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Elevated thyroid per oxidase ab
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Elevated thyroid per oxidase ab

I am currently experiencing pain and swelling of the  joints in both my pinky fingers.   Both are getting bent inward and look somewhat deformed.   I also have pain in the joints of my hands.   My knees, arms and legs and neck are always in pain.    At the end of a 7 hour work day,  I feel like if was picked up off the ground and dropped crushing every bone in my body.  
I went to my family doctor.  He tested me for rheumatoid arthritis which was negative and other autoimmune diseases.  Only thing that came out abnormal was the peroxidase ab 577.0.   T4 normal. Tsh normal.  
I have a goiter of the thyroid, nodules, pain.    After numerous years of blood work, scans and endocrinologists.  This is the first time  something has been found really out of common with my thyroid.    
My doctor sent me pain medication and anti inflammatory medicine  Diagnosed that instead of the thyroid being the focus of the peroxidase anti bodies that my joints are.  
Question.
what now. I'm only 50 and feel like I'm 90.  I don't want hands to get deformed    My fingers are my bread and butter (typist)  Do I spend my life taking pain killers and anti inflammatories.   The doctor is not treating the cause of the problem only trying to ease the results.   Is there treatment for a normally functioning thyroid ? Would this indicate the need to have thyroid surgery?  Thanks for reading. Would appreciate any advise.    
13 Comments Post a Comment
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Avatar_f_tn
Elevated TPOab indicates Hashimoto's thyroiditis.  Hashi's is autoimmune hypothyroidism and the most prevalent cause of hypo in the developed world.

Please post the exact results of your other thyroid tests.  Include reference ranges as they vary lab to lab and have to come from your own lab report.  

When it comes to thyroid testing, "normal" isn't necessarily "normal".  We can take a look and give you our analysis of whether you should be on thyroid meds or not.  

Nothing you have posted indicates the need for surgery.  Surgery is most often done for cancer and Graves' disease (hyperthyroidism), very seldom for hypothyroidism.  
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Avatar_m_tn
Just because your T4 and TSH were in the so-called "normal" ranges does not mean all is well.  If you will please post your thyroid test results and reference ranges shown on the lab report, members will be better able to comment further.  Also, if you look at this list of 26 typical hypothyroid symptoms, do you have some of those as well?

http://endocrine-system.emedtv.com/hypothyroidism/hypothyroidism-symptoms-and-signs.html
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Avatar_f_tn
Thanks for your reply.   The t4 is 7.6.     Range. 4.5-12.5.    Tsh is 1.19 range 0.40-4.00.    Throglobulin ab.   42.   H.   Range -40.   Thyroid peroxidase ab 577.0.  H   Range.    -35.0
I do have most  of the symptoms.   Weight gain, dry skin,  swollen a ankles. Aches and pains muscles and joints.  Trouble remembering things. And feeling depressed.  the depression and anxiety I have had since my father died 5 years ago.   Which I take anti.  Depressives and anxiety pills.  I also  have swollen gland(. Goiter.)   And cholesterol readings were.  241. H range -200. LDL cholesterol, calc.    171.   H  range -100.        Thanks
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Avatar_f_tn
Thanks for your reply.  I have posted my lab results.      
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Avatar_f_tn
Your doctor has orderd total T4, which is considered an obsolete test, of limited usefulness.  He should be ordering FREE T4.  Total T4 tells the total amount of T4 in your blood, but much of that isn't available.  FREE T4 tells what's available.  He should also be ordering FREE T3.  T3 is the active form of the thyroid hormones, so very important.

That being said, your TT4 is a little low.  Many of us find that T4 has to be around the middle of the range or we still feel hypo.

High cholesterol is also a symptom of hypo.  So are depression and anxiety.  In fact, anti-depressants can actually make depression worse if the cause of the depression is hypothyroidism.  

Your TPOab is elevated, which indicates that you have Hashi's.  Although your T4 isn't all that low (yet), you have symptoms, so your doctor should be putting you on meds.  

Is "...calc.    171.   H  range -100."  calcium?  If so, that's a separate issue of the parathyroid.  The only relationship of the thyroid to the parathyroid is their proximity in the body.  Parathyroid regulates serum calcium.

If I were you, I'd pursue this with a good thyroid doctor if your current doctor isn't inclined to treat.  
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Avatar_f_tn
Thanks very helpful.  Yes calc. Is calcium.    I made apt with a dr who specializes in thyroid treatment.    You have given me a lot of information I was unaware of and what to discuss with the doctor.   Appreciate your time. I will post the results of my visit.   My appointment is for tomorrow.
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Avatar_f_tn
Good luck with your appointment.  I hope you like your doctor and he's responsive to your symptoms.  If I were you, I'd spend some time today writing a list of your symptoms so you don't forget anything when you're talking to the doctor.  You can google a "complete" list of symptoms or follow gimel's link above.
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Avatar_f_tn
Thanks.  Will do.  I'm also gathering past blood work for comparison.  
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Avatar_f_tn
Hello back from doctors appointment.   No medication needed.  I have a perfectly functioning thyroid.
If I were to take medication, it would have adverse effects. No concern over high anti bodies, and goiter.  However, she wants me to do an ultra sound.  She said she is very interested in the results.  She told me she  is very concerned about the swelling of the joints of my fingers and referred me to a rheumatologist . I told her that the blood work came out  negative. She won't rule it out until he says so. I am  having the ultra sound done this weekend and seeing the rheumatologist  asap. I am back at square one.

Now I am wondering what can be causing the swelling of my joints. Any ideas            

Thanks
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Avatar_f_tn
Did she tell you that you have Hashi's?  Did she order proper tests?  She's not concerned about your goiter?  Why does she think your thyroid is swelling?  Just for the heck of it?  It's inflamed.  Did she comment on the antibodies at all?  What about your long list of hypo symptoms?

Sorry, i don't mean to badger you, but I'd like to beat her up!  LOL
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Avatar_f_tn
Hi.  I can understand how you feel.  It is so frustrating.  Yes she did say I have Hashi's.   she didn't really care about the goiter said it is not that big.   Even though, my neck is swollen. And I feel some what self conscious about it,   I don't know if I'm hypo or hyper.   She said that in time it will change to either one because of the antibodies.  Is there a specific size for them to say ok it should be removed.    It should be up to the person who is all dealing with the discomfort and pain and the rest of the symptoms.  My mother had to have hers removed and a small part was cancerous and my daughter just had half removed along with an egg sized nodule attached to it.  
She did ask about family history. When i told her that my father died of a massive heart attack five years ago., that caught her attention.  I'm guessing that these autoimmune diseases increase probability of heart attacks.    I'm actually hoping that my ultra sound shows more growth.   I wish I could have it removed and take a pill for the rest of my life.  I have been dealing with this for so long , but they just don't think I need surgery not yet anyways.




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Avatar_f_tn
I'm sorry, "I" should be the one maintaining my cool and comforting you!  I just get so mad at doctors at times.

Your doctor didn't order FT3 and FT4, so we don't know for sure, but given your symptoms, my money's on hypo...definitely.  

Removal of the thyroid is seldom recommended for Hashi's, unless there are extenuating circumstances, e.g. swallowing and/or breathing is being impacted.  Meds will often reduce the size of the goiter by making it work less hard.  Perhaps you could see another doctor who would consider meds???

I've never seen any studies linking autoimmune disease to more heart attacks.  Heart attack usually gets their attention...they understand that a lot better than they do thyroid.  

Don't just suffer with this.  Find a doctor who knows more about thyroid and is willing to give you some meds.
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Avatar_f_tn
Believe me I am fed up with doctors myself.   I had given up with the follow ups.  When my joints began to swell, I got back on the thyroid roller coaster.
This doctor seems to be a good doctor.  She has a good reputation and works for one of the best hospitals.  Waiting to get the results of my ultra sound.    Funny thinking back at the age of 22 was the first time I went to check my thyroid.  The doctor told me that I should have my thyroid removed because I had cancer.  I went to my doctor and he sent me for tests which came out negative. As of today, no cancer thank god.  Lets see what happens with the ultra sound.   I will keep you posted.  Appreciate your advise.  
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