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....

[Amydreamer]

Hi.  I just picked up a copy of my recent lab reports:

3/1/10
Vitamin D 25.2  (Low she asked me to take 1000 extra vitamin D a day)
TSH   5.44       (range should be 0.450-4.55 from what this results states)

3/18/10
TSH  4.680
T4 (Free Direct) 1.05  (range .82-1.77)
Thyroid Peroxidase (TPO) ab   600

Thank you for your time helping me to understand hypo.

[goolarra]

The currently accepted range for TSH, according to AACE, is 0.3-3.0.  Most labs are using obsolete ranges still.  So, both your TSH readings were high.  Your FT4 is in range, but very low in the range.  Midrange is the rule of thumb for FT4...midrange doean't work for everyone, but it is a guideline until we establish our own comfort zone.  Your FT4 is in the bottom quarter.

The next time you have labwork, insist on FT3 as well.  It's the most biologically active thyroid hormone, and establishing a personal history is very important.  It can make diagnosis of any problems that arise later so much easier.  At the moment I don't think you really need any further testing.  You’ve had your U/S; you have a diagnosis of Hashi’s; you know that your FT4 is approaching borderline; you’re asymptomatic at the moment.

Of course, since you have Hashi's, the antibodies are going to continue to destroy thyroid function, and you will eventually become symptomatic.  Now, you and your doctor have to decide when to start treatment, which is a controversial subject.  Some argue that it’s best to start before symptoms appear because it takes pressure off the thyroid and can forestall some of the physical problems of the thyroid that result.  Others argue that it’s useless to treat early, since the cause of Hashi’s is untreatable, and the only goal of treatment is symptom relief.  I encourage you to read as much as you can on both sides of the argument.  Let me know if you have questions, and I’ll be happy to play devil’s advocate for either side!

Do you have an appointment set to discuss your latest results with your doctor?

[Amydreamer]

Sigh..

[Amydreamer]

So it's inevitable that I will definitely have problems down the road?  Are there any stories where the thyroid went back to normal anywhere??  Without meds. I guess I'm in denial.  My doctor is adamant about taking synthroid now. Oh my FT4 was 1.13  on 3/1. So it went up as my TSH came down a few weeks later.
No doctors appt yet she wants to order the synthroid then do more lab work in July with a follow up then.
I'm just torn between Natural (NatureThroid or Armour) and Synthetic at this point. Or just wait till July without taking any meds.  I wonder if my Vitamin D goes up will my thyroid heal. Just a thought.
Thank you gollarra I appreciate your replies.  I'll let you know what happens.

[Amydreamer]

I just received mail from the Dr.  She has a prescription for synthroid .05mg 1 po q am on empty stomach.

She wants me to go for a progesterone lab work now.
April the 3rd week Tsh +Free T4 labwork.

[goolarra]

Well, I'm sure almost everything happens SOMETIME, like spontaneous remission of antibodies, but I've never heard of it, and I really wouldn't hold my breath.

Yes, it is inevitable.  However, sometimes antibodies are present for years or even decades before thyroid function is compromised enough to cause symptoms.  On the other hand, it can go like gangbusters.

FT4 will go up and down in the early stages of Hashi's.  The thyroid doesn't just quit working on a nice, even straight-line slope.  Instead, it works in fits and starts...some days too little, some too much.  

Vitamin D might help you feel better, but it's not going to cure your Hashi's.

Most of us start out on synthetics.  They're arguably the easiest to control IF they work for you.  The "natural" thyroid products have had a very tough past year.  Armour was reformulated, causing it not to work for people who had done extremely well on it for years.  That prompted people to flock to other dessicated brands, which caused a shortage (nationwide) in them.  It was a mess, and some people are still trying to recover from it.  

Your doctor seems to be doing the right things.  50 mcg is a reasonable start if you are under fifty and have no other health issues (especially heart arrythmia).  Also, she's retesting in about four weeks, which is good timing when your dose is new or being adjusted.  Ask her to order FT3 also to establish your history.  Many doctors don't like to order FT3 (it's a constant issue on the forum), but should do so upon patient request.

I'd still encourage you to research both sides of the "when to start meds" issue.