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Normal Thyroid Test But high TPO?
Hello my name is Stephan and i am a 26 year old Male. I have been suffering from hypothyroidism for going on 4 years. I was basically a human guinea pig for 8months before they finally diagnosed me with hypothyroidism(after going through every test in the book). So i got put on levothyroxin 50mcg and been on it since diagnosis. Took me a while to get back on my feet but the past 4months i have been going back downhill. My doctor pretty much shut me up everytime i asked for a thyroid test and said it was too soon. My symptoms are:
- fatigue
- night sweats/hot flashes(ill wake up soaking wet from head to toe, but cold)
- intolerance to hot/cold(makes my fingers/toes go numb and lose color if i touch something cold)
- no appetite
- i have stayed 130lbs on the dot for the past 4 years. Never gaining or losing.
- severe depression
- severe anxiety and panic attacks
- irritable
- unable to concentrate/focus/cant remember things well(cloudy mind)
- my hair is shedding and very dry. I can wash it and before night it feels like sandpaper.
- fingernails grow like crazy and are brittle
- and many more.
I have been sent to see a psychiatrist for these symptoms and diagnosed bipolar. Was put on Risperidone, and seroquel xr(which i refuse to take because of side efftects, its like going for a headache and they give u a pill that says make cause death) and 20mg Celexa. After taking Celexa, Risperidone, and .05 lorazepam(3 times a day) Nothing is helping its actually making me worse. I went back to doctor last week after reading some things on Hashimotos. I demanded test that were listed online. My doctor usually only checks TSH t3 t4 and sends me on my way as if im lying about my symptoms. I do not feel that i am bipolar. I feel this is 100% thyroid. My Grandma had Graves Disease, and Grandpa and great aunt had thyroid cancer and my mother has nodules. After getting blood test back here are results. I have an appt back with the endocrinologist Mar 27th. But my curiousity is getting the best of me.
TSH 4.09
Free T4 1.0
T3 Reverse 18.6
T3,Free, Serum 3.2
TPO 221 (norm 0-34)
Thyroid Antithyroglobulin only <20
Also two test showed Abn, but idk if they have anything to do with this:
Carbon Dioxide 33(Abn H)
BUN/CREAT Ratio 7.5(Abn L)
My question is: What does this mean if my TSH,t4,t3 are normal But my TPO is off the charts? Any help will be greatly appreciated. Thanks in advance.
Stephan
- fatigue
- night sweats/hot flashes(ill wake up soaking wet from head to toe, but cold)
- intolerance to hot/cold(makes my fingers/toes go numb and lose color if i touch something cold)
- no appetite
- i have stayed 130lbs on the dot for the past 4 years. Never gaining or losing.
- severe depression
- severe anxiety and panic attacks
- irritable
- unable to concentrate/focus/cant remember things well(cloudy mind)
- my hair is shedding and very dry. I can wash it and before night it feels like sandpaper.
- fingernails grow like crazy and are brittle
- and many more.
I have been sent to see a psychiatrist for these symptoms and diagnosed bipolar. Was put on Risperidone, and seroquel xr(which i refuse to take because of side efftects, its like going for a headache and they give u a pill that says make cause death) and 20mg Celexa. After taking Celexa, Risperidone, and .05 lorazepam(3 times a day) Nothing is helping its actually making me worse. I went back to doctor last week after reading some things on Hashimotos. I demanded test that were listed online. My doctor usually only checks TSH t3 t4 and sends me on my way as if im lying about my symptoms. I do not feel that i am bipolar. I feel this is 100% thyroid. My Grandma had Graves Disease, and Grandpa and great aunt had thyroid cancer and my mother has nodules. After getting blood test back here are results. I have an appt back with the endocrinologist Mar 27th. But my curiousity is getting the best of me.
TSH 4.09
Free T4 1.0
T3 Reverse 18.6
T3,Free, Serum 3.2
TPO 221 (norm 0-34)
Thyroid Antithyroglobulin only <20
Also two test showed Abn, but idk if they have anything to do with this:
Carbon Dioxide 33(Abn H)
BUN/CREAT Ratio 7.5(Abn L)
My question is: What does this mean if my TSH,t4,t3 are normal But my TPO is off the charts? Any help will be greatly appreciated. Thanks in advance.
Stephan
Ok thanks alot for all the info. I will give them a call and find that out. I do know when i was first going through all of this and being a human guinea pig for 8months this doctor ran test that the others did not and found the problem right then. I was feeling alot better once he gave me levothyroxin and he actually listened to my symptoms and all. Rather than "Ok test are normal have a good day", and push me out the door.
Something you should be aware of before your appointment.
First I'd like to mention that you don't have to have an Endo, just a good thyroid doctor. Many times Endos have the "Immaculate TSH Belief" and only want to test and medicate based on TSH. That absolutely doesn't work for everyone. Other Endos that go beyond TSH often revert to "Reference Range Endocrinology", by which they will tell you that a thyroid test result that falls anywhere within the range is adequate for you. That also is wrong.
A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels. You can get some good insight into clinical treatment from this letter written by a good thyroid doctor for patients that he sometimes consults with after initial tests and evaluation. The letter is then sent to the participating doctor of the patient to help guide treatment. In the letter, please note the statement, "the ultimate
criterion for dose adjustment must always be the clinical response of the patient."
http://hormonerestoration.com/files/ThyroidPMD.pdf
Rather than assume that the Endo will be a good thyroid doctor, I'd call and try to get a nurse to answer two questions. First I'd ask if the doctor is willing to treat clinically, by testing and adjusting Free T3 and free T4 as necessary to relieve symptoms, without being constrained by a suppressed TSH. Then I'd ask if the doctor is willing to prescribe meds containing T3. If either answer is no, then you will need to keep looking for a good thyroid doctor.
First I'd like to mention that you don't have to have an Endo, just a good thyroid doctor. Many times Endos have the "Immaculate TSH Belief" and only want to test and medicate based on TSH. That absolutely doesn't work for everyone. Other Endos that go beyond TSH often revert to "Reference Range Endocrinology", by which they will tell you that a thyroid test result that falls anywhere within the range is adequate for you. That also is wrong.
A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels. You can get some good insight into clinical treatment from this letter written by a good thyroid doctor for patients that he sometimes consults with after initial tests and evaluation. The letter is then sent to the participating doctor of the patient to help guide treatment. In the letter, please note the statement, "the ultimate
criterion for dose adjustment must always be the clinical response of the patient."
http://hormonerestoration.com/files/ThyroidPMD.pdf
Rather than assume that the Endo will be a good thyroid doctor, I'd call and try to get a nurse to answer two questions. First I'd ask if the doctor is willing to treat clinically, by testing and adjusting Free T3 and free T4 as necessary to relieve symptoms, without being constrained by a suppressed TSH. Then I'd ask if the doctor is willing to prescribe meds containing T3. If either answer is no, then you will need to keep looking for a good thyroid doctor.
I agree with goolarra. And in prep for having the discussion with your doctor about treating you clinically, rather than by TSH, which doesn't work, I thought this might be some good info for you. It was written by a good thyroid doctor.
http://hormonerestoration.com/Thyroid.html
http://hormonerestoration.com/Thyroid.html
Thanks alot goolarra. I goto a endocrinologist march 27th so hopefully i can get something done because i am just miserable and tired of dealing with it. Sitting at home and not able to work is driving me crazy.
It's obvious that your doctor is treating based on TSH. On 9/20/10, he increased your meds even though your FT4 was the highest it ever was. It was your TSH that botherd him there because FT4 was good.
Unfortunately, we don't have old FT3 levels for comparison. Your FT4 is now 1.0, and you can see that that is lower than it's ever been and much lower than it was on 9/20/10 when you had the increase to 50 mcg.
i think you clearly need an increase. I see that the top of your TSH range is 5.5. From your history, it's obvious that your doctor won't increase meds until TSH is above 5.5. You may have to either educate him or find another doctor. He should be paying more attention to FT4 and FT3, and you may have to really emphasize your symptoms to him.
Unfortunately, we don't have old FT3 levels for comparison. Your FT4 is now 1.0, and you can see that that is lower than it's ever been and much lower than it was on 9/20/10 when you had the increase to 50 mcg.
i think you clearly need an increase. I see that the top of your TSH range is 5.5. From your history, it's obvious that your doctor won't increase meds until TSH is above 5.5. You may have to either educate him or find another doctor. He should be paying more attention to FT4 and FT3, and you may have to really emphasize your symptoms to him.
This is from 2008-2012 and the only results i have on paper.
9/10/08:
Free T4 = 1.3
TSH = 4.34
8/11/09:
Free T4 = 1.1
TSH = 4.92
7/27/10
Free T4 = 1.2
TSH = 2.37
09/20/2010:
Free T4 = 1.4
TSH = 5.81
1/24/2011:
Free T4 = 1.4
TSH = 3.10
6/24/2011:
Free T4 = 1.4
TSH = 5.0
2/2/12:
Free T4 = 1.3
TSH = 4.28
6/1/12:
Free T4 = 1.1
TSH = 1.94
11/19/12:
Free T4 = 1.3
TSH = 4.35
Around January 2010 i think is when My Endo ran bloodwork and found my TSH 8.5 therefore diagnosed me with hypothyroidism and gave me the levothyroxin 25mcg. Then on 9/20/2010 they upped it to 50mcg.
9/10/08:
Free T4 = 1.3
TSH = 4.34
8/11/09:
Free T4 = 1.1
TSH = 4.92
7/27/10
Free T4 = 1.2
TSH = 2.37
09/20/2010:
Free T4 = 1.4
TSH = 5.81
1/24/2011:
Free T4 = 1.4
TSH = 3.10
6/24/2011:
Free T4 = 1.4
TSH = 5.0
2/2/12:
Free T4 = 1.3
TSH = 4.28
6/1/12:
Free T4 = 1.1
TSH = 1.94
11/19/12:
Free T4 = 1.3
TSH = 4.35
Around January 2010 i think is when My Endo ran bloodwork and found my TSH 8.5 therefore diagnosed me with hypothyroidism and gave me the levothyroxin 25mcg. Then on 9/20/2010 they upped it to 50mcg.
Thyroid removal for Hashi's is very seldom recommended, unless there are extenuating circumstances. I still have mine...dead as it may be.
Hashi's compromises more and more of your thyroid function all the time, so your meds increases have to keep up with the degeneration. 50 mcg is not a total replacement dose, which indicates that your thyroid is still producing some hormone. However, it will produce less and less over time. Increases are to be expected and labs should be done as frequently as you feel necessary (with respect to symptoms). Hashi's progresses at different rates for different people. It can take decades to kill your thyroid, or it can go like gangbusters.
Do you have labs from four months or longer ago (when you were still feeling well) for comparison to current labs?
Hashi's compromises more and more of your thyroid function all the time, so your meds increases have to keep up with the degeneration. 50 mcg is not a total replacement dose, which indicates that your thyroid is still producing some hormone. However, it will produce less and less over time. Increases are to be expected and labs should be done as frequently as you feel necessary (with respect to symptoms). Hashi's progresses at different rates for different people. It can take decades to kill your thyroid, or it can go like gangbusters.
Do you have labs from four months or longer ago (when you were still feeling well) for comparison to current labs?
also did you have your thyroid removed? Am i gonna have to have mine removed? Or will this be treated with meds?
I have been checked for raynaud's however after i got on thyroid med that all went away. Now its back.
TSH = 4.09 uIu/mL 0.35-5.50
Free T4 = 1.0 ng/dL 0.6-1.8
T3 Reverse = 18.6 ng/dL 9.2-24.1
T3 Free Serum = 3.2 pg/mL 2.0-4.4
TPO =221(abn) IU/mL 0-34
Thyroid Antithyroglobulin antibody only = <20 IU/mL 0-40
TSH = 4.09 uIu/mL 0.35-5.50
Free T4 = 1.0 ng/dL 0.6-1.8
T3 Reverse = 18.6 ng/dL 9.2-24.1
T3 Free Serum = 3.2 pg/mL 2.0-4.4
TPO =221(abn) IU/mL 0-34
Thyroid Antithyroglobulin antibody only = <20 IU/mL 0-40
"- intolerance to hot/cold(makes my fingers/toes go numb and lose color if i touch something cold)" Check out Raynaud's syndrome on this.
What are the ranges on your FT3, FT4 and RT3? Ranges vary lab to lab, so you have to post them with results.
Elevated TPOab indicates Hashimoto's thyroiditis. Hashi's is an autoimmune disease and the most prevalent cause of hypo in the developed world. It's not really off the charts. We often see numbers in the high hundreds, or even thousands. Just to give you some perspective, my TPOab on diagnosis was 900+, and my TGab was 3,000+.
What are the ranges on your FT3, FT4 and RT3? Ranges vary lab to lab, so you have to post them with results.
Elevated TPOab indicates Hashimoto's thyroiditis. Hashi's is an autoimmune disease and the most prevalent cause of hypo in the developed world. It's not really off the charts. We often see numbers in the high hundreds, or even thousands. Just to give you some perspective, my TPOab on diagnosis was 900+, and my TGab was 3,000+.
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