Hashimoto's-what should I do

[lilynne]

Hello

I'm new to this forum and I would really appreciate it if someone could give me some good advice.

I'm 24 years old female been suffering from hypothyroid symtoms for more than 3 years but doctors will not prescribe me anything as my TSH which was initially out of normal range is now normal despite no medication (Praise God!). I tested positive for thyroid antibodies though in 2006.(thyroid peroxidase).

The following are my blood test results
17/02/2006
Serum Free T4 level = 8 pmol/L
Serum TSH level = 4.52 mui/L
No antibodies done
03/08/2006
Serum Free T4 level = 10 pmol/L
Serum TSH level = 4.22 miu/L
Thyroid peroxidase numeric value supplied = 19.3 ku/L
05/02/2007
Serum Free T4 level = 13 pmol/L
Serum TSH level = 2.79 miu/L
No antibodies done

I did not even realise that if you tested positive for thyroid peroxidase, that means you have Hashimotos. My doctor did not even tell me that.

Should I get treatment for Hashimoto? My doctor has left me to be on my own as my TSH is normal. I have read other people's experience whereby doctor's have treated their Hashimoto irregardless of the reading of their thyroid antibodies.

Can anyone advice me what I should do? I'm worried that because this is an autoimmune disease, by not treating it it will worsen-right?

Also, what supplements can u recommend for Hashi/hypo?

Many thanks!
Li

[GravesLady]

There is no treatment or cure for antibodies....nothing can be done about them! Its the thyroid that is treated from the damages of the antibodies. Once tested and autoimmune conditions has been confirmed, it is generally not useful to repeatedly measure levels of thyroid antibodies in the blood.


Levels are the prevailing diagnose for thyroid conditions including autoimmune thyroid!

TSH tells if a person is either hyperthyroid or hypothyroid.  Your TSH is in Labs reference range, so it relates to no thyroid issue!

A person has to be either hypo or hyper to be autoimmune!

FTs, both, will relate to what type of hypo or hyper condition you have and other test just confirm, including antibody tests!

Presence of  antibodies is not enough for a diagnosis of Hashimoto’s thyroiditis. A lot of people with normal thyroids have antibodies including other autoimmune conditions such as Sjögren syndrome, lupus, rheumatoid arthritis, and pernicious anemia.  

Some hypos and some hypers have both antibodies!  Hashi antibodies are seen in Graves' disease (as well as other autoimmune disorders).  Graves' antibodies are seen in Hashi (as well as other autoimmune disorders).  So antibodies are not too reliable at what condition we might have, if any. Unless thyroid antibodies confirms the prevailing diagnose with thyroid test stating first.....TSH, and both FTs!

We do not suffer thyroid symptoms with normal levels that state no thyroid condition! Then levels would be way high (or low).
Other health conditions share a lot of thyroid symptoms.  So if you are suffering with symptoms other conditions sharing symptoms must be tested and eliminated of the cause, before thyroid should be blamed.
As it is, thyroid treatment is not a cure-all for symptoms!  Symptoms might have to be treated separately from each other and from thyroid, regardless.

Per US Government Jan 14, 2004 and AACE revised 2006, hypothyroidism treatment is indicated with TSH  10 or higher.  However, with a goiter treatment is warranted with a TSH between 5 and 10.
Available data show no benefits for early treatment.  Therefore, the US panel does not recommend routine levothyroxine treatment for patients with TSH levels between 4.5 and 10 mIU/L, but thyroid function tests should be repeated at 6- to 12-month intervals to monitor for improvement or worsening in TSH level.

Trust and believe in your doctor!

[lilynne]

Thank you so much for your advice. You mentioned that a person has to eb either hypo or hyper to be autoimmune but although my TSH is normal, I have alot of hypo symtoms like

my hands and feet are extremely cold
feeling tired and lethargic all the time
i get colds very easily
i can't concentrate
knee joint pain
hair loss although that has reduced dramatically praise God

I was initially hypo when my TSH was 4.52 and 4.22 more than 1 year ago but it has since reduced. Does that mean I was then Hashi but am no longer suffering from Hashimoto?

[GravesLady]

Your TSH (4.52 and 4.22) does not state hypothyroidism per AACE and US Government.

TSH does not relate Hashi, only hypothyroidism or hyperthyroidism.  The FTs relate autoimmune with TSH.

A person can be hypothyroid without being autoimmune, but can not be autoimmune without being hypothyroid.  Same with hypers - A person can be hyperthyroid without being autoimmune, but can not be autoimmune with out being hyperthyroid.

Once we are autoimmune we will always be autoimmune because there is no treatment or cure for autoimmune thyroid - Graves' or Hashi!  In other words, Hashi nor Graves' are not curable, only the hyper or hypo side of the disease, hopefully! Once Hashi always Hashi (or Graves').

I am stating all this with the assumption that you have not been diagnosed with hypothyroid (TSH 10 or higher), or Hashi,  plus you have no goiter, and you are not on any thyroid meds. If you have been, seeing your diagnosed levels, all three, would be helpful for me to understand a little more what you are trying to relate.

I have 5 out of 6 of your symptoms and I am Graves'.  I do not blame thyroid for these symptoms for I have had them most of my life, way before diagnosed Graves'.

I don't know if this helps you to understand thyroid and thyroid levels.

[lilynne]

Hi there again

Thank you so so much for your explanation. This clears up some misunderstanding about my thyroid gland. You are the first person to explain it so clearly.

I have tried reading about Hashi and hypo on the internet and they actually said something different hence I was confused. They actually mentioned that irregardless of whether one was hypothyroid or not,l if one tested positive for antibodies, some doctors may recommend treating for Hashi. I don't know whether that makes sense or not. May I know how you got all your information?



Lynne

[momto3girls]

I'm really confused here.  I thought the AACE clinical guidelines stated a TSH of over 3 to be outside the normal range.  What 2006 AACE update are your refering to?  Can you post the address so I can read it myself?  Your information is conflicting with what my doctor has told me.  I should mention that my doctor is highly respected and a fellow of the Mayo clinic, a speaker for the Cleveland Clinic Endocrinology and Metabolism Board Review, and is on the board of directors for the AACE.  So obviously I highly respect and trust his judgement.  Can you clarify for me what you're talking about because I'm so confused.  Thanks!

[GravesLady]

lilynne,

I do a lot of searching and reading, after all I do have Graves' Disease with possible early stages of Hashi according to my Labs.  I only us information from legit sites such as
thyroid org., thyroid associations, government - US or other countries, etc. I would share URLs sites, but I have already been put on the carpet with a warning from management for some reason and I do not want to take the chance in listing URLs and lose my membership here - I'm on my last warning even if its the first - instead of three and strikes your out, its two ;)

momto3girls,

There was so many conflicting info., and complaints from a lot of medicals, that AACE has revised their guidelines in 2006, which now corresponds with the US Government guidelines as well..
The TSH between  3 and lower, is just a TARGET RANGE for ALREADY DIAGNOSED AND TREATED PATIENTS.  Diagnose and treated patients have different Lab ranges.  As well as hyper, hypo and goiters, nodules, plus all different types of thyroid conditions,  all have different diagnose and target ranges.

These are guidelines for doctors and Labs to follow, however it is not a 100% law. If you are already diagnosed and on treatment, then the TARGET (TSH 3 or lower) range within your Labs reference range is fine. I post the guild so people will understand why their doctor will not treat them when TSH is just a tad off or not in AACE range of 3.
There is much more to thyroid than just TSH, antibodies and being hyper or hypo, and, their diagnosed and treated ranges.

I am sure your doctor is very reputable. You must go by his knowledge of treatment and with your Labs reference range.  After all he is the one with the long expensive education and I would never undermine a doctor.

As I mentioned above to  lilynne regarding posting URLs, stands here as well.  However you can do what I did and google for the information. Make sure it is AACE 2006 revised and 2004 US Government guidelines.


Good Googling!  ;) ;) ;)

[lilynne]

Hi

I'm actually in the UK. Sorry, I should have mentioned that earlier and looking at the blood test done, any TSH above 3 appears abnormal as it was clearly stated next to my earlier TSH results. So, it looks like for UK TSH of more than 3 is abnormal.

GravesLady since you state that TH relate to autoimmune disease cans you please let me know what sort of values I should be looking out? As in, normal range? I know the only TH value I have provided is free T4 but if I feel that I should have tests done on other THs, pls let me know and I will try to ask my doctor to do it.

Thanks again for the help.

By any chance, would you recommend any supplements?

[GravesLady]

If you  are meaning TSH when you typed TH (?), you  missed read my post.  It is not TSH that relates autoimmune, but rather both the FTs with TSH relating hypo or hyper.  In other words, if the FTs show possible Hashi, the TSH would state hypo level higher than Labs reference range and antibody test would confirm.  

It depends where in  the UK and which Lab is being used, for the  UK is the same as the US, not all Labs have the same TSH range. For instant one Lab uses a TSH range of 0.5 - 5.5, which again, are for already treated patients, not for diagnose.

You look for the values that your doctor suggest.

TSH and FT-4 is enough to state if you are hypo.  And I repeat, people have to be hypo to have autoimmune (Hashi). Also to repeat again, Antibodies are not a primary diagnose, for people with no thyroid problems can have antibodies, as well as other autoimmune conditions.  I am sure you wouldn't want to be treated for thyroid by antibodies alone (without Labs stating), when you could possibly have other  autoimmune conditions, with them being ignored, because you think your antibodies are thyroid, when in fact the antibodies are due to another health condition.  

I recommend vitamin/mineral supplements, good nutrition, stress free life style as possible, plenty of rest and sleep, exercise and no smoking, for general good health.  

Keep getting test done on an regular bases.  There is a possibility that some time in the future your Labs might show Hypo/Hashi.

Good luck!

[GravesLady]

The TSH range that I refered to in my last post of 0.5 - 5.5, is from a UK Lab.

[lilynne]

Thanks you so much for your reply and advice.
It's hard to live  a stress free life as my job is very demanding.
I speak for myself when I say that stress probably contributes to 80% of my hypothyroid symptoms.
I wish I could just retire!


Anyhow, thanks again for your advice. I guess I will just have to monitor my TSH and T4 levels for now then

Lynne

[GravesLady]

I would say, from all that I have read and peronally experienced, that stress is 80% of all health conditions and their symptoms.  Stress is not good for general health, period. Stress can bring on health conditions and make existing ones worse.
But we do the best we can in handling the stress.  Plenty of rest, sleep, meditation, yoga exercise, even candle light aroma baths, and plenty of time for pampering yourself,  helps keep stress down and hopefully keep our health condition(s) at bay.

Keeping in mind that I am Graves':
I have cold hands and feet all my life which is the reason I never took up winter sports as snow skiing.  This is also a symptoms of MVP.

Knee joint pain could be arthritis (stress and/or autoimmune related) - My arthritis started in my early twenties (in remission now) with really bad to tears knee pain (as well as other joint pain). Also diet can cause joint pain too.

Tired, lethargic, can't concentrate and hair loss, all could be from too much stress.  If you are too stressed you might be burnt-out, which effects concentration, tiredness,  lethargic, and, more.

I wish you could retire too, however it  might not be a cure-all, even for stress. Some people are just prone to stress, its naturally in their  make-up/genes. Sometimes we have to train ourselves to eliminate or minimize stress, retired or not. But retired  is nice! :o)

You will be doing right by yourself, by getting thyroid tested on regular bases, so if and when you do become hypo enough for treatment, it will be caught in time as not to be too hypo.

Good luck - you are going to be OK!