Aa
anti-tpo antibodies 275 IU/mL
I was diagnosed with hypothyroidism in 1997 and have been on levothyroxine ever since. Over the years my dosing has increased from 50mcg to 137mcg currently. I recently saw my PCP with complaints of increased fatigue, brain fog, muscle/joint pain & irritability. Bloodwork shows anti-tpo ab 275, anti-thyroglobulin ab <20, TSH 3.08, FT4 1.6, T3 92. also had morning cortisol checked and it is 11.5.
I do not have an endo but am concerned about the anti-tpo elevation and symptoms. I would love suggestions as I am new to researching this. Before last week I didn't even know there was an autoimmune connection to thyroid disease.
I do not have an endo but am concerned about the anti-tpo elevation and symptoms. I would love suggestions as I am new to researching this. Before last week I didn't even know there was an autoimmune connection to thyroid disease.
"Bioidentical" really isn't the correct term for Armour thyroid. Armour is desiccated porcine thyroid, and it contains both T3 and T4. However, the proportions of T3 to T4 are in no way identical to what our thyroids produce. Armour has a lot more T3 in it than our thyroids produce. For some people, who convert very slowly, that added T3 is a bonus, for others, it can be too much.
Yes, it is possible to add synthetic T3 (Cytomel and generics) to your T4 meds. One advantage of going the synthetic route is that T3 and T4 can be manipulated separately for a "custom" fit. Synthetic T3 and T4 in correct proportions are really more "bioidentical" than desiccated is.
Since your FT4 is relatively high, and your TT3 relatively low at the moment, it looks like you might benefit from adding T3 to your meds. If you and your doctor decide to try synthetic T3, bear in mind that T4 meds are usually reduced 20-25 mcg for every 5 mcg T3 added in (to to the relative high potency of T3). Also, since T3 has a very short half life compared to T4, many people find that they have to split their dose into one in the morning with their T4 and one in the early afternoon. That will smooth out the peaks and valleys of T3. Be sure to start out low (5 mcg total per day???). Once you get used to taking it, you can increase further if needed.
Yes, it is possible to add synthetic T3 (Cytomel and generics) to your T4 meds. One advantage of going the synthetic route is that T3 and T4 can be manipulated separately for a "custom" fit. Synthetic T3 and T4 in correct proportions are really more "bioidentical" than desiccated is.
Since your FT4 is relatively high, and your TT3 relatively low at the moment, it looks like you might benefit from adding T3 to your meds. If you and your doctor decide to try synthetic T3, bear in mind that T4 meds are usually reduced 20-25 mcg for every 5 mcg T3 added in (to to the relative high potency of T3). Also, since T3 has a very short half life compared to T4, many people find that they have to split their dose into one in the morning with their T4 and one in the early afternoon. That will smooth out the peaks and valleys of T3. Be sure to start out low (5 mcg total per day???). Once you get used to taking it, you can increase further if needed.
Thank you for all of this information. Here are my blood work results with ranges:
Vit B12 561 range 220-1000
D3 35.3 range 30-80 (I typically range 55-70 but had not been supplementing for the past month. I am now back on 7000IU/day)
Folate 17.7 (H) range 3.0 - 16.0
Cortisol AM 11.5 range 5-23
anti-thyroglobulin antibodies <20 range 0-40
anti-tpo antibodies 275 (H) range 0-34
TSH 3.08 range .35-5.50
T3 92 range 60-181
FT4 1.6 range 0.9-1.8
I started a conversation with my PCP about bioidentical hormone replacement and they are willing to work with me but they do not have many patients using bioidentical. I was a little concerned about changing over and the learning curve involved to get my levels adjusted correctly. I am beginning my nursing program in September and am concerned with juggling the program with a hormone balance issue.
If I do not change over to something like armorthyroid is it possible to add T3 replacement to my current treatment program of levothyroxine .137mcg? My PCP seems willing to listen to my concerns and prescribe accordingly. I just haven't known the questions to ask.
Again, thank you!
Vit B12 561 range 220-1000
D3 35.3 range 30-80 (I typically range 55-70 but had not been supplementing for the past month. I am now back on 7000IU/day)
Folate 17.7 (H) range 3.0 - 16.0
Cortisol AM 11.5 range 5-23
anti-thyroglobulin antibodies <20 range 0-40
anti-tpo antibodies 275 (H) range 0-34
TSH 3.08 range .35-5.50
T3 92 range 60-181
FT4 1.6 range 0.9-1.8
I started a conversation with my PCP about bioidentical hormone replacement and they are willing to work with me but they do not have many patients using bioidentical. I was a little concerned about changing over and the learning curve involved to get my levels adjusted correctly. I am beginning my nursing program in September and am concerned with juggling the program with a hormone balance issue.
If I do not change over to something like armorthyroid is it possible to add T3 replacement to my current treatment program of levothyroxine .137mcg? My PCP seems willing to listen to my concerns and prescribe accordingly. I just haven't known the questions to ask.
Again, thank you!
The usual tests for thyroid antibodies are TPO ab and TG ab. With your history and the elevated test result for TPO ab, I assume you have been told that you have Hashimoto's Thyroiditis which is the most common cause of diagnosed hypothyroidism. With Hashi's the thyroid gland is gradually destroyed by the thyroid antibodies. The resultant loss of natural thyroid hormone production has to be offset by taking gradually increasing dosage of thyroid meds.
Hashi's patients seldom have problems directly related to the level of antibodies. Instead they mostly have problems with the usual hypo symptoms, some of which you mentioned, due to inadequate medication, either type or dosage.
You don't necessarily need an Endo, but you do need a good thyroid doctor. By that I mean one that will treat you clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms. Symptom relief should be all important, not just test results, and especially not TSH levels.
For us to best assess your test results, we really need for you to also post their reference ranges shown on the lab report. From your results, I would assume that your Free T4 is high in its range, and the Total T3 result is low in its range. An imbalance like that frequently occurs with hypo patients taking T4 meds, when their body does not adequately convert the T4 to T3.
In the future you should always request to be tested for Free T3, and Free T4, not Total T3 and T4. The Free portions of T3 and T4 are the biologically active portions. Free T3 is the most important because it largely regulates metabolism and many other body functions. Scientific studies have also shown that Free T3 correlated best with hypo symptoms, while Free T4 and TSH did not correlate.
When you go in for testing again, I also suggest that you should also test for Vitamin A, D, B12, and ferritin. Each of these can be deficient with hypo patients, and each is important to help relieve symptoms. You should also be aware that just being in the low end of the ranges for these is also not adequate for many patients.
You don't necessarily need an Endo, but you do need a good thyroid doctor. By that I mean one that will treat you clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels., Symptom relief should be all important, not just test results, and especially not TSH levels.. Many of our members, myself included report that symptom relief for them required that Free T3 was adjusted into the upper third of its range and Free T4 adjusted to around the middle of its range. You can gain some good insight into clinical treatment from this letter written by a good thyroid doctor for patient that he sometimes consults with from a distance after the initial testing and diagnosis. The letter is then sent to the participating PCP of the patient to help guide treatment.
http://hormonerestoration.com/files/ThyroidPMD.pdf
In the letter, please note this statement, "the ultimate criterion for dose adjustment must always be the clinical response of the patient."
Hashi's patients seldom have problems directly related to the level of antibodies. Instead they mostly have problems with the usual hypo symptoms, some of which you mentioned, due to inadequate medication, either type or dosage.
You don't necessarily need an Endo, but you do need a good thyroid doctor. By that I mean one that will treat you clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms. Symptom relief should be all important, not just test results, and especially not TSH levels.
For us to best assess your test results, we really need for you to also post their reference ranges shown on the lab report. From your results, I would assume that your Free T4 is high in its range, and the Total T3 result is low in its range. An imbalance like that frequently occurs with hypo patients taking T4 meds, when their body does not adequately convert the T4 to T3.
In the future you should always request to be tested for Free T3, and Free T4, not Total T3 and T4. The Free portions of T3 and T4 are the biologically active portions. Free T3 is the most important because it largely regulates metabolism and many other body functions. Scientific studies have also shown that Free T3 correlated best with hypo symptoms, while Free T4 and TSH did not correlate.
When you go in for testing again, I also suggest that you should also test for Vitamin A, D, B12, and ferritin. Each of these can be deficient with hypo patients, and each is important to help relieve symptoms. You should also be aware that just being in the low end of the ranges for these is also not adequate for many patients.
You don't necessarily need an Endo, but you do need a good thyroid doctor. By that I mean one that will treat you clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels., Symptom relief should be all important, not just test results, and especially not TSH levels.. Many of our members, myself included report that symptom relief for them required that Free T3 was adjusted into the upper third of its range and Free T4 adjusted to around the middle of its range. You can gain some good insight into clinical treatment from this letter written by a good thyroid doctor for patient that he sometimes consults with from a distance after the initial testing and diagnosis. The letter is then sent to the participating PCP of the patient to help guide treatment.
http://hormonerestoration.com/files/ThyroidPMD.pdf
In the letter, please note this statement, "the ultimate criterion for dose adjustment must always be the clinical response of the patient."
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