1) Hashimoto thyroiditis (autoimmune hypothyroidism) - antibodies to various thyroid antigens, the most frequently detected of which include anti-thyroid peroxidase (anti-TPO), antithyroglobulin (anti-Tg), and to a lesser extent, TSH receptor-blocking antibodies.
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2) Some doctors don't like to rush into treatment for any number of reasons such as symptoms resolving without further treatment needed, unnecessary side effects etc.
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3) Yes. There is a lot of information online and published (based on clinical trials, ancedotal evidence, and clinical practice) showing thyroid antibodies can be lowered. Just to note, not all thyroid sufferers will show the same results so take that into account. This is just a small sample...
Clinical practice -
From the book called Your Thyroid Problems Solved by Dr Sandra Cabot. This is what she noted in her practice with one of her patients. Dr Cabot is a famous naturopath (is also an MD) here in Australia. I've edited this information:
Patient with Hashimoto's Thyroiditis:
The level of her T3 hormone is very low, whilst her T4 level is quite high; the high T4 is coming from her thyroxine medication. The body is not converting thyroxine (T4) into T3.
Free T3 = 1.1 pmol/L (2.5 - 6.0)
Free T4 = 23 pmol/L (8.0 - 22.0)
TSH = 2.0 mIU/L
Anti thyroglobulin antibodies = 80
Anti microsomal antibodies = 1200 (thyroid peroxidase antibodies)
New treatment: Patient prescribed T3 (brand name tertroxin) 20mcg three times a day, T4 100mcg a day, selenium (Dr Cabot recommends 200mcg daily), gluten and dairy free diet, bowel and liver detox.
Three months later:
Free T3 = 5.0 pmol/L (2.5 - 6.0)
Free T4 = 16 pmol/L (8.0 - 22.0)
TSH = 1.9mIU/L
Anti thyroglobulin antibodies = 40
Anti microsomal antibodies = 350
Clinical trials -
I've just added two but there are many more:
Turkey - 2006 Journal of Endocrinology. This study showed a 30% decrease in anti-thyroid antibodies after 3 months of 200mcg per day of L-selenomethionine supplementation for in women with Hashimotos Thyroiditis. The starting average TPOAb was 803 and after 3 months the average was 572.
"In the study of 21 patients with euthyroid Hashimoto's Thyroiditis (normal range TSH, but elevated antibodies), half of the patients were treated with levothyroxine for a year, the other half were not treated. After 1 year of therapy with levothyroxine, the antibody levels and lymphocytes (evidence of inflammation) decreased significantly only in the group receiving the medication. Among the untreated group, the antibody levels rose or remained the same."
Ancedotal evidence -
Gluten free diet lowers TgAb antibodies.
http://www.medhelp.org/posts/Thyroid-Disorders/Gluten-Free-Diet-Lowers-TgAb-but-not-TPOab/show/1003484
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4) Yes. "Elevated thyroid antibodies are often associated with chronic urticaria, also called hives. Studies report that as many as 57.4% of patients with hives have the presence of anti-thyroid antibodies. An August 2010 paper suggests that treatment with T4 improves the itching associated with urticaria, but did not advise treatment with T4 unless the patient was hypothyroid." - excerpt from Life Extention - Thyroid Regulation
From what i've read, vitamin D deficiency is common in 98% of patients suffering with autoimmune thyroid due to defects in the receptor site for vitamin D.
The University of Nebraska Medical Center research study has determined that patients with chronic hives may benefit by supplementing with vitamin D. The researchers found patients with chronic hives had significantly reduced levels of vitamin D, with nearly half of them considered to be vitamin D deficient. Try 1,000 to 2,000 international units (IUs) daily. The vitamin D council state optimal vitamin D levels - 80ng/mL or 200nmol/L.
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5) As thyroid disease progresses, the worse the symptoms may grow in severity. In some rare emergency cases, untreated hypothyroidism may lead to seizures, coma, heart failure. Death related to Hashimoto thyroiditis typically results from failure to make the diagnosis of hypothyroidism or to start thyroid replacement therapy in adequate doses, or from failure on the part of the patient to take the replacement medication.
Instead of waiting for a week, maybe the doctor will agree for your husband to come in now and have blood drawn for testing. Then the results would be available for discussion at the appointment. When your husband does go in for blood work, he should request testing for the biologically active thyroid hormones, Free T3 and Free T4 (not the same as Total T3 and Total T4), along with the TSH they always test for. If the doctor resists, then insist on it and don't take no for an answer. Free T3 is the most important thyroid hormone test because FT3 largely regulates metabolism and many other body functions. Scientific studies have also shown that Free T3 correlated best with hypo symptoms, while Free T4 and TSH did not correlate.
Since hypo patients frequently have deficiencies in other areas, I would suggest additional testing for Vitamin A, D, B12, zinc, selenium, and RBC magnesium.
With Hashi's there seems to be two approaches used by doctors. One is to start medication fairly early, to prevent the worst of hypo symptoms. Others like to wait until hypo symptoms become overt. You can read about the preventive approach at this link.
http://thyroid.about.com/od/hypothyroidismhashimotos/a/preventative.htm
Regardless of the treatment approach, Hashi's does not go away, but the resultant symptoms can be minimized by taking adequate doses of the proper medication. It will become very important to him to find a good thyroid doctor that will treat him 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 all important, not just test results. This is a link to a letter written by a good thyroid doctor. Note the clinical approach to treatment.
http://hormonerestoration.com/files/ThyroidPMD.pdf
If your husband will get that testing done and get the lab report and post results and reference ranges, then members will be glad to help interpret and advise further. In the interim, there are a couple of thing that he can do that have been reported to help. One is to take 100 mg of selenium daily. Some members have found this to dampen the level of the antibodies. I also remember some member reporting on using a lotion of some kind that helped the rash a lot. I will do some searching and see if I can locate that info.