High tsh no symptoms, thyroid doc recommendations

[Mihu]

Tsh 38.5, free t4 .68 (.82 - 1.77) free t3 2.9 (2.0 - 4.4) no symptoms other than excessive ear wax. Suspect Hashimotos disease (my mom has it) Getting tested for antibodies. Recommdations for thyroid dr. On south side of Atlanta Ga? Also is it better to take synthroid or desiccated thyroid hormone for hashi. Age 55 male. Not sure if family doc is expert on thyroid don't want wrong meds I feel good now don't want to mess that up.

[goolarra]

I just sent you a PM with the names of a couple of doctors in Atlanta from a list compiled by one of our members (on the recommendations of other members).  

Go to the blue bar at the top of the page, then My MedHelp and Inbox to retrieve the message.

[goolarra]

So, both are positive, which is, as you say, a strong indication that you have Hashi's.  Remember that we can have antibodies for years, or even decades before they do enough damage to cause symptoms and/or knock our labs out of range.  Some people never have symptoms.

So, it's definitely something to keep an eye on.  If you start having symptoms, you'll know where to look.  With your TSH (most doctors are pretty fixated on TSH) and your below range FT4, I'm sure your doctor will want you on meds.  So, prepare your argument if you don't want to start meds at this time.  Symptoms are more important than all the lab work put together in most cases.

[Mihu]

Thanks, I just received antibody test results. TPO antibodies 175 reference (0-35), ATA antibodies 6.7 reference (0-0.9). Sure looking like Hashimotos to me although I have had no symptoms and feel great! Waiting for Dr. Appt. to confirm.

[goolarra]

T4 is Synthroid, Levoxyl, other brand name T4 meds and generic levothyroxine.  All these contain T4 only.

Desiccated thyroid hormone is the thyroid of a pig and contains both T3 and T4.

If you take any of the T4 meds, you can add T3 (Cytomel and generics) to them if you find you need the T3.  

T4 is the "storage" form of the thyroid hormones.  It's very slow acting and stays in your system for a long time.  Before cells can use it, it has to be converted to T3, the "active" form of the thyroid hormones.  T3 is fast acting and quickly neutralized by your body if not used promptly.  The theory behind T4 only meds is that the body will convert the T4 to T3 on demand.  Sometimes yes, and sometimes no.  People who convert slowly have to add a direct source of T3 to their meds, either Cytomel or desiccated.
  

[Mihu]

Not familiar with taking t4, what is t4 treatment or drug called?

[goolarra]

Your FT4 is clearly below range.  TSH is very high.  Your FT3 is not bad, considering your low FT4.  This sometimes happens with low FT4 levels as the body tries to kind of over convert to keep FT3 levels up.  Obviously, this is not sustainable in the long term.

Some people do better on one treatment or the other.  Unfortunately, we usually have to be our own guinea pigs and see what we feel best on.  Right now, your FT3 looks good relative to your FT4, so there's no indication yet of slow conversion or the need to take anything but T4.  Personally, I would try that.  You can always add T3, either synthetic or desiccated, at a later date if it becomes necessary.