:. If you want a copy of the whole article in Pulse online, email louise.warvill@thyroiduk.org-

    2 I often see patients who have an elevated TSH but normal T4. How should I be managing them?

    The combination of a normal serum T4 and raised serum TSH is known as subclinical hypothyroidism. If measured, serum T3 will also be normal. Repeat the thyroid function tests in two or three months in case the abnormality represents a resolving thyroiditis.2

    But if it persists then antibodies to thyroid peroxidase should be measured. If these are positive – indicative of underlying autoimmune thyroid disease – the patient should be considered to have the mildest form of hypothyroidism.

    In the absence of symptoms some would simply recommend annual thyroid function tests until serum TSH is over 10mU/l or symptoms such as tiredness and weight gain develop. But a more pragmatic approach is to recognise that the thyroid failure is likely to become worse and try to nip things in the bud rather than risk loss to follow-up.

    Treatment should be started with levothyroxine in a dose sufficient to restore serum TSH to the lower part of its reference range. Levothyroxine in a dose of 75-100µg daily will usually be enough.

  • ....the information that Shaws give above is of course correct. However I was diagnosed here in Crete in 2005 with all the TFT's - thyroid functions tests - within the ranges but anti-bodies were high. Here they believe that if an ultra-sound reveals nodes on the thyroid and anti-bodies are present - then they assume the thyroid is struggling with auto-immune disease and T4 treatment will support. This is what happened to me. After 7 years it was apparent that the T4 was NOT converting into T3 and so I was able to commence with a small dose of T3. Things have now improved !....and yes the TSH is suppressed.....

  • Thank you Shaws and Marz for your comments.

    Feel like I am getting nowhere all I want to do is feel normal and get through the day without sleeping or feeling ill.

    Why do I have abnormal Liver function and Inflamation markers - does it all go hand in hand with thyroid antibodies ?

  • Loulabel,

    You need to see every GP in your practice until you find one with some common sense!!!! You have positive thyroid antibodies - what do they think these are indicating??? it confirms that you have autoimmune hypothyroidism. Do you have close family members with thyroid disease?

    Tell your GP that this is one of the reasons the NHS is running out of money because he wants to spend money on investigating your symptoms instead of treating the cause !!!

    It makes me so mad!

    I too kept having the inflammation markers because my thyroid was inflamed.

    Please keep writing to your GP's and pester them. Also get your vitamin d, b12, ferritin and folate tested and let us know the results.

    Sue

    thyroiduk.org

  • How can they be so negligent? Antibodies mean there is an autoimmune thyroid disease present.

    Also, sleep apnoea is a symptom of hypothyroidism.

    Years ago a study noted that a group of female mental patients who were part of a study to see if thyroid treatment improved their mental health also noted that they all snored loudly and stopped breathing in their sleep. They nearly all improved mentally when treated, and it was noted they also stopped snoring !

  • OK - I see 2 separate issues here

    1. Yes on the SUB-CLINICAL hypothyroidism - although when your antibodies are that high it's only a matter of time.

    2. Your liver looks like it's in trouble.

    The two may be linked but in order to get action I'd separate the issues.

    Inflammation markers (CRP, ESR could be linked to an inflamed thyroid OR liver). Gamma-GT is a clear marker for liver disease.

    Your immune system will be going crazy if you have inflammation anywhere in your body and will try to eradicate the cause of it. If it's your thyroid that's inflamed this will accelerate cell destruction, if it's your liver ditto.

    No matter how you look at the results your liver function tests indicate your liver is struggling and it's getting worse over time. You need to know why. It could be inflamed and probably is. It's likely to be struggling to detoxify your body. This may explain your cholesterol readings. Either way you need to know what's going on. I'm sure there are many liver disorders that would give these readings. Also the liver's crucial organ in T4 and T3 production.

    My advice - separate the liver issue out and make a loud noise about that. You HAVE to get a second opinion and in my view as soon as possible. The thyroid issue has to be dealt with as well but I'd be worried about my liver right now. If your liver's not working properly your thyroid readings will be affected. Get them to sort the thyroid out in parallel; especially if they're telling you that's subclinical and patting you on the head.

    Not a great suggestion I know but this is how the GPs work - one thing at a time.

    DEMAND A SECOND OPINION - you're totally entitled to it. even if it means going to another surgery.

    Good luck and love

  • wish the range of information-regarding lo- iodine uptake here in the UK is to blame for many abnormal readings the W.H.O. sites stats of hypo. relating to iodine deficiency and how other countries have been able to address this issue but the UK gov't ignores this issue, also see selenium connection.ever wondered why so many people in the UK have gaps/spaces between their teeth--another end result.. for many hypo. can at least be prevented if not alleviated the stats are there to see and not ignore..

  • just re-remembered the other link was iron.. so iodine, selenium & iron deficiencies contribute to thyroid hypo. perhaps looking at the causes is an alternative to pills, the research is plainly out there..

  • Definitely ask for another opinion.

    In my case I had my TSH checked as part of my diabetes review about a year ago and it came back slightly elevated at 5.5 (range used 0.3 - 4.2) and the GP asked for thyroid antibodies to be checked.

    At my review appointment with the diabetes nurse I was told the results of that test were normal. I asked for a print out of all my results and this was readily given. There I saw that the antibody result was 19.7 (range used 0 - 34) and therefore negative. BUT I also saw that this result had a comment written on it saying 'Normal - No Action Mrs xxxx xxxx Admin'

    and below that this comment from the lab:

    TPO <35iu/ml = Negative

    Anti-TPO antibody test is an enhanced antimicrosomal assay. A negative anti-TPO does not exclude autoimmune thyroid disease. If TSH is slightly increased (up to 10miu/L) and there are no typical hypothyroid symptoms, consider deferring replacement and recheck in 1 year unless symptoms develop.

    (Royal College of Physicians Consensus Statement 1996)

    I expressed surprise that a member of admin could make such a decision without knowing anything about me or whether I had any symptoms or not, and told the nurse about the many symptoms I had (although fairly mild in relation to what I read on this board about many sufferers). She suggested I make an appointment to discuss this with my GP and she did this for me there and then.

    At that appointment I raised my concerns that a member of admin staff with no medical qualifications whatsoever and without knowing anything about me could decide that 'no action' need be taken - especfially given that the lab comment said that negative does not exclude autoimmune disease. The GP's response was that the PCT was happy for admin staff to screen out blood tests with normal results as the doctors ordered so many tests and were so busy. I didn't respond to that but gave her one of my looks (which my husband and kids say could make Hell freeze over).

    The upshot was that after discussing my list of symptoms including dry skin, tiredness, palpitations, mood swings and brain fog, and also my family history of other autoimmune conditions, she agreed to start me on a small dose of levothyroxine. She actually said that a professor of endocrinology at Birmingham says that GPs should treat the patient and their symptoms not the blood test results.

    The effect was was swift. The palpitations stopped almost immediately and the brain fog and dry skin etc resolved quickly. I now feel more like my old self and much more positive about the future.

    This wouldn't have happened if I hadn't asked for the print out and taken matters further myself. We shouldn't have to do this, but that's how things are.

  • with reference to the previous comments from marz and grizelda........please always remember that YOU CAN [if you insist] on a second opinion and also insist on who or where this is carried out -----YOUR CHOICE------always insist on FULL TESTS BEING CARRIED OUT AND THE RESULTS COPIED TO YOU [t3 /t4 /and all others that may affect your problem inc.vitamin supps ] i have used this to enormouse effect in the past two weeks......if these people know that you have these results THEY know that they cannot hide at a later time-------so they will always double /triple and quadruple all results before using US as guinea pigs and maybe treat correctly-----after all they dont have to suffer the problems of health/family /lifestile/relationships/....that are all affected by some or all of these conditions.......please keep in touch with this site ----- I HAVE LEARNT MORE ABOUT THIS THAN IN MY WHOLE LIFE......

  • A TSH above 2 may suggest hypothyroidism. Sounds like you are in the early stages of hypothyroidism due to hashimoto's disease.

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