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High Perioxidase Antibodies/Small thyroid
Dr. Lupo.
I recently had my thyroid checked. A doctor had pulled me back in my meds after seeing a fasting TSH between 0-1 two years ago. At the time, I felt I was thriving for the first time in 20 years, and had no hyper symptoms whatsoever, but I trusted her. Since that time, I have slowly begun to lose mental sharpness, memory lapses are much more frequent, I have moderate cognition problems, slowness of motor coordination, lots of muscle pains and joint pains, difficulty breathing on mild exertion and I struggle to write as my fine motor coordination is weak. I'm much more worried about the mental slowness than the 7 pound weight gain, but it is not great either. Now, I have a test and it shows very markedly high perioxidase antibodies, TSH of 3.5, T4 mid range and T3 uptake 30%. They took an ultrasound of the gland and they noticed it was really small, only 2.5 total volume and about 3.2 cm each side. The new doctor put me on Armour 90 mgs. (the equi of the 150 mcg of Levothyroxine I was on).
Could this mean that I should be on total replacement? Why is my thyroid so small? I feel like a 90 year old woman and I am only 36.
I recently had my thyroid checked. A doctor had pulled me back in my meds after seeing a fasting TSH between 0-1 two years ago. At the time, I felt I was thriving for the first time in 20 years, and had no hyper symptoms whatsoever, but I trusted her. Since that time, I have slowly begun to lose mental sharpness, memory lapses are much more frequent, I have moderate cognition problems, slowness of motor coordination, lots of muscle pains and joint pains, difficulty breathing on mild exertion and I struggle to write as my fine motor coordination is weak. I'm much more worried about the mental slowness than the 7 pound weight gain, but it is not great either. Now, I have a test and it shows very markedly high perioxidase antibodies, TSH of 3.5, T4 mid range and T3 uptake 30%. They took an ultrasound of the gland and they noticed it was really small, only 2.5 total volume and about 3.2 cm each side. The new doctor put me on Armour 90 mgs. (the equi of the 150 mcg of Levothyroxine I was on).
Could this mean that I should be on total replacement? Why is my thyroid so small? I feel like a 90 year old woman and I am only 36.
MEDICAL PROFESSIONAL
The dose is weigh based (usually 0.7mcg/pound) but 150mcg of LT4 is a full-replacement (or more) for most women. The thyroid is small likely b/c of atrophy in the setting of long-standing hashimoto's. A target TSH in the low-normal range may be appropriate for you.
Dear Dr. Lupo, thank you so much for your opinion about my thyroid and the antibodies. My GP humored me and switched me to Armour 120 and frankly, it has improved my energy and muscle pain but my T4 went down. My hair is not growing too fast, and I am constipated more. Anyway, then a new doctor wrote an Rx for Cytomel 20 mg per day (spread out) and 50 mcg of Levothyroxine. My free T4 and free T3 were at the time both bottom of normal range. I am afraid to take this prescription because I don't want to mess with my levels. Do you have any opinion on amping the T3 like that and muting the T4 so severely? Do you think this is equiv to 120 mg of Armour? It seems like it would be lower. Thanks in advance. K
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