TPO and Tg Lab Questions

[Meesh00]

Hello!

I am waiting to hear back from my doctor after getting my lab results and was hoping to start researching a bit.

Having Hypothyroid symptoms I had lab tests done -

TSH 8.4     (0.45 - 5.10)
Tg <0.9      (0.0 - 4.0)
TPO 94      (0.0 - 9.0)

I understand my TSH is a little elevated but I'm confused about having a high TPO vs Tg. Is this indicative of Hashimoto's having only one of the antibodies? Is there other things this could be?

Thanks!

[Red_Star]

Depression, insomnia, anxiety, hair loss, constipation, menorrhagia, low body temperature, weight gain/unable to lose weight, miscarriage are all listed symptoms of untreated or undertreated hypothyroidism.

[gimel]

You have lots of hypo symptoms, including some for which you are taking medications already.   As you get your thyroid hormones up to optimal levels you may find no more need for some of those.  

It is good that the doctor gave you a starter dose of 25 mcg of the Synthroid, which is a T4 med.  I am also glad that you were directed to return in 4 weeks for re-test and hopefully a further increase in your Synthroid.    

In the future I suggest carrying to the doctor's office a list of the tests you want done.  That way nothing gets overlooked.  You should make sure they test for Free T3 and Free T4  and also Vitamin D, and ferritin.  If the latter two are too low in their ranges that can also cause symptoms as well as adversely affect how thyroid hormone is metabolized.  

Also keep in mind what I mentioned above:.  As you proceed, keep in mind that a good thyroid doctor will treat a hypo patient clinically, by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be the main concern, not just lab test results.  Many members, myself included, say that symptom relief required Free T3 in the upper part of its range and Free T4 around the middle of its range.

[Meesh00]

Thanks for the response!

Unfortunately, my doctor didn't test Free T3. She said she would test "everything" but the nurse was having a hard time remembering what tests that included. I'll definitely bring it up at my appointment in 4 weeks. My lab results are not with me at the moment.

My doctor did call in a prescription of 25mg (0.25 mg, I don't know what it technically is) of Synthroid. In the message she left, she said that my TSH was higher than she liked and my Total T4 had something going on (but I don't remember what) but everything else looked ok. And to come back in 4 weeks to retest. So, I was confused by that message as I thought it looked like I was positive for Hashimoto's but it wasn't mentioned. So I turned to the internet. :)

As far as my symptoms, I take the following medications (for the last 8 years or so):

Wellbutrin XL -  300mg for depression
Lorazepam - 4mg for insomnia (I've been able to fall asleep with just melatonin lately though)
Xanax (don't know dosage) as needed for anxiety
* Spirolactone - 50mg for hair loss (don't always take this)
Linzess - 290mg for Chronic Idiopathic Constipation
* Skyla IUD for Menorrhagia  

My body temperature is always under 97 degrees (no matter the time of the month), I am always ice cold (especially my feet),  despite being active/calorie aware I am borderline overweight, and I've had 3 miscarriages (these occurred long before my current set of doctors).

My CIC, Menorrhagia and being cold are really my main issues these days.

[flyingfool]

My first question is:  How do you feel?  That is what symptoms if any are you having?

[gimel]

The reason for running both tests is that Hashi's can show up in either.  Your TSH is more than elevated just a little.  Taken together, your test results are strong evidence of Hashimoto's.  

But TSH is affected by so many things that it is only an indicator, to be considered along with more important indicators such as symptoms, and also the biologically active thyroid hormones, Free T3 and Free T4 (not the same as Total T3 and Total T4).  In the future you should always get tested for Free T3 and Free T4 each time you go in for tests.  Scientific studies have shown that Free T3 correlated best with hypo symptoms, while Free T4 and TSH did not correlate at all.  

As for what to expect from your doctor, for Hashi's some doctors like to wait until the patient is having overt symptoms, others will be more proactive and start the patient on meds to gradually build up the levels of Free T3 and Free T4 with the objective that symptoms are minimized and eventually eliminated.  So how are you feeling?  What, if any, symptoms are you having?  

As you proceed, keep in mind that a good thyroid doctor will treat a hypo patient clinically, by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be the main concern, not just lab test results.  

I suggest that when you hear from the doctor, you should inquire about getting the Free T3 and Free T4 tests, and also if the doctor is going to be willing to treat clinically, as described.  If not, then you will eventually need to find a good thyroid doctor that will do so.

When you have additional test results, please post them along with reference ranges and members will be glad to help interpret and advise further.