Sorry - so many questions in search of knowledge

[bluebottle228]

Sub-clinical hypothyroidism Doctors are often faced with the dilemma of a patient with a normal serum free T4 and a raised TSH level but who does not have symptoms or signs of hypothyroidism.2 Such patients have sub-clinical hypothyroidism and they require follow-up.
When an isolated raised TSH level is found, TSH testing should be repeated, along with a serum free T4 measurement. Measurement of microsomal (thyroid peroxidase) antibodies should also be carried out. Occasionally, repeat serum TSH measurements are normal, which may indicate an episode of transient thyroiditis or a laboratory error. If the TSH level remains raised (above 5-6 mIU/L), and microsomal antibodies are positive, then treatment with thyroxine should be given. Some patients with sub-clinical hypothyroidism do derive clinical benefit from thyroxine replacement. In addition, replacement therapy will avoid the development of overt hypothyroidism if the patient is lost to follow-up. If the TSH level is only mildly raised (<10mIU/L) without microsomal antibodies, thyroxine replacement may be withheld, but serum TSH and microsomal antibodies should be measured again after three months.

I have found the above - I think i am in the last sentence category - my question is... what about after being tested again after three months, then what happens?  I can find alot about re-testing after 3 months but no more.  I feel tired, very tired at times, have a swollowing past apea sensation going down to my sturnam.  How many tests does one have to have and for how long?  What is the significance of anti-bodies and what if the doc hasnt tested for this?

[bluebottle228]

Thank you for your reply as that is the clearest explanation I have had.  From your information I have now scheduled an appointment with my GP to discuss my results and what tests she has done and proposed course of action as I just seem to keep having re-tests every three months.  I am very greatful to you.

[AR-10]

The significance of anti-bodies;

If you have thyroid anti-bodies at an elevated level, the doctor knows that your thyroid is being damaged. He also knows that even if your hormone levels are normal, sooner or later they will not be, because your thyroid damage will mess things up. Therefore you need follow-up testing.

If you have Hashimoto's anti-bodies, and your TSH is above 5.0, treatment is indicated.

If you have no anti-bodies and your TSH is above 5.0, then your doctor should be running other tests to find out why. Because it should not be.

If you have a TSH that is either high normal or low normal, your doctor should run ALL thyroid anti-body tests.