Thyroid test

[annette83_B]

Hello!
My father (57 years old) made some thyroid tests. Here are the results:
ATPO: 104 (norm up to 34)
Thyroglobulin: 0.36 (norm 3.5-77)
Free T4: 11.74 (norm 12-22)
The ultrasound shwed a small node.
Previously, ATPO was higher. It has been high for the past couple of years. The doctor says nothing should be done, no meds should taken. Is that true? Is it the Hashimoto disease? Can something be done to stop it or cure it? What meds should be taken?
Thanks a ot in advance for any help.

[Barb135]

With Free T4 below the reference range, it's obvious that your father's thyroid is not producing adequate hormones for some reason, since his level should be "within" the range, not below it... Additionally, you should have Free T3 tested as Free T3 is the biologically active thyroid hormone that is used by every cell in the body.  

TSH is considered to be the gold standard in thyroid testing, but it's actually a pituitary hormone and doesn't always reflect actual thyroid function as you can clearly see... For instance, with a Free T4 as low as your father's, we'd expect to see a TSH much higher than 1.34.  The fact that his TSH is so low would, typically, indicate central hypothyroidism, where there's a problem with the pituitary/hypothalamus axis, rather than the thyroid gland - which is still a possibility, even with with elevated TPOab.  These are things a good thyroid doctor would try to find out...

Simply dismissing someone because they have pristine TSH is the first sign of a doctor one should run from as fast as you can...

Hashimoto's can be present for many years before thyroid labs can go out of range and so can symptoms of hypothyroidism... however, your father's FT4 is "already" out of range and it definitely warrants further investigation.

[annette83_B]

Thank you so much for your answer. Will try to find a good doctor now.

[annette83_B]

Sorry, I accidentally pushed Enter before finishing the post.
It is realy thyroglobulin (Tg). The other parameter was TSH and it was OK - 1.34 (norm up to 4.2). My father took these tests as part of the annual medical check, so it was not the doctor who prescribed the tests. And he actually saw a couple of doctors afterwards to show the results (but we don't have good doctors in here), and all of them told him nothing should be done, that the elevated ATPO is not bad, it should just be monitored.. But after reading on the internet, I realized my father has the Hashimoto disease and got worried. So I would like to have more information on what he might have and possible treatment, so that he could go to another doctor and have a talk having this information in hand.

[Barb135]

What was the previous TPOab and was the thyroglobulin really thyroglobulin or was it Thyroglobulin Antibobodies?

The elevated TPOab indicates Hashimoto's...

Was Free T4 the only thyroid function test ordered?  It's obviously below the reference range, so there's something wrong with the doctor's reasoning if he thinks nothing needs to be done... If other tests were ordered, please post results with reference ranges.

It looks like your father should find a better doctor, who understands how to interpret thyroid function tests...

[annette83_B]

Thank you for your reply.The previous ATPO were around 200.

[annette83_B]

Sorry, I accidentally pushed Enter and did not finish. Yes, the thyroglobulin is thyroglbulin (Tg). Another parameter was TSH, but it was OK - 1.34 (norm up to 4.2). He did the tests as part of the annual medial check. So it was not the doctor who prescribed these tests. And he saw a couple of doctors afterwards, and all of them said nothing should be done, that the elevated ATPO is not bad... But after reading on the internet I realized he has the Hashimoto disease and got worried. So I would like more information on what he might have and possible treatment so that he could go to another doctor and be ready for a talk with him.