Can TPO ever fluctuate??

[Amydreamer]

Hello- Please help.  I'm so confused.  I'm 48 years old, have exercised all my life, ate healthy. Can the thyroid's TPO test show high because the thryroid was compromised due to dental problems?  What I'm trying to ask is can the thryoid bounce back from a high TPO result? For 6 months I went to a dentist, dental surgeon, endodontist, and finally a periodontist to find out what exactly was wrong with my constant pain in my tooth.  After numerous root canals and antibiotic, about 10 in those 6 months the periodontist told me what was wrong.  Keep in mind I floss and brush regularly....
After this ordeal which was stressful and with all the antibiotics I was on now I'm showing signs of hypothyroidism.  Can my thyroid bounce back after a month or two and become better by itself???
I really don't want to take synthroid for the rest of my life if I don't have too.
I'm 128lbs (same as high school), 5'5" walk/run 20 miles a week and very active.  I have no signs of hypo other then tired with 4 children.  My hair and skin is healthy also.
I'm really scared and don't know who to turn too.  My doctor said I have to take the medicine or I'll be sick.  She won't listen to me and won't think of Armour.  I was to get my adrenal glands checked and my progesterone checked but she isn't calling.  If feel so lost.  I know two people on synthroid and they can't even walk 1 mile, can't lose weight and have hair loss....

[goolarra]

Your mom's uptake is high, indicating hyper, but T3 uptake is considered an obsolete test.  However, from what you say about her symptoms, she sounds hypO???  The T4 test looks like a total T4, not free T4 to me...also of limited usefulness.  TSH certainly does not look hyper.  

Methimazole is an anti-thyroid med used to control hyper.  In addition to the tests you mentioned, I'd include a TSI (thyroid stimulating immunoglobulin).  TSI is the definitive test for Graves' (autoimmune hyperthyroidism).  Is she feeling any better on the methimazole?

[Amydreamer]

Hi thanks for responding.  As far as Mom goes its a bit of a nightmare right now.  I urged my Dad to see an Endo but he doesnt want too.  My Dad has been through a lot (double bypass with complications) and didn't want to hear about going to another doctor and put all his trust in the primary doctor. He (primary doctor) seemed to get uptight with my questions and wanting further tests.
I'll be visiting them soon and check what blood tests he had done and reply.  
She is back on the methimazole which I believe will interfere with the other readings correct?
What is frustrating is my Mom has all the signs of an autoimmune disease but the primary doctor feels if he did the Uptake it ruled out any problems from the beginning.
I'll get back to you when I return.  Thanks again and I hope you are feeling well.

[goolarra]

Thank you so much for the update.  I just realized that I never saw the post about your mom.  Did the doctor run the tests you requested?  How's she doing?  Yes, you aked for the right tests...FT3 and free triiodothyronine are the same test (thus the abbreviation!). The only thing I'd have added is TGab, which is the other antibody that indicates autoimmune disease.

Your numbers are a little on the low side still...but if you feel well, they are not seriously off.  A definite improvement...keep up with regular bloodwork.  As your thyroid function further deteriorates, you'll need meds increases.

[Amydreamer]

Hi!  You had asked me to check back and let you know how I was doing.  After a month on synthroid .25 the doctor had my blood checked again.  Here are the results:

TSH           2.480                          ref .450-4.500

T4, Free (Direct)  1.23                   ref .82-1.77

Reverse T3        221                      ref 90-350

Triiodothyronine, free, serum    3.0  ref 2.0-4.4

It seems like the sythroid is doing it job.  I feel fine too.  I hope this followup finds you well.

Regards,
Amydreamer

[Amydreamer]

Hi goolarra how are you?
My Dad asked me for advice and I want to make sure I gave him the right info since you were such a big help to me.  I urged him to get her thyroid tested since I found I was hypothyroid.  
My Mom is on Dilantin for a seizure she had many years ago.  She has been very sleepy and out of it and going downhill for the last year.  The doctor just took her off arisept for dimentia  and detrol for urination because of her condition.  Now her blood work came back as follows.
T3 Uptake range 42.70   Range 22.5-37.01
T4    9.5                        Range 4.5-10.9
Tsh   2.079                    Range 0.35-5.60
Albumin 3.0                   Range 3.2-4.6
The Primary doc put her on methimazole.  
With all the help from you and the rest of the great people here today I gave my Dad this advice today but told him I was also waiting to hear back from Med Help.

She starting methimazole yesterday.  I told my Dad to stop giving her the methimazole.
Have the primary doc prescribe TSH +Free T4, Free T3, TPO Perioxidase and the Triodothyrnonine, Free, Serum..
I called the primary Doc and left a message on this answering machine to please have these tests done and that my Mom is off the methimazole until we know these numbers.
I believe the T3 Uptake is outdated and we need to know the rest of these numbers.
Did I advice him correctly?
Thank you,
Amydreamer

[goolarra]

It's hard to say which of the two doctors is the lesser of the two evils...the first won't use dessicated, the second will, but thinks your antibodies might miraculously disappear and doesn't want to start treatment until you've had ample opportunity to get sick!  What a choice!

You usually have to interview through a nurse...they guard their doctors better than a junkyard dog does.  This endo you interviewed should be testing FT3.  Confused about Armour and T3 meds...maybe the nurse just didn't know what you were talking about.  The brand name for T3 is Cytomel (she might recognize that).  

My advice (my personal opinion only) is that I'd keep trying to find another thyroid doctor.  If you are absolutely sold on dessicated, then Dr. #1 is not going to do you any good.  However, Dr. #2 won't treat you.  Have you ever contacted your cardio to get his opinion on thyroid meds and LBBB?  I don't know how much of an issue these two create together, but it might be nice to have the cardio's opinion.  I would probably go with Dr. #1.  First, because she's willing to treat you now, not wait until you're sick and have gained 50 lbs.  Second, many of us do absolutely fine on T4-only meds.  Crossing each bridge as it comes along,  if that is not the case with you, you can address that later. And has she even said that she would not consider using T3 meds or dessicated if T4 alone doesn't do it for you?

I'm sorry to hear about your family's health problems....at least you are feeling good and have the energy to deal with it (relatively speaking, of course).