It means that you have high levels of thyroid antibodies, consistent with having Hashimoto's Thyroiditis, which is the most common cause of hypothyroidism. With Hashi's the autoimmune system for some unknown reason decides that the thyroid glands are foreign, and produces antibodies to attack and over usually an extended period of time, the glands are destroyed.
Some doctors want to wait to start treatment with thyroid meds until symptoms have become overt. This frequently will result in unpleasant levels of symptoms, until medication is started and increased enough to make the doctor happy with your test results. Another alternative is to start earlier with medication and prevent some of the worst of the effects. You can read about this approach in this link.
Before going to the doctor, I think I would take a look at this list of typical thyroid symptoms and mark those that you have, then take a copy of the list with you. Then I think I would ask the doctor what his plan is to test and treat you. A good thyroid doctor will treat a hypo patient clinically, by testing and adjusting levels of the biologically active thyroid hormones, Free T3 and Free T4 as necessary to relieve symptoms. Symptom relief should be all important, not just test results. Test results are valuable mainly as indicators during diagnosis and then afterward to track Free T3 and Free T4 as meds are revised to relieve symptoms.
Be aware that many doctors, especially endos , have the '"Immaculate TSH Belief", by which they only want to use TSH as the diagnostic for treatment. This doesn't work because TSH is a pituitary hormone that is affected by so many variables that it doesn't even correlate adequately with Free T3 and free T4, much less with hypo symptoms.
If the doctor goes beyond TSH and tests for theyroid hormones, many will use somewhat outdated tests such as Total T3 and Total T4 and T3 Uptake, and FT Index. Don't waste time on those, just insist on testing for Free T3 and Free T4. FT3 is the most important to know because it largely regulates metabolism and many other body functions. Scientific studies have shown that FT3 correlated best with hypo symptoms, while FT4 and TSH correlated very poorly.
Many doctors that do test the thyroid hormones, then rely on "Reference Range Endocrinology", by which they think that any test result that falls within the reference range is "normal" and thus always adequate. This is incorrect. The ranges are far too broad. I won't get into the details of why right now, but suffice to say that the ranges for FT3 and FT4 should be more like the upper half of the current ranges. Many of our members report that symptom relief for them required that FT3 was adjusted into the upper third of the range and FT4 adjusted to around the midpoint of its range.
What you most need to know is if your doctor is going to be willing to treat you clinically as I described above. If not, then you will need to find a good thyroid doctor that will do so. If you want more assurance about clinical treatment, this is a link to a letter written by a good thyroid doctor for patients that he consults with from a distance. The letter is sent to the PCP of the patient to help guide treatment.
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