Autoimmune problems? Help please

[Lily9876]

Could someone please help me to interpret my bloods please.

TPO antibody - 276 (<34)
TG antibody - 288.3 (<115)
Tissue transglutaminase antibody - 3 (<1)
Ferritin - 61 (15 - 150)
MCHC - 28 (20 - 22)

I have underactive thyroid, polycystic ovaries, connective tissue disease and oesophageal hypertrophy. Have had lumpy breasts for 2 months, current period has now ended within 3 days instead of 5 but was still heavy.

I have no idea what next to do about results or ongoing issues.

Thanks in advance.

[TheLightSeeker]

Hi Lily.
My opinion is to have the reverse T3  (RT3) test, before increasing the Levothyroxine, which would make matters much worse, should your RT3 result comes back high.
Reverse T3 is converted directly from T4 and Levethyroxine is synthetic T4.
Any increase as a trial should be in T3, like Cytomel or whatever brand T3 comes in.
Please refer to my previous post.
From your most recent results your FT3 is rather low and it ideally should be in the upper one third of the reference range -->4.95-6.80 if my math is correct.
The high MCHC should be addressed ASAP, as the iron infusions-while improving your iron status- may have be doing very little to correct the suspected "functional" anemia, a definite factor in hypothyroidism, which BTW maybe the underlying cause of the suspected high RT3.
I feel that there are a lot of simple connections that your
doctors are not making.
That is sad :(  because you may be stuck in limbo and unnecessarily suffering greatly.
Best wishes,
Niko

[Lily9876]

Thanks Niko, i have an appointment on Tuesday to discuss everything with my doctor.

[TheLightSeeker]

Your TPO and TG are well above range, indicating Hashimoto's Thyroiditis.
What thyroid treatment are you on and why is it NOT working? What type of doctor is treating you???
Your tTG is well above range as well indicating Celiac
Disease. You are obviously NOT on a gluten-free diet.
*More on this later.
Your ferritin (storage iron) is mid-range/OK.
Your MCHC is above range, possibly indicating hemolytic anemia with symptoms of varying degrees of anemia, fatigue, splenomegaly and so on.
Partial splenectomy would be the preferred treatment.

You may also have estrogen dominance ( causing an imbalance in the estrogen/progesterone ratio and leading to fibrocystic breasts, polycystic ovaries and more).
You may need to modify your diet and avoid xeno-estrogens and boost your progesterone levels by taking bio-identical progesterone cream.
*Most Hypothyroid & Hashimoto's sufferers have gluten intolerance or Celiac's and may not even know it!
The gluten molecules-mainly from gmo grains- resemble the TPO(Thyroid Peroxidase - an enzyme necessary for the signalling Thyroid hormone production) molecules and thus the immune system in its response against gluten, attacks the TPO in the Thyroid also!
You must go gluten-free  as a trial ASAP!
Gluten is in everything! Envelopes, shampoos, cosmetics, creams, lotions, sauces, condiments, soups, beer,
play-dough, and many other products often not listed as an ingredient or listed with a different name!

I'm puzzled. With so many strong and clear indicators
and test results, why are you not being treated appropriately for your conditions.
Estrogen dominance might be a challenge for many doctors, but it's not rocket science either.
Celiac's no excuse !
Hashimoto's/Hypothyroidism just needs some attention to get thyroid function properly regulated, by frequent monitoring and adjusting thyroid meds as needed.
Prolonged under-treated thyroid function may be responsible for the development and onset of autoimmune conditions, including connective tissue disease (one of thyroid's lesser known functions is to activate enzymes responsible for cellular debris removal, thus leading to autoimmunity) and perhaps esophageal hypertrophy ( possibly as result of diminished motility because of low thyroid function).
Please post details regarding current treatments and other pertinent information.
Best wishes,
Niko

[Lily9876]

Thanks for getting back to me Niko.

I am under a haematologist and endocrinologist at the moment.

I was initially treated with hypothyroid in 2014 and iron deficiency in 2016 but had low ferritin and low MCV 5 years before that which went untreated.

Iron deficiency has been addressed with iron infusions but since having this my ferritin drops and the MCHC stays raised so I wonder if the haematologist (who arranged the iron infusion) couod have investigated more.

I currently take 150mcg Levothyroxine and 10mcg T3. Recommendations set out by my endocrinologist suggest I am under medicated but she told me my levels were stable and required no dose increase.

Results for thyroid (previous 3 results)

MAY 16 (125mcg Levothyroxine and 10mcg T3)
TSH - 3.94 (0.2 - 4.2)
FREE T4 - 12.7 (12 - 22)
FREE T3 - 4.2 (3.1 - 6.8)

JUL 16 (150mcg Levothyroxine and 10mcg T3)
TSH - 2.70 (0.2 - 4.2)
FREE T4 - 18.9 (12 - 22)
FREE T3 - 4.8 (3.1 - 6.8)

OCT 16 (150mcg Levothyroxine and 10mcg T3)
TSH - 3.86 (0.2 - 4.2)
FREE T4 - 15.4 (12 - 22)
FREE T3 - 4.1 (3.1 - 6.8)

I have been checked for calcium, vitamin B12, folate, CRP, liver function, etc. I have been told the results should be ready by today.

I took an antidepressant called Fluoxetine, I stopped this about a week ago. But the high MCHC cropped up before I started the Fluoxetine.

Thanks again.

[TheLightSeeker]

Thanks for replying so promptly!
A couple key observations.
Your suspected estrogen dominance and the related symptoms have not been addressed.
Your thyroid test results indicate likely
conversion issues.
I would ask for a gradual reduction of the Levothyroxine (which may be contributing to converting from T4 to reverse T3, thus lowering further your free T3) and a gradual increase of the T3 supplement.
Ask for a reverse T3 test and if your Endo agrees, please send me the result when you have it.
The MCHC is of concern since it usually leads to a functional anemia, called hemolytic anemia, caused by destruction of (altered) red blood cells in the spleen.
I'm surprised your Haematologist did not look into this.
Discontinuing the Fluoxetine is really good news, since the issues and symptoms it would have addressed are likely rooted in the hormonal dysregulation/imbalance.
Treating the thyroid* and rebalancing your estrogen/progesterone ratio
may take care of the aforementioned
problems.
* The suspected hemolytic anemia may be contributing to hypothyroidism including type 2 (thyroid-resistance).
The Haematologist and the Endo should co-ordinate their approaches in addressing these conditions,
in order to optimize your recovery.
And please talk to your Endo about
bio-identical progesterone cream.
If s/he does know or recognize estrogen dominance as a serious issue for you, look for a holistic minded Endo to help you with this.
Do not accept synthetic versions which are not bio-identical.
Your body one day will thank you
for making the right choice, lol!
Feel free to post your new test results and any questions you may have.
Cheers,
Niko

[Lily9876]

Thank you Niko, I have had a letter from my endocrinologist today, she wants me to increase my Levothyroxine to 175mcg on alternate days. She does not want to increase that much because I had what she thought to be thyrotoxic symptoms and she is not convinced my symptoms are from thyroid. She has asked me to discuss my symptoms with my doctor.