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Avatar universal

possible auto-immune hypo?

Over the last 1.5yr,I've gained 22-25lbs.At 1st I thought it was because I started hormonal BC,&maybe because of eating too much.After a 2 week holiday last summer (where I didn't watch my food intake but also didn't gain weight) I started watching how much (and what) I ate.I found that I just could not lose weight,I would gain weight every week,or stay the same (if I was lucky).I stopped BC a few months ago,but still my weight keeps creeping up...
I had my thyroid checked last June (for another reason) &the doc said it was fine,but he was looking for hyper,not hypo (he believed my HR to be elevated because of hyper,but high HR is hereditary).
I realise my numbers could be worse or better at this moment,but what do you think of these numbers?

free T4: 1.15 ng/dL (range: 0.90 - 1.70)
TSH: 1.73 mU/L (range: 0.27 - 4.20)
TSI (TSH Rec. auto-antibodies): <0.30 U/L (<1 : negative ; 1-2 : borderline ; >2 : positive)
antiTPOantibodies: 17 U/mL (range: <35)
antithyroglobulin antibodies: 43 U/mL (range: <40)

Could this indicate thyroid problems?If so, what kind?Could it be caused by iodine deficiency? (after examining my eating habits, it seemed plausible to me)
Also, I've been needing a lot of sleep the past 6 months,&I have cold hands &feet (but I think I've always had that?)
I also have a very slight non-nodular goiter,which the doc was not concerned about in June)
My trapeze muscle (neck/shoulders) is also very tense,tenser than usual...
I'll definitely see a doc later, but I want to know if I should pursue this. My doc didn't think so, so I should find another doc?
15 Responses
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Avatar universal
With Hashimoto's, the gland will eventually die and no antibodies will be detected but meds will need to be increased to keep the body functioning. There's no way to tell how long the process will take.

I've read that some have achieved remission but it's not typical.

It is uncertain whether or not "goitrogenous" foods cause problems for those with thyroid disease...there are no conclusive studies. There are however studies that suggest cooking the foods (mostly soy products and cruciferous veggies) reduces the goitrogenic components.

Kelly

Helpful - 0
Avatar universal
Thanks :-)

I'm good with the veggies and stuff (Europeans are a bit better at that than the average American ;-) ) I hate fast food :-) 1lb of veggies every day and one piece of fruit. I'm going somewhat low carb too. And have a gym membership, to do what I love (weight training) and what I must (cardio) I guess I mainly have some processed food to eliminate, nothing drastic.

I'm pretty positive, so I'll try to stay that way...
Only stress is a problem right now: I'm in the middle of exams ;-) That too shall pass.

Anyway, good to know that remission is possible, nice change from all the "horror stories" ;-)
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Avatar universal
PS: you mentioned strawberries... I heard somewhere else that it's a goitrogen...
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Avatar universal
That is great what you do to keep healthy. Your half way there! Sorry you have exams, the bright side, it is really good to excercise our mind with learning, it helps so we don't get alzehimers...LOL

I eat strawberries all the time. I never have a problem. I love them. I will definatly have to check that out. I don't know if them being a goitrogen, will stop me though..Strawberries are one of my weakness...LOL

lil deb
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Avatar universal
lietchi

Don't worry, with proper monitoring and proper medication, 1000's and 1000's of people live with this disease everyday, leading normal and productive lives.

Though it is not curable, you can go into remission. That means no auto-antibodies detected and many people become euthryoid. That means no medicine and normal thyroid hormone levels.

Yes, birth control can have an effect, but it is not the cause. The auto-antibodies are the cause. This is an auto-immune disease. That means your own immune system is attacking your thyroid. Some things that you can do right away, is to get rid of anything that can stress your immune system out, get them out of your life, such as dust, processed foods, etc.

Eat a well balanced healthy diet, all home cooked foods from scratch if you could with plenty of fresh veggies and fruits. That is the best, because you can control what goes into your foods. Look at fruits as a vegtable and add them to side dishes in meals. It is easy and everyone will gobble it up. One recipe I got online was so easy. Fresh spinach with sliced strawberries and orange slices. It was good and so easy. In all actuality. Cooking from scratch is not hard at all, in most cases, it is easier and tastes so much better.

Getting rid of all external stresses too is really important. For instance, most people have finance problems. Don't stress about it. It always works out. Try to look at life more positive and do things you CAN do, rather than worry about things you CAN'T.

When I was really hypERthyroid, it was difficult to do much of anything. I was able to stand and cook, so that is what I did ALOT of. And I enjoyed it very much. When HypOthyroid. It helps to get your metabolism moving by some excercise. I am not an excercise fan. So for excercise, walking around the neighborhood is best for me. I can now walk steep hills too. I couldn't do that before, so I am really proud of that. Basically, anything to get your blood moving. Up and down stairs a few times works too.

The most important thing to do is to learn all you can about this disease, so YOU can be in charge, not this disease. Also, Patience is key with this disease too. It takes time for adjustments of medication to work. This disease is very managable. So Relax, make an appointment to see an endocrinologist. Look for a really healthy meal to have for dinner tonight, something you really will enjoy.

lil deb
Helpful - 0
Avatar universal
I had an ultrasound, no nodules found or anything...

On a side note, in my country, the lab slip is not printed by the doctor, it is a standard form (same one with each doctor, or at least each GP).

Is there any chance that all of this was caused by birth control?

Worried now... Never had a serious illness, and definitely not an incurable one... Have there been instances of thyroid function returning to normal i.e. not needing medication or being able to stop the medication?
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Avatar universal
I was diagnosed with autoimmune thyroid disease based on elevated antibodies. My labs were not out of range. I am on 50mcg of levoxyl which has helped some but I still have some persistant symptoms.

My endo said that even the slightest elevation in antibodies means autoimmune thyroid disease. Most likely you have Hashimoto's thyroiditis (which is what I have).

Iodine is needed for proper thyroid function and is obviously helpful in thyroid conditions caused by iodine deficiency but it can cause more harm than good in the presence of autoimmune thyroid disease.

There are some studies that show the free T4 and free T3 need to be in the upper third of their ranges before a person will function optimally. Your free T4 would be low according to that standard.

Because your thyroid is enlarged you may want to have an ultrasound done if you haven't had one already.

If you are having symptoms you are definitely not "subclinical" (meaning abnormal labs without symptoms...you have the opposite problem it sounds like).

It's true that if you have autoimmune thyroid disease it can predispose you to other conditions of the endocrine system (adrenal disease, diabetes, PCOS etc...).

Based on the symptoms you described, your elevated antibodies and a goiter...it seems that you should request a "trial run" for a few months on thyroid hormone.

Kelly

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Avatar universal
I posted back to you.
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Avatar universal
I posted a question for you & Dr. Mark below on the question about RAI.              Thanks
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Avatar universal
I posted a question for you & Dr. Mark below on the question about RAI.              Thanks
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Avatar universal
lietchi,

I'm sorry. It was someone elses TSH that dropped and I got it mixed up. But your is kinds low end.

Your doctors lab slip is probably printed up by thier own office. It is a way to save money. He probably has a guidebook he is supposed to follow. Alot of the forms I have seen, the Free T3 has to be written in.

You should see an endocrinologist if you could. One that specializes in the thyroid. And deals with the thyroid primarily. Many primarily deal with diabetes. So it is important to ask.

The antibodies are produced in the bone and thymus. B-cells come from the bone and T-cells come from the thymus.

I hope this helps.

lil deb
Helpful - 0
Avatar universal
Just one thing: where did I say my TSH had dropped? Misunderstanding I guess... I just have one TSH number, and that's the one I posted here...

Interesting about the estrogen... I used Nuvaring, which is supposed to have low hormones and local effect, but maybe it was the cause... Wouldn't explain the antibodies though I guess?

As for the free T3, that only gets tested if the free T4 is off... (It says so on the printed form where the doctor has to check the boxes of the stuff he wants blood examined for...) I probably need an endo to prescribe that test, not a GP...
Helpful - 0
Avatar universal

You need to ask to get all the proper lab tests. That would include the TSH AND Free T4 AND the Free T3. These are not the same as the T3 and T4. The T mean Total. The total levels is a combination of the thyroid hormone that is already used, which means it has bounded onto its receptor; and the hormone that is free and roaming in the blood stream, waiting to be used.

The TSH can be interfered with by other hormones besides the thyroid so I wouldn't look at that one right now, except that you say it dropped. It could have dropped because of another entity, such as a recent stress. Your Free T4 looks good, so that leaves the Free T3 which we don't have, but could very well be too low. The Free T3 is the active part of the thyroid hormones. T4 converts to T3. Having the Free lab test can give you a bigger picture of what is happening.

Women have natural estrogen flucuations, estrogens and thyroid hormones fight for the same receptors in the body. Estrogens interfer with the Total Thyroid lab tests. That is why it is important to use the "Free" T3 and the "Free" T4 lab tests also. These show the thyroid hormone that is available and waiting for use in the body, and is more accurate. Also, too many estrogens can make a person hypO. If you took BC and had normal estrogen levels, this could throw you toward hypOslightly. Basically, with too much estrogen, the pituitary gland would sense this and turn off some of the estrogen and unfortunately signal to shut down some thyroid production too, making you hypOish. Because women are all different, getting reproductive lab tests along with thyroid lab tests may help you to get a bigger picture of what is going on. The adrenalin gland, reproductive glands, the thyroid gland and others are sort of like a family. When one goes off the others can go off too.

I did this with my labs and over many months, finally a pattern emerged. Estrogen low, thyroid low, estrogen high, thyroid high. One come before the other and it could be different for different people, but it can help in managing your disease.

You definately need iodine. You need 150mcg per day. The best way to get this is to take a multivitamin.

Yes, you should pursue this. It sounds to me that you are subclinically hypothyroid. But only full labs can tell.

Also, with your goiter, generally what happen is they thyroid cells reproduce themselves in order to produce more hormone.

I would ask my doc for the full lab testing, and if he didn't do it, I would go to someone else. Also, when trying to get diagnosed. One lab test is not always enough to show. My sister was clearly hypOthyroid with all the symptoms and a goiter.  Her labs kept showing normal. Low end normal, her doc wouldn't do anything at that point. She always went to get her labs at the same day of the month. We had her try getting her labs done two weeks earlier then her usual day. and it finally showed up. She was out of range hypOthyoid.  

Also check this out for your antibody testing in which you were:
antithyroglobulin antibodies: 43 U/mL (range: <40)
You are showing likely Hashimotos!

Here is the link:
http://www.medterms.com/script/main/art.asp?articlekey=20477

Definition of Antibody, antithyroglobulin

Antibody, antithyroglobulin: An antibody directed against thyroglobulin which is a key protein in the thyroid gland essential to the production of thyroid hormones (thyroxine and triiodothyronine). Antithyroglobulin antibodies can damage the thyroid gland and affect its function.

Testing for antithyroglobulin antibodies in the blood is useful in the diagnosis of some thyroid and other disorders. Conditions in which there may be antithyroglobulin antibodies include: Hashimoto thyroiditis (an autoimmune thyroid disease), Graves disease (overactivity of the thyroid), hypothyroidism (underactivity of the thyroid), thyroid cancer, lupus, rheumatoid arthritis, autoimmune hemolytic anemia and Sjogren syndrome.

Antithyroglobulin antibodies are also called antithyroid antibodies.



I hope this helps,
lildeb
Helpful - 0
Avatar universal
Hi, I'm just a patient but the lab results show you had an elevated "antithyroglobulin AB" reading and two in the "TSI" antibodies that might need followed up on (one borderline, the other elevated). Some people read the "<40" reference range on the antithyroglobulin ABs and think it means, 40 or below but it actually means they need to be "below 40".  Yours were above 40 (43), which isn't highly elevated but seems your Dr. would see need for follow-up monitoring, especially with having symptoms.
Dr. Mark will have better answers for you.
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97953 tn?1440865392
MEDICAL PROFESSIONAL
The Thyroglobulin antibody is slightly elevated otherwise thyroid tests are completely normal.  Doesn't look like I- deficiency.  A trial of thyroid hormone would not be unreasonable but if after 4 or so months if there is no symptomatic improvement I would stop it.  Goal TSH with treatment would be around 0.5 (ie if you are young & healthy start with 50mcg levothyroxine).
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