high TPO and high TSH with normal free T3 and T4

[rahulmpt]

hi everybody
I got my lab tests doe with following results
AntiTPO  392.6          range   <60
free T3     3.33           range 2.3-4.2
free T4     1.29           range 0.89-1.76
TSH    7.726              range   0.550-4.780
what should i do next ?
kindly advice
the only symptoms i can relate to hypothyroidism is fatigue....

[goolarra]

I don't know what your range is for B-12.  In many countries, the lower limit is 500.  Here, in the U.S., it's usually about 200.  Many people find that B-12 should be close to the top of the range.  If you start taking B-12 orally, be sure to retest to make sure you're absorbing it.  Pernicious anemia is the inability to absorb B-12 through the gut.  If you have PA, you have to take injectable, sublingual or nasal spray.

For proper thyroid health, D has to be well up into the range, too.  Ask your doctor about supplementing.  If D is very close to the bottom of the reference range, you might have to take quite a bit to raise your level.  50,000 IU per week, tapering as levels rise, isn't unusual.

Of course, it would be a great idea to test again to see where you really are starting from before you supplement.  

[rahulmpt]

Sorry for replying late... Searched my old reports.. Vit D n B12 very in the lower range but normal... Ferritin was in d middle... So should I start any supplements for D n B12... Kindly advice...

[goolarra]

Do you have the results of those from a year ago?  Have you made sure you're well up in the ranges on them?

[rahulmpt]

I would like to postpone thyroid meds as of now.... My b12 , vit D and iron profile were normal 1 year back... Then my TSH used to be in d ranges f 9... Should I get them tested again? Kindly suggest

[goolarra]

Your TPOab is high, and that indicates Hashimoto's thyroiditis, which is an autoimmune thyroid disease.  Selenium is purported to lower antibody counts.  If you do take it, be sure to follow label dosages since too much selenium is worse than too little.  

Have you explored other reasons for your fatigue?  Deficiencies of vitamin B-12, D and iron can all cause fatigue.  Pernicious anemia (inability to absorb B-12 through the gut) is another autoimmune disease.  A complete iron panel, including ferritin, is a good idea.  Keep in mind with all of these tests that you want to be well up into the ranges, not just barely in the bottom.

Do you want to try thyroid meds, or would you rather put that off until you have more symptoms?

[rahulmpt]

just to inform i also have vitiligo which is a auto immune disorder
and my tpo is high so can i have a auto immune thyroid disorder
can i take selenium to help my TPO levels

[goolarra]

Your FT3 and FT4 look quite good.  However, your TSH is high, which means that your pituitary thinks you need more thyroid hormones.  You're one of the lucky ones because most doctors put a lot of weight on TSH, so you could probably get treatment relatively easily.

Do you want to go on meds and see if it helps your fatigue?