Diagnosed with Hashimoto's. What do you think?

[Smurrffie]

My doctor diagnosed me with Hashimoto's based off of my below test results. I am still in a bit of shock as it was unexpected. I knew something was wrong but never expected a thyroid issue. Although, reading more about Hashimoto's it definitely make sense. Can you lend me your 2 cents on my results? I am trying to decipher what all of this means and how T3/T4/TSH work together. My doctor did not go into specifics on the diagnosis and why he came to that conclusion except for that my TPO(ab) was above normal. Do my results say more? The rest are all in the "Normal" range but I have a follow-up appointment with my doctor soon and I want to make sure I have a solid background on what these results mean.

TSH: 0.885 (0.450-4.500)
Free T3: 2.3 (2.0-4.4)
Free T4: 1.35 (0.82-1.77)
Thyroglobulin Antibody: <1.0 (0.0-0.9)
Thyroid Peroxidase (TPO) Ab: 39 (0-34)

[gimel]

I know little about pre-diabetes, but I don't think the one test is adequate to rule out the condition.   For example, I ran across this while doing some reading.


How is the A1C test used to diagnose type 2 diabetes and prediabetes?
The A1C test can be used to diagnose type 2 diabetes and prediabetes alone or in combination with other diabetes tests. When the A1C test is used for diagnosis, the blood sample must be sent to a laboratory that uses an NGSP-certified method for analysis to ensure the results are standardized.

Blood samples analyzed in a health care provider’s office, known as point-of-care (POC) tests, are not standardized for diagnosing diabetes. The following table provides the percentages that indicate diagnoses of normal, diabetes, and prediabetes according to A1C levels.

Diagnosis* A1C Level
Normal below 5.7 percent
Diabetes 6.5 percent or above
Prediabetes 5.7 to 6.4 percent
*Any test for diagnosis of diabetes requires confirmation with a second measurement unless there are clear symptoms of diabetes.



So I suggest that you might get some good insight from members over on the Diabetes Forum.  

[gimel]

You have a lot of symptoms that are frequently associated with being hypothyroid.  Looking at your test results, your TPO ab result indicates Hashimoto's Thyroiditis, although it may be early stage, since your TPO ab is only slightly over the range.  That would also be consistent with your TSH being relatively low in the range for a Hashi's patient.  It is also consistent with your Free T4 still being at an adequate level, at 56% of its range.  Your symptoms are apparently coming from your low level of Free T3.  Free T3 is used by the cells throughout your body.  Studies have also shown that Free T3 correlates best with hypo symptoms.  For some reason your body is not adequately converting the available T4 to T3, or is perhaps over-converting the T4 to Reverse T3, which is biologically inactive.  

Two of the most important variables that affect conversion of T4 to T3 are ferritin and selenium.  In addition, hypo patients are frequently too low in the ranges for Vitamin D, B12 and ferritin.  I'm not sure what your doctor plans to do for you, but before taking any action, I would suggest that you go back and get tested for Reverse T3 along with a Free T3 again (same blood draw), morning serum cortisol, Vitamin D, B12, ferritin and selenium.  With that information you will be able to get a better idea of the cause for your low Free T3, and to determine what supplementation, if any, is needed to optimize for D, B12, ferritin and selenium.  Longer term, the Hashi's will result in diminishing output of both T4 and T3 from your thyroid gland and will require replacement thyroid med.  

One thing further is that the symptom of always feeling thirsty can be  related to being diabetic.   Hypothyroidism can also lead to being pre-diabetic.  So it would be a good idea to test for that.  

[Smurrffie]

Thank you, this is very helpful. I did get B12 tested and was 441 (211-946).

I also tested for Hemoglobin A1c and it was at 5.3%  (4.8-5.6).  I was told that rules out pre-diabetes.

I will discuss the other tests with my doctor.

[gimel]

You haven't mentioned the most important factor in diagnosing and treating a potential hypothyroid patient:  symptoms.  Please tell us about any symptoms you are having.

[Smurrffie]

My symptoms are:.

dry flaky skin on my face and scalp
fatigue
joint pain
daily, mild headaches
constipation and abdominal pain
always feeling thirsty
general brain fogginess
some days I wake up and I am completely sore to the touch, like my skin is sore
digestive issues (bloated, gas, undigested food in bowel movements)
More recently I have experienced a sensation like my throat is numb, tingly and swollen but I worry that is all in my head as it doesn't look enlarged when I look in the mirror.

Thank you for your assistance.