I feel like my levels do not indicate HT, but I have all the symptoms?

[mellymoo32]

I've read quite a few of the posts here and it seems any value outside of the antibody ref. range is considered to be positive for Hashimoto's...but mine are so much lower than the others posted?! I feel like I'm barely hitting the threshold for this disease. I've been waiting for an endocrinologist appointment in my city for 6 months and it's right around the corner, thank goodness. I'm starting to get too attached to the idea the physician will be able to help my fatigue, exercise endurance, and mood. I'm also sick frequently; chest colds that last 8 weeks, frequent yeast infections, inability to shake anything. Probably because I'm always so tired and run down? My GP shrugged it off and said I was fine and had no issues. Now I'm doubting myself and the push for a referral. The rheumatologist I saw had no issues referring me. He had initially prescribed an antidepressant, and called me 5 days later with my results and told me to stop the dep. med and gave me a course of steroids.  I'm in my thirties and have two children. My symptoms started after having my first and got worse after my second was born.

THYROID PEROXIDASE AB 86.7   0.0-9.0 (IUnits/mL)
THYROGLOBULIN ANTIBODIES 29.0  0.0-4.0 (IUnits/mL)
TSH REFL TO FT4       2.09   0.27-3.50 (uIU/mL)

Side Note:
I also have a positive ANA test and a value for 160:1
RNP Antibody 2.2 0-     0.9al
ANTI-DNA (ds) 395.8   <200.0 (IU/ML)

Thanks for the help!

[gimel]

It might be too early in disease process to be diagnosed by usual practice, but a good thyroid doctor pays attention first to symptoms, and then Free T4, Free T3 levels.  You can get some useful information from reading at least the first two pages of this link.

http://www.thyroiduk.org.uk/tuk/TUK_PDFs/diagnosis_and_treatment_of_hypothyroidism_issue_1.pdf

[mellymoo32]

I appreciate the reply and encouragement. Also, the med. and lab info you supplied. I&#39;m hoping this endo is who I&#39;m looking for. I requested a doctor who treated HT despite euthyroid levels. In her practice description she focuses mainly on thyroid and thyroid issues related To pregnancy. I&#39;m anxious to make it through a day without a required nap and be able to continue my race training schedule! Much gratitude to you!

[Barb135]

Have you been diagnosed with lupus (SLE) or another connective tissue disease?

[mellymoo32]

No. After telling my doctor I'm frequently sick, exhausted, and period is erratic on Mirena, the GP ran the ANA test and it came back +, the lab ran batch testing b/c of the +result and found the others (RNP and Lupus test.) the rheum. I requested to see ran blanket labs and discovered the elevated antibody levels said I don't have enough symptoms to obtain a lupus diagnosis. I have 3 of the 4 symptoms related to lupus. He did say I had HT. I went back to my GP for a referral who refused and said I was fine with No HT bc my TSH is fine-but the TSH rising from the 1.5 it was ...I asked the rheum for a referral to endo and he gave it to me. I did get a second opinion on lupus Dx who concurred with the first doctor. No lupus, big relief. so IF I have anything else going on it's too early to see OR its just overlap + from the HT, probably? But like I said in my original post. All my levels are barely positive... I'm worried I'm too early in disease process to by diagnosed-but I'm exhausted, forgetful, anxious, frequently Ill and I'd say mildly depressed/emotional trying to parent two young children and maintain a healthy lifestyle exercise and healthy food in struggle to prepare bc of exhaustion. Looooong story, thanks for reading this far.

[gimel]

Your doctor was wrong to shrug off your results.  You should make sure they always test you for both of the biologically active thyroid hormones,  Free T4 and Free T3.  TSH is a pituitary hormone that is affected by so many things that at best it is only an indicator to be considered along with more important indicators such as symptoms and also levels of Free T4 and Free T3.  

With your symptoms and your positive tests for TPO ab and TG ab, that is indicative of Hashi's, regardless of the TSH.  It may be that you are in the early stages of Hashi's, thus your TSH is relatively still low; however, with your symptoms, I expect that when tested you will find your Free T4 and Free T3 to be in the lower half of their ranges, and that you need start on thyroid med to raise your Free T4 to at least mid-range, and your Free T3 high enough in the upper half of its range to relieve symptoms.  

I would not over anticipate that all will be well from seeing the Endo.  Frequently they specialize in diabetes, not thyroid.  Also, frequently they have the "Immaculate TSH Belief and only pay attention to TSH, which doesn't work.  If they test beyond TSH then it is only for Free T4 and if in range, they use "Reference range endocrinology" and say that your results are normal and symptoms are not due to thyroid.  That also may be very wrong.  

A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T4 and Free T3 as needed to relieve symptoms, without being constrained by TSH levels.  Symptom relief should be all important, not just test results.  

When you see the Endo, I suggest that you ask to at least be tested for Free T4, Free T3, Reverse T3, TSH, cortisol, Vitamin D, B12 and ferritin.  I also suggest that you ask the Endo if he is going to be willing to treat clinically as described.  Also ask if he is willing to prescribe T3 type meds like Armour Thyroid and Cytomel.  If either answer is no, then you will need to find a good thyroid doctor elsewhere.  

When you have further test results, please post them here, along with reference ranges shown on the lab report and we will be glad to help interpret and advise further.