New labs, high TPO

[CinLou24]

I have received some of my labs. They are  incomplete for now, they had to redraw some blood.

51 yr old female. Cold all the time, dry skin, red rash on face and hands, muscle/joint aches, alopecia areata, fatigue, i'm beyond tired, weight gain(20+ in 6 months).
Known non celiac gluten sensitive, dairy and soy interolence

Reverse T3, Serum                           20.8ng/dL              9.2 - 24.1 02
Histamine Determination, Blood       118 ng/mL              12 - 127
Vitamin D, 25-Hydroxy                       25.4  Low ng/mL    30.0 - 100.0
Thyroid Peroxidase (TPO) Ab          65 High IU/mL         0 - 34 01
Thyroglobulin Antibody                   <1.0 IU/mL              0.0 - 0.9 01
Thyroxine Binding Globulin               14 ug/mL                13 - 39 02
Triiodothyronine,Free,Serum            2.9 pg/mL               2.0 - 4.4   (?this is Free t3)

TSH and Free T4 is on a different report I don't have yet.

Any ideas

[gimel]

I am not well versed on how to interpret your E1, E2 and E3 results.  Your progesterone and testosterone appear to be adequate.   Your cortisol is over the mid-point of the range, which I am sure the doctor will tell you is also adequate.  Your DHEA is way too low.   You need to ask your doctor about taking 50 mg of DHEA daily.  If interested further, this is a good link on DHEA.

http://www.hormonerestoration.com/DHEA.html

From you symptoms and test results I think you need to supplement your Vitamin D and B12 to optimize.  D should be at least 50 and B12 should be in the upper end of its range.  In addition, you need to test for ferritin and if needed, then supplement to raise it to at least 100.  All three should help reduce your Reverse T3 level and ferritin will help with conversion of T4 to T3.    Once you have optimized all three and given some time for full effect, then you should follow up and re-test Free T4, Free T3,  Reverse T3,  Vitamin D, B12 and ferritin to see what further may be needed.

[gimel]

Well the good thing is that even if you have difficulty with your doctor accepting that your biochemical test results confirm your  symptoms as being likely due to hypothyroidism, what you need to do first is to get those tests done and then adequately supplement your Vitamin D,  B12 and ferritin.  that should help with getting T4 converted to T3 instead of Reverse T3.    Also need to  do the cortisol test since cortisol affects thyroid hormone.  

If you expect that you will have trouble getting your doctor on board with all this, let me know and I can give you some information that might get him to read and reconsider your requests.  

[CinLou24]

I've now received my hormone saliva results.
Estradoil (e2) 3.4         Range (Therapeutic) 2.9-13.7 pmol/L                     Reference Range (Menopausal) 3.7-9.4
Estrone (E1) 26.8  H                                           5.5-26.1   ""                                                                                           4.7-18.9
Estriol (E3)   394    H                                          <=135    """                                                                                             same as thera
Testosterone   58                                                 34-183  ""                                                                                              34.-148
Progesterone    115                                              52-850 """                                                                                             45-370
P/E2 Ratio       34                                                  10-108                                                                                                  12-62

Coritsol
7-9 am .261                         ref .097-.337mcg/l
11-1        .054                               .027-.106
3-5pm    .041                              .013-.068
10-12am    .021                          <=.034
all noted within range

DHEA
7-9am    67  L           ref 71-640pg/ml
DHEA/Cortisol Ratio  257  L      ref 358-2535

I'm just so confused!!!!

[gimel]

Your TPO ab result indicates the presence of autoimmune antibodies normally associates with Hashimoto's Thyroiditis.  With Hashi's the antibodies attack the thyroid gland, eventually resulting in inability for the gland to produce enough thyroid hormone.  As this is occurring the pituitary is increasing output of TSH in an attempt to adequately stimulate the thyroid gland.  Your TSH is not indicative of this at present, so it may be that you are in the very early stages of Hashi's.  

Looking at your thyroid hormone test results, your Free T4 is adequate; however, your Free T3 is somewhat lower than needed by most people.   Your FT4 is about 70% of its range, while your FT3 is only about 37% of its range.  Taken together that indicates inadequate conversion of T4 to T3.    This is also adversely affected by your Reverse T3 being at about 80% of its range.  So your Free T3 to Reverse T3 is only 1.4, when recommendations are for it to be at least 1.8, and some sources say 2.0.  

To help with this I think you need to supplement your Vitamin D and B12 to optimize.  D should be at least 50 and B12 should be in the upper end of its range.  In addition, you need to test for ferritin and if needed, then supplement to raise it to at least 100.  All three should help reduce your Reverse T3 level and ferritin will help with conversion of T4 to T3.    Once you have optimized all three and given some time for full effect, then you should follow up and re-test Free T4, Free T3,  Reverse T3,  Vitamin D, B12 and ferritin to see what further may be needed.  At that time I would also try to get a cortisol test done.  

One last thing for now.   How long have you been having all those symptoms?

[CinLou24]

Off and on for a while, 2-3 years I'm thinking.
I wont see the Dr. who ordered all this blood-work until the 24th so the medication thing may change. I'm just hoping this gives some answers and the Dr's quit telling me this is all in my head. Which is how this was found. I was sent to 'counseling' because I kept telling the Dr's (primary, neurologist, ortho surgeons pa) that something was way off.  
I went to see him and immediately he said I needed blood-work for thyroid and adrenal issues.  He wonder why no one had already checked it!
They all put it down to the acdf surgery and titanium I now own.Kept telling them but I felt like this BEFORE surgery and that is how they found the cord compression!
Sigh, it's not all in my head, it's also in my neck and gut HAHA!
This forum has been so helpful and reading others posts gives me encouragement!

[gimel]

There is much to discuss, but first,  are you taking any thyroid med currently?  

[CinLou24]

No. no meds.

[CinLou24]

I don't know how or if one can edit.
Here are my other labs

GLOBULIN (Calc) 1.90 g/dL L                    2.3-4.0 g/dL
CRP 0.02 mg/dL L                                          0.05-0.20 mg/dL
TSH 1.35 uIU/mL                                              0.50-6.00 uIU/mL
FREE T4 1.3 ng/dL                                            0.8-1.5 ng/dL
GLYCOHEMOGLOBIN   5.7 %                     4.2-6.2 %
EST AVG GLUCOSE 117 mg/dL H             70-105 mg/dL
Vitamin B12        493 pg/mL                         232 - 1245 01
Folate (Folic Acid), Serum 8.1 ng/mL       >3.0