First results

[Carmen]

Hi, I just got back some results and wanted some help evaluating them.

Anti-TG <20
Anti-TPO 265.0
TSH 4.40
T4 (free Thyroxine) 1.07

I also got low ferretin (11) and strangely high cholesterol (Im 36, and have a healthy vegetarian diet) and the doc has ordered me on a low fat diet:

Cholesterol 240
HDL 77
LDL 143
TRIGS 102

The doctor said the underactive results are very mild, almost normal and has asked me to go back for new blood tests in 6 months. She says they are too mild to notice symtoms, but I am very tired, unmotivated and have no short-term memory. Some days I am suicidally depressed. I have a load of other symptoms too, chronic constipation, flaky skin on my forehead, really painful periods, acne...

Do I need medication?

[Andros]

Hi, I just got back some results and wanted some help evaluating them.

Anti-TG <20
Anti-TPO 265.0
TSH 4.40
T4 (free Thyroxine) 1.07

I also got low ferretin (11) and strangely high cholesterol (Im 36, and have a healthy vegetarian diet) and the doc has ordered me on a low fat diet:

Cholesterol 240
HDL 77
LDL 143
TRIGS 102

The doctor said the underactive results are very mild, almost normal and has asked me to go back for new blood tests in 6 months. She says they are too mild to notice symtoms, but I am very tired, unmotivated and have no short-term memory. Some days I am suicidally depressed. I have a load of other symptoms too, chronic constipation, flaky skin on my forehead, really painful periods, acne...

Do I need medication?

Hi there, Carmen!! With that high TPO (antimicrosomal antibodies), something is definitely wrong w/your thyroid. Very much so!!

The diagnosis of Hashimoto's thyroiditis is simply diagnosed by two blood tests. First the routine thyroid function tests to confirm that a patient has an underactive thyroid gland, and second the thyroid antibody tests (anti-microsomal or anti-thyroglobulin antibodies), which pinpoint Hashimoto's thyroiditis as the cause of the hypothyroidism. Anti-microsomal and anti-thyroglobulin antibodies are immune components which the body produces to attack specific portions of the thyroid cells. The anti-microsomal antibody test is much more sensitive than the anti-thyroglobulin, therefore some doctors use only the former blood test. These thyroid autoantibodies blood tests are high in about 95% of patients with Hashimoto's thyroiditis.

http://www.cumc.columbia.edu/dept/thyroid/thyroiditis.html

http://www.labtestsonline.org/understanding/analytes/thyroid_antibodies/test.html

AACE recommends the range for TSH to be 0.3 to 3.0. Using that model, you are hypothyroid.
http://www.aace.com/pub/pdf/guidelines/hypo_hyper.pdf

As you know, your ferritin is in the basement. Are you taking iron? You would get faster results w/ a liquid iron. Ferritin should be 50 to 100; the closer to 100,the better.
Ferritin http://www.thewayup.com/newsletters/081504.htm

Your cholesterol no doubt is out of whack because of the hypothyroid. Treating the thyroid will treat that. High cholesterol is one of many symptoms of thyroid disease.

So is passive suicidal ideation a common symptom. See; I hear ya' loud and clear here. May I suggest that you get in to see a clinical psychologist or psychiatrist? Believe it or not, both are highly trained in getting a client through a major illness such as the one I believe you have.

I am of the opinion that you need medical intervention. It may be in your best interest to find another and much better doctor. You cannot go on like this!

Also, at the very least.............a sonogram of the thyroid. At the very best, RAIU (radioactive uptake) to rule out cancer of the thyroid.

Whew!! I hope I have helped some and pointed you in the right direction.

http://img.photobucket.com/albums/v129/LuLu1471/hug-3.jpg I am saying a prayer for you as well.

[Carmen]

Hi Andros

Thank you for your wonderful, fast and informative reply! It really means a lot! I suspected something was wrong because of my lack of energy. I thought the depression was a character fault and my bad memory misspent youth... so in a way it’s a relief to think I may be able to take something at some point to improve my wellbeing.

Today my boyfriend said I was making something out of nothing for attention (when I got worried about the high anti-bodies) b/c the doc also said its nothing to worry about. So I really do appreciate your reply even more.

You have given links which I will read with care and try to get informed.

My doctor seems nice, but it may be hard to ask her to run more tests or refer me to a psychologist (they only offer anti-depressants) as her words were "the results are so mild I shouldn't even be mentioning them to you..." and "You are NOT hypo and might never be, its just smth we shld keep an eye on." She didnt see the cholesterol link either. Do you really think a sonogram is really necessary?

She has prescribed me iron tablets though, 80mgs a day.

Its so strange to hear it said like that: a major illness. The main thing I would love, is just to have enthusiasm for living again.

[lavender]

your symptoms are all related to thyroid, and yes it is possible to feel very symptomatic at your levels! Plus with the antibodies at work, I am sure your body is going through it! My old endo's favorite line was "this is not thyroid related," and that's why I fired him! I even had to leave a very nice Family Care Doc because she thought the only way to help me was anti-depressants! Amazing that all those symptoms improved when I got a few hormones! Yuu need a doc who will take this seriously, weather it's a GP, endo, psychiatrist, surgeon, whoever as long as they will help you manage your thyroid!

If you are having suicidal feelings, I think it is important to talk to someone, psychiatrist, psychologist, therapist, someone trained to evaluate your condition and help you through it. Thyroid disease does a number on our emotional health, and I know my therapist has been an essential piece of my treatment team! I don't personally take anti-depressants, but some people find them helpful, even if just for a short time until they get your thyroid meds straight.

[Carmen]

hi lavender,

Thank you also for being so kind. I feel quite overwhelmed by it. Im about to hit the hay now, and it was really nice to see your answer before I turn in.

Maybe I will go back to my GP, armed with the latest data and information on this issue, and ask her to reconsider how she has evaluated my results.

I will post again. Thank you once more! xx

[northernlite]

You need a doctor that will treat you. Many labs are running now with the new upper limit of TSH of 3.0. You are above that. You need to be started on a low dose of levothyroxine or Synthroid and see how you respond.

I was diagnosed with a TSH of 8.44 and a normal FT4 but I also had the antibodies and was very symptomatic. After 6 weeks on medication my TSH had dropped to 2.01 but only 80% of my symptoms were gone. So even at a TSH =2.0 I was not well! Now I am 5 weeks into my dosage increase and most of my symptoms are gone, most days.

My doctor too was satisfied with my results when I came into range but I had to fight for myself and explain that I was not yet 100% and wanted to be.

Good luck, go back to your doc and find a new doc if you have to. You deserve to feel well!

I have not yet had a ultrasound or RAIU, my doctor doesn't feel anything out of the ordinary on my thyroid. I am working hard at getting her to get my medication level right and then I will make a decision about pushing for some of those other things. I go back on Monday and am going to try to talk her into running a FT3 also. She only runs TSH and FT4 normally.

[Carmen]

Hi Northernlite,

Thanks for your contribution. At the moment I am reading a lot and trying to learn about this disorder.

It seems that my anti-body count points to Hashimoto's, is this pretty much a certainty? How how is high? (mine's 265.0) (range 0-60).

Im a bit down regarding the fact that my doctor has told me to go away for 6 months, before another test or recap, even though I my TSH is slightly over, 4.40 (range 0.4-4.0).

With my results, I wonder how likely it is that this condition will progress/get worse? Is everyone different, or does it tend to follow a pattern? How long am I likely to have been subclinically hypo? (Ive had ongoing severe depression, really bad period pains and low energy since age 14, 36 now).
------
I would like to add that I noticed my declining ability to remeber words at age 26 and even spoke to a doctor about it, as at that time, I wanted to be a writer, (she said I should read the dicitionary every night).

Has anyone noticed any short-term/verbal memory improvement after medication? Thnks.

[Andros]

Hi Andros

Thank you for your wonderful, fast and informative reply! It really means a lot! I suspected something was wrong because of my lack of energy. I thought the depression was a character fault and my bad memory misspent youth... so in a way it’s a relief to think I may be able to take something at some point to improve my wellbeing.

Today my boyfriend said I was making something out of nothing for attention (when I got worried about the high anti-bodies) b/c the doc also said its nothing to worry about. So I really do appreciate your reply even more.

You have given links which I will read with care and try to get informed.

My doctor seems nice, but it may be hard to ask her to run more tests or refer me to a psychologist (they only offer anti-depressants) as her words were "the results are so mild I shouldn't even be mentioning them to you..." and "You are NOT hypo and might never be, its just smth we shld keep an eye on." She didnt see the cholesterol link either. Do you really think a sonogram is really necessary?

She has prescribed me iron tablets though, 80mgs a day.

Its so strange to hear it said like that: a major illness. The main thing I would love, is just to have enthusiasm for living again.

Carmen; it is my humble opinion that one should not take anti-d's from anybody but a psychiatrist. They are the only ones qualified to diagnose the need and to monitor it's use.

Take those tablets. Between the low ferritin and the thyroid disease, those two things alone affect your limbic system (mood-related portion of the brain.)

I think that you need sonogram at the very least because "sometimes", once in a blue moon, high TPO does present it's self w/thyroid cancer. Just to make sure, you know?

Lavendar is a total doll. I love her "soothing" way with folks. That in and of it's self is healing.

We are here for you at all times.

[Carmen]

Thanks Andros, you are very kind...I will keep that in mind.
For the moment the doctor has said she wont treat me, unless I get worse.
So I am weighing up my options and thinking about how to proceed.

[Andros]

Thanks Andros, you are very kind...I will keep that in mind.
For the moment the doctor has said she wont treat me, unless I get worse.
So I am weighing up my options and thinking about how to proceed.

Carmen; that makes no sense. You are ill. You went to the doctor to get find out what is wrong and to get treatment.

You now know what is wrong so therefore you now need to find a doctor who will treat you. To withhold medical intervention is cruel and unconscionable!

Please don't let this uncaring doctor discourage you and make you feel unworthy. Find a doctor. You "do" have thyroid disease. Left untreated, it can damage your heart, your kidneys, your liver and a whole bunch of things including your psyche!

http://img.photobucket.com/albums/v129/LuLu1471/hug.gif

[Carmen]

Thanks for the polar bears, so cute! And of course for the encouragement. xx

[jm1910]

Hi Carmen

I'm in exactly the same boat as you and great to see i'm not the only one, i'm 40. Results are as follows

TSH 8.68
Free T4 11.1 (9-25 RANGE)
Free T3 4.7 (3.5 - 6.5)
Iron level 4.3
HB 98 Female range should be over 130
TG 192 u/ml (<60) Thyroglobulin Antibodies
TPO 43 U/ml (<60) Thyroid Peroxidase Antibodies

Ultrasound shows normal size with inreased blood flow and patchy surface not uniform in colour.

I went back yesterday for the doctor to advise that my thyroid definately looks like it's on the downward slide and that they'll monitor it as they don't like to medicate until your outside of the normal range. To change my diet, read the Thyroid Diet book by Mary Sholom, take iron tablets and she'll see me in 4 weeks to do all the tests again.

I too have a husband that thinks i'm making a mountain out of a mole hill, and moans if he catches on the computer looking things up. The fact that i could sleep through a hurricane and am extremely lethargic, find the easiest tasks difficlut, gaining weight by a kg per week, unable to walk in the morning until i get my ankles motivated, swing from high to low, libido (that is non existant and major issue with OH), Carpal tunnel syndrome, pins and needles in my legs and feet, dizzy spells and lack of memory.

Jane :hugs:

[Andros]

Hi Northernlite,

Thanks for your contribution. At the moment I am reading a lot and trying to learn about this disorder.

It seems that my anti-body count points to Hashimoto's, is this pretty much a certainty? How how is high? (mine's 265.0) (range 0-60).

Im a bit down regarding the fact that my doctor has told me to go away for 6 months, before another test or recap, even though I my TSH is slightly over, 4.40 (range 0.4-4.0).

With my results, I wonder how likely it is that this condition will progress/get worse? Is everyone different, or does it tend to follow a pattern? How long am I likely to have been subclinically hypo? (Ive had ongoing severe depression, really bad period pains and low energy since age 14, 36 now).
------
I would like to add that I noticed my declining ability to remeber words at age 26 and even spoke to a doctor about it, as at that time, I wanted to be a writer, (she said I should read the dicitionary every night).

Has anyone noticed any short-term/verbal memory improvement after medication? Thnks.

We call that brain-fog and we all have had it. Most of us if not all of us found that to be much much improved once our thyroxine replacement took hold.

There is a pattern. The patient usually flip flops. Feel good, then feel hypo, then maybe a bit hyper. This goes on and on but the caveat is each time, the real underlying problem becomes worse.

For instance, if you are hyper.................you can tell by the worsening symptoms usual for hyper and so on. This is called "rebound!"

Try to find a doctor to treat you and may I also suggest that you get checked for endometriosis if you have not done so?

http://img.photobucket.com/albums/v129/LuLu1471/Hug-4.gif

[northernlite]

Carmen -

The presence of the TPO antibodies indicates your body is have an autoimmune response attacking your thyroid. The presence of any at all tells you that your thyroid is being damaged. TPO can be elevates in both autoimmune disorders Hashimotos and Graves. TgAB are indicative of Hashimotos and thyroid cancer.

265 is plenty high, I have seen higher on these boards but anything is bad so 265 certainly qualifies.

All labs are different so it is tough to direct compare. I was diagnosed by a lab that uses an index value range where 0.0-0.9 is considered negative and 1.10 and greater is positive. If you were between those two they would retest. I was 3.88 which is high but how does that compare to your 265? Each test sample kit is sent out with a conversion chart to more standard IU units. I don't know what mine is but in a sample conversion chart, 3.88 was equivalent to 150 UL.

So you ask if you definitely have Hashimoto's, I would guess that you do but I can understand the wait and see approach to the diagnosis.

My doctor based my diagnose of Hashi on 5 factors:
High TPO
High TgAB (262)
High TSH (8.44) which told her I was having a hypo not hyper response
I have two brothers and they were both diagnosed with Hashi's as young men and have been for more than a decade.
I had most of the symptoms of hypothryoidism

Although I can understand the wait and see attitude towards saying you are Hashi, I can't understand why the doctor will not treat you -
You are symptomatic
You have antibodies which indicate you have autoimmune thyroid disease going on
Your TSH is above the range - barely but it IS above
Your low ferritin and elevate cholestrol

I would push for a 25 or 50 mcg trial of Levothyroxine or Synthroid.

[Carmen]

Hi Jane,

Thanks for posting. I hope your hubby proves more sympathetic in future...
I had a serious talk with my boyfriend, (and read him some of the posts from this board) and he is being a little more understanding these days.

As for your results, I am a total newbie at this, but your TSH results are double mine, I am REALLY surprised that your doc wont treat you, from what I can gather, even out of touch, unsympathetic doctors will treat you if your TSH is over 5. They wont treat me becuase my 4.40 is considered normal by their out-dated ranges, but your 8+ is not normal even by out-dated standards. You have low TPO antibodies though, so maybe its not Hashimotos? I say this due to the info I have picked up thru reading over the last few days, as i say I am by no means an expert at all, maybe some more experienced posters will comment.

Andros, (thanks for the hug!) and for the suggestions. It's really good to know that brain fog improves with the right medication! As for endometriosis, maybe some day... In an ideal world I also want to be tested for heavy metals (used to eat a lot of tuna) and adrenals, but lets see if I can get up top of the hypo first... but thnks for the tip.

Finally, Northernlite, thanks for your reply and analysis which put things into perspective, and cleared up some lingering doubts. I will post again if I manage to make any progress. Thanks everyone!!

[Andros]

Hi Jane,

Thanks for posting. I hope your hubby proves more sympathetic in future...
I had a serious talk with my boyfriend, (and read him some of the posts from this board) and he is being a little more understanding these days.

As for your results, I am a total newbie at this, but your TSH results are double mine, I am REALLY surprised that your doc wont treat you, from what I can gather, even out of touch, unsympathetic doctors will treat you if your TSH is over 5. They wont treat me becuase my 4.40 is considered normal by their out-dated ranges, but your 8+ is not normal even by out-dated standards. You have low antibodies though, so maybe its not Hashimotos? I say this due to the info I have picked up thru reading over the last few days, as i say I am by no means an expert at all, maybe some more experienced posters will comment.

Andros, (thanks for the hug!) and for the suggestions. It's really good to know that brain fog improves with the right medication! As for endometriosis, maybe some day... In an ideal world I also want to be tested for heavy metals (used to eat a lot of tuna) and adrenals, but lets see if I can get up top of the hypo first... but thnks for the tip.

Finally, Northernlite, thanks for your reply and analysis which put things into perspective, and cleared up some lingering doubts. I will post again if I manage to make any progress. Thanks everyone!!

Hey; we hope you make progress but don't leave us!! We like to hear from you all the time. The good, the bad and the ugly! LOL!

[lavender]

Hi Northernlite,

Thanks for your contribution. At the moment I am reading a lot and trying to learn about this disorder.

It seems that my anti-body count points to Hashimoto's, is this pretty much a certainty? How how is high? (mine's 265.0) (range 0-60).

Im a bit down regarding the fact that my doctor has told me to go away for 6 months, before another test or recap, even though I my TSH is slightly over, 4.40 (range 0.4-4.0).

With my results, I wonder how likely it is that this condition will progress/get worse? Is everyone different, or does it tend to follow a pattern? How long am I likely to have been subclinically hypo? (Ive had ongoing severe depression, really bad period pains and low energy since age 14, 36 now).
------
I would like to add that I noticed my declining ability to remeber words at age 26 and even spoke to a doctor about it, as at that time, I wanted to be a writer, (she said I should read the dicitionary every night).

Has anyone noticed any short-term/verbal memory improvement after medication? Thnks.

I wanted to comment on the memory. I started back to graduate school one month after having my thyroid removed. I ended up having to drop a class and go to part time because I could not function when I was hypothyroid, even when my doctors insisted my levels were in the "normal" range. My memory was terrible. I could not read because I could not remember what I was reading. I would simply read the same paragraph over and over and look at it again and it would look totally foreign to me. I had a really hard time with the exams even though I am usually a stellar test taker.

I was also extremely depressed. I had no energy, no spark for life. My doctors said my thyroid levels were fine and wanted me to take anti-depressants, even though my PCP knew that anti-depressants have failed with me in the past. So, I found a new doctor who was willing to take a different approach with my thyroid. I started on new medication, and within weeks, my old lively self was returning. I had energy. I was able to read and digest what I was reading. Best of all, I started to remember the names of the students in my classes. =) !!!

My memory is not up to full speed yet, and I am having to re-learn things and be patient with myself. But, I can see improvements.

Your antibody results show that there is an auto-immune attack on your thyroid. The fact that you have antibodies at all is significant, and that they are out of the "normal" range is even more telling. To my knowledge, with antibodies, it's not necessarily a matter of higher number correlating with worse symptoms. The fact is that they are there and you have symptoms which point to a thyroid disorder. Treatment could significantly improve your quality of life.

Not treating a person who is sick because their thyroid levels are "not bad enough yet" is like having a car with an oil leak and not putting oil into it because the leak is "not that significant" and then waiting until the engine is destroyed to declare that something is wrong.

[Carmen]

Hi Lavender, thanks for sharing your experiences. Again, it’s great to hear that my congitive function could improve with the right treatment. I was so sorry to be losing my mental faculties at such an alarming rate! (I can turn the cooker on, and then ask my boyfriend why he has turned it on 2 mins later. Shocking really.)

Originally Posted by lavender: Not treating a person who is sick because their thyroid levels are "not bad enough yet" is like having a car with an oil leak and not putting oil into it because the leak is "not that significant" and then waiting until the engine is destroyed to declare that something is wrong.

I know you are right, but I am kind of avoiding dealing with it, because I think it’s going to be so difficult to get the doctor to perscribe medication (I think you are more ahead of the game in the US). Reading a post today, on another website from someone called Thalia made me realise what I am up against:

“It isn’t the (British) National Health Service that’s doing the witch hunting (of sympoathetic Thyroid doctors) it is a group of senior Endocrinologists, most of whom are in the British Thyroid Association, who unilaterally issue “guidelines” that every doctor in the UK must follow or they’ll get the General Medical Council onto him/her. Weetman is President of the BTA and others active in the persecution of doctors who actually correctly treat thyroid patients by assessing symptoms as well as blood tests, are members and past presidents. Weetman is also a member of the General Medical Council. It’s all a power thing among Endos that the National Health Service just goes along with.”

http://thyroid.about.com/b/2008/01/07/the-uks-effort-to-put-a-popular-thyroid-doctor-out-of-business-fails.htm

I too believe my quality of life could improve with meds, and sometimes I wonder about going private... but as this may be a life-long condition I am hestitant to go down that road, as my funds are limited (very). (In the European Union, the general population usually depends on their (state)health services, so most people dont have medical insurance). I guess I just have to keep trying to persuade my doc, or wait to see what my results say in 6 months time.

[lavender]

Unfortunately, no one country's system is perfect. Even in the US, we have trouble finding doctors who will properly treat thyroid patients, and we end up spending thousands of dollars on useless medical care.

I personally no longer see an endocrinologist because mine was so tied to the AACE (American Association of Clinical Endocrinologists) most conservative suggestions that he was useless. (According to his lab a TSH of 6 was in range). I also had to leave my family doctor (what you call a GP) because she would not go against his judgment, no matter how sick I was. It took me 2 months to get an appointment with a new family doctor, and it takes me 30 minutes minimum to reach anyone on the phone in her office, but it was well worth the struggle because I am able to function again.

You may find that there is a doctor in your area who is willing to treat you alternatively if you start asking other patients. You don't have to see an endocrinologist. Many family doctors (GPs) are willing to treat thyroid disorders and even psychiatrists prescribe thyroid meds because the thyroid is so closely tied to our emotions.

I just want to encourage you to keep searching until you find a doctor who is willing to address your thyroid, even if it is a bit harder to switch doctors in the UK. It may take some time and energy to find a helpful doc, but You may find that it is the key to improving your overall well-being.

[Carmen]

Thank you Lavender-

With everyone's help on this board, I am feeling more positive tonight and perhaps next week will see me take some concrete steps towards improving my life. As many people have said before me, the support and the kindness seen on these boards really makes a difference, and I am starting to believe I can do this!

Hugs to you all!