Thyroid results

Over the last two weeks I have been seeing a doctor due to having extremely severe issues related to fatigue and sickness.

He ordered some blood tests and initially tested for lots of things, which included iron studies as well as thyroid studies. When he read these results he called the pathology clinic and asked them to run another test for antibodies which they faxed to him a few days later.

He said I had autoimmune disease which is attacking my thyroid.

I have attached a screenshot of the results.

Is he right or should I get another opinion?

[goolarra]

He's right.  Both your TPOab and TGab are elevated, and that indicates Hashimoto's thyroiditis, which is an autoimmune disease and the most prevalent cause of hypo in the developed world.

Your TSH is high, and TSH is counterintuitive.  When TSH is high, it indicates low (hypo) thyroid function, and when it's low, it indicates high (hyper) thyroid function.

Your FT4 is in range, but it's a little on the low side as many of us find we have symptoms until FT4 is about midrange.  

Is he suggesting meds?

[Introextrovert]

He did not tell me whether I was hypo or hyper.

I am so confused.

[Introextrovert]

I should also add that I am a 28 year old male.

I get so worried sometimes that I could have female genes because most of the people who have this issue are females :-(

[goolarra]

He's right.  Both your TPOab and TGab are elevated, and that indicates Hashimoto's thyroiditis, which is an autoimmune disease and the most prevalent cause of hypo in the developed world.

Your TSH is high, and TSH is counterintuitive.  When TSH is high, it indicates low (hypo) thyroid function, and when it's low, it indicates high (hyper) thyroid function.

Your FT4 is in range, but it's a little on the low side as many of us find we have symptoms until FT4 is about midrange.  

Is he suggesting meds?

[Introextrovert]

Well I am currently seeing a General Practitioner, and he said he wants me to have another blood test done in 6 weeks before he will consider anything.

Should I demand to be referred to a specialist?

[Introextrovert]

My ferritin results (accidentally put a line before the comment on my iron studies) are low as well. The other day a manager where I worked came up to me telling me: "if you would like to talk about anything, I am always here" thinking that I was depressed and even suicidal.

I look so washed out, so pale and sick!

[goolarra]

I meant to mention your ferritin and forgot...thanks for reminding me.

Yes, you should do something about that.  Ferritin is necessary to metabolize thyroid hormones, so low ferritin can contribute to intolerance of thyroid meds.  It takes a while to raise ferritin levels, so the sooner you start working on that, the better.

Whether you want to wait six weeks depends on just how bad you feel.  Is six weeks going to make or break your treatment?  No.  On the other hand, why be miserable for six weeks when you can be getting started on the road to recovery.  I think you'd feel better on meds.  

I'd get a second opinion as there's a considerable amount of disagreement in the medical community about when to start treatment for Hashi's.  Some doctors feel it should be started early before labs go out of range and symptoms appear; others want to make sure you've been a little miserable before they start treatment!  LOL

Unfortunately, just finding a specialist (endocrinologist) isn't always the answer.  Many endos only want to treat diabetes.  Many also treat by TSH alone.  FT4 (and FT3, which your doctor didn't test and should have) are the actual thyroid hormones (TSH is pituitary) and a much more direct measure of thyroid status.  However, TSH has long been taught in med schools as the "gold standard" in thyroid treatment, and old dogma dies slowly.

By and large, most of us are women, but we have quite a few male forum members as well.  You're not alone by any means...Hashi's doesn't discriminate by sex.  

We have a list of doctors recommended by forum members.  If you provide your location, I can have a look and see if we have anyone near you.

[goolarra]

On the subject of vitamins and minerals...seem to have a hard time this morning keeping them in mind...other deficiencies that also often seem to go hand-in-hand with hypo and that can mimic or exacerbate symptoms:  vitamin D, B-12, magnesium and selenium.  You might want to test those when convenient.

[Introextrovert]

I am in Sydney, Australia.

Could the ferritin levels be the cause of the autoimmune antibodies and if I fix the ferritin levels I'll end up cured or are the antibodies independent of anything else?

Sorry for all the silly questions, I just don't know about any of this and reading website information just makes me confused!

[goolarra]

Being in Aus makes it a little more difficult.  We don't have any doctors listed in Aus at all.  It's also going to be tough for you to get FT3 testing since most Aussie doctors don't "believe in it".  Ask Red_Star (she responded to your other thread) if she has a recommendation for you; she's Aussie.

Nothing cures the antibodies.  Ferritin is necessary for the metabolism of thyroid hormones, but it will not change antibodies.  Once you have them, you have them for life.  There are some people out there who have developed protocols that claim to lower antibodies.  However, even they stop short of saying "cure".  Until medicine advances, we and our antibodies have to learn to get along...

That's why we're here...to answer questions...ask away!  

[Introextrovert]

Now that I know I should get both TSH, FT3 & FT4 tested I will do that.

In terms of my doctor, I'll just tell him to add it onto the pathology request, there isn't any harm in having it tested and I am sure the pathologist wouldn't care either (more money from Medicare for them).

We have Universal Medicare in Australia, but it isn't like the systems used in Canada or the UK... it only pays for "part" of any medical bill, unless the doctor accepts what is known as the Medicare rebate as a full payment (very rare).

However, because Medicare is based around paying private doctors, it means we can choose who we go and see, we're not assigned to a doctor, meaning it is quite easy to get a 2nd, 3rd or even 4th opinion on things. So I will get that FT3 test done, even if it means going to another doctor lol.

[Red_Star]

I had to see a few doctors to have all the thyroid labs i wanted done.  Not sure why you say a full medicare rebate is rare? I've never paid for a general doctor (i go to bulk billing surgeries) and even my current doctor is private but agreed to see me and bulk bill. :) I've never paid for a blood test, CT scan, ultrasound, xray either.  I have paid a small amount for a few specialists (75% rebate) and i paid out of pocket once for a private surgeon. My choice of course but he was worth the money! :)

[Introextrovert]

My GP is bulk billing, but only some of his consultations. The medical centre does it in such a way that there are only a limited amount of "bulk billed" appointments with the rest being "private".

I have never paid for ultrasounds, pathology tests etc, that is true.

However I have always had to pay specialists, sometimes with only half being rebated.

[Red_Star]

Well, at least we don't have some pencil pusher from an insurance company telling us what you can and cannot have approved eh? :)

[Introextrovert]

True.

I guess we have the best of both worlds in Australia... universal health care WITH choice.

I also have private health insurance on top of Medicare.

[Red_Star]

I don't have insurance but that would of been handy when i chose to go private for surgery that's for sure. :)

[goolarra]

I hear that's the way to do it...universal health care with added specialty line insurance.  It can also be done like the Swiss model...private insurance handles the whole thing.  They don't make money on the "required" basic insurance that everyone has to have, but they do make money on their specialty lines.

What can I say?  We (Americans) have our heads up our butts, as usual.  We have a health "care" system about to implode.  Of the people who use our regional hospital here in central Oregon, only about 25% are paying customers.  The rest are either uninsured or on government programs.  How long can 25% carry the rest?  We're already paying for everyone, and we're paying for them in the most expensive way possible, yet all we hear is "how expensive" universal health care is.

The current affordable health care bill isn't the be-all and end-all for sure, but we have to start somewhere.  It will evolve.  Unfortunately, many Americans still harbor the myth that we have the best health care system in the world...yeah, if you can afford it (and I'm not even sure about that).  As far as I'm concerned, if the current bill starts the discussion and starts the ball rolling, it's done its job.

See, you got me started!  

  

[Red_Star]

I hope your health system does improve. I read that more than 26 000 working age adults die prematurely in the US each year because they lack health insurance. That is 72 deaths per day, or 3 every hour. Terrible.

[JMcKale]

I don't know why your doctor wants to wait. I suppose he considers waiting being thorough, but if you have the anti-bodies, and your TSH is high now, indicating your thyroid is struggling, even if it returns to normal on it's own, you are always going to have those antibodies and they can always up and attack your thyroid, meaning you could fluctuate up and down and experience symptoms you don't have to experience.

My doctor put me on synthroid when I went in with symptoms and my TSH was found to be elevated. My FT4 was fine but it probably wasn't stable and the synthroid resolved my symptoms within about three weeks.

[Introextrovert]

I will probably tell him that I am happy to start treatment once I have my next bloods done. I am not afraid of treatment, it could solve quite a few issues I suspect.

I was diagnosed with ADHD back in 2003, and also depression.

After looking into autoimmune hypothyroidism, I just wonder how many cases are diagnosed as something else, especially among young men, considering extremely skewed ratio of women to men.

Not saying my friend has hypothyroidism, but my friend has so many symptoms of it and is so worried about his health. He has been diagnosed with all sorts of things, and the doctors have run blood tests on him for everything EXCEPT thyroid function. They probably haven't requested this test because doctors likely believe men don't get thyroid problems!

I have told him to go get tested and have told him to be forceful with the doctors. I have explained to him that he is a CLIENT of theirs and they should do what he asks within reason. Running a particular test which is relatively inexpensive and quite standard is WITHIN REASON.

[goolarra]

It's not just men who are misdiagnosed.  There are those of us that don't believe fibromyalgia or chronic fatigue syndrome are "real" diseases, but undiagnosed hypo.  It's interesting that both are sometimes successfully treat with thyroid hormones...what was the first clue?  LOL

FT3 and FT4 ranges are also severely flawed for a number of reasons.  As a result, FT4 often has to be midrange and FT3 upper half to upper third before hypo symptoms are alleviated.  Many doctors won't treat if FT3 and FT4 are in range, or won't continue to treat once the patient pops into the bottom of the ranges.  Symptoms?  Who cares about those?  The numbers say you're normal, so darn it, you are!

In many ways you're lucky your TSH isn't in range because that's another stumbling block.  Many doctors were taught in med school that TSH was the gold standard in thyroid testing, and if TSH is in range, they refuse to see a problem.  TSH is also fraught with difficulties.  Once on meds, TSH often approaches zero.  Doctors often interpret that as overmedication, even though hyper symptoms are not present, and, in fact, hypo symptoms continue.  

Stick around...it's a fascinating subject!    

[Introextrovert]

My doctor already printed off a pathology referral for me to use in 6 weeks time, and I was at my desk at work (as I keep it in the draw there) and looked at what tests he wanted done.

TSH, FT4, FT3.

I am hoping that is an indication I have a good doctor, and he isn't even a specialist.

Hopefully he is the sort which believes in patient self determination, because next time I see him I will tell him that I want to start treatment to get my FT4 midrange like you say and my FT3 in the upper third.

I can only guess what will happen though... I'll get my bloods done and my TSH will be within range lol... as you said in a previous reply, it can fluctuate quite drastically during the day.

I'll try and get the test done at the exact same time that I had my last one done in the hope that it is above range... not because I want it to be but after reading through the replies here I know that if I want any chance of being properly treated it needs to be "abnormal" in the eyes of the doctor.

[goolarra]

I think you've grasped the concept!  LOL  You have to "prove" to them that you're sick.  

Good luck with your next set of tests.  I imagine you could move the timeframe up on that (since you have the lab order in your desk drawer) if you get tired of putting up with the wait.  

Let us know what you find out.

[hypokat]

hi there,, i am going through exactly what you are experiencing atm.the dr will just put you on thyroxine and send you on your way most likely. which is what they have done for me. i collapse everywhere, have heart palpatations, heat intolerance, hardly sleep, lost weight and many more symptoms. i am currently trying to find somewhere in sydney that does adrenal & melatonin saliva tests, and bulk bill of possible as they are a bit pricey. there is a gr8 site called "well woman" that link up with facebook too but they also have guys there too and i've had  alot of support and advice from there. unfortuantely they are in the UK. i wish aussie dr's would learn more about what we are going through and get with the program. BUT you really need to get your iron & ferrraitin levels up as any treatment wont work properly unless they are better. last week my ferratin level was *3. seems we are in the same boat...good luck and i look forward to seeing how your treatment goes...check out that site,,,very informative and DONT let the dr's fob you off ok