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]

My dad had a double by pass and we are taking care of Mom so I had to put my issues on the back burner...I had a few minutes so: I called the endo my Primary wants me to see.
I spoke to the nurse and she said the doctor will not look at a questionaire to answer to ask her the questions.  (I should have known then to hang up)  I took your advice and asked her:
Which tests does the she routinely order and use to treat thyroid patients?  
Her answer was TSH Ft4
I asked if they use Armour or any T3 combo drugs and they sounded confused.
When I asked if the Dr. ever treated a patient with the Left Branch Bundle Block they called back and told me to find a specialist maybe out of the area because they are unfamiliar with all of my questions!!
Actually Dr.2 is open to anything and I wonder if he would work with me on the T3/T4 meds.  He wants to recheck all my levels in 3 months.  Not just the TSH/FT4.
Your thoughts?  Should I continue to search for an endo in my area that would work with me?  I think I know what your answer is. :/  

[goolarra]

I understand your concerns about taking meds...I don't take anything I don't absolutely have to take.  However, you do have Hashi's, so it's only a matter of when, not if, you start meds.  I was very symptomatic when I started meds, and, I'll tell you, those symptoms sure convinced me that I couldn't do without these meds!  If I sat for more than about 10 minutes, I was asleep.  My muscles in my back would hardly hold me up.  The problem is that it can be very insidious...symptoms creep on you until one day you're in really bad shape and don't know how you got there and so many of the symptoms can be "blamed" on something else..  I really think there's some merit in avoiding all that...  

However, I think avoiding Dr. 2 is a very good idea.  He missed the mark on several points.  Get another opinion...hopefully, you'll find someone you feel you can trust and work with.  Keep us posted.

[Amydreamer]

Again a million thanks on all your info.  I appreciate your time and effort in explaining this to me in detail.  
I've decided not to go back to Dr. 2.
I will do a follow up and let you know the results of my Endo search and my progress on which medication I will be taking.
I'm scared to take meds and keep thinking of what I read about synthroid making the thyroid stop working...because the medication does the work for the thyroid.

[goolarra]

Question #1 - Which tests does the doctor routinely order and use to treat his thyroid patients and adjust meds?

If they say "TSH only", run. don't walk away!  If they say TSH and FT4, you can walk this time.  If they say FT3, FT4 and TSH, they've passed question #1.

Question #2 - Which meds is the doctor open to using...T4-only, synthetic T3/T4 combos, dessicated?  

I believe they should be open to all three.  This will weed out doctors who only treat using one or two of the three.  Some of us only function well on one of the three, so we don't want our options limited.

Question #3 - Does the doctor have first-hand experience treating thyroid in somone with LBBB (and any other health issues that you think might conflict with thyroid treatment)?

Question #4 - Does the doctor recommend therapy and expect the patient to follow it or does he work with the patient, sharing all test results and informing her of all options so that doctor and patient can come to a mutually agreed upon treatment plan?

This may sound like a no-brainer, and you'd think that NO one would say that they expect the patient to blindly follow.  However, when I was looking for a dentist a while back, most of the people I interviewed had no problem whatsoever, saying "oh, in this office, patients have NO RIGHT (eek!) to refuse "proper" care. Amazing...

You might also ask if you see the doctor himself or a PA, if that's important to you.  I think there are many things a PA can do quite nicely, but once you're referred to a specialist, you've already seen and MD or DO, so isn't seeing a PA in a specialist's office a bit of a step backward?

Just some ideas, although I'd never make an appointment with an endo without asking at least #1 and #2.  I actually made up a multiple guess questionnaire when I was looking and faxed it to the possible endos in the area.  Because it was multiple choice, it didn't take much of their time to fill out.  Good luck in your search.

[Amydreamer]

I really appreciate all of your help.
Yes I would like an idea of some questions to ask.
Thank you very much.

[goolarra]

Sorry, I calculated that and then forgot to mention it.  FT3 / RT3 * 100 is 1.34.  My readings have indicated that this ratio should be between roughly 1 and 2, preferably in the upper end of the 1-2 range.  Your range and mine are off by a factor of 10.  Yours would be 1.8-2.0 if we adjusted for that.  Maybe that's what they mean by "preferably the upper end of the range"???  It may be tilted a little toward RT3 dominance, but I think I'd work on FT3 and FT4 levels at the moment and just monitor RT3 for future reference.

IF RT3 dominance is truly a factor, the treatment is usually straight T3 therapy with no T4 meds at all.  This is temprorary until FT3/RT3 balance is restored.  Then T4 meds are re-introduced (or introduced in your case).  Whether or not you need to take both T3 and T4 depends on your FT3 and FT4 levels, not RT3.  If FT4 is midrange or above (general rules of thumb here), but FT3 lags in the bottom of the range and symptoms persist, this indicates that you are not converting properly and need some added T3.  However, you will not know this until you've gotten your FT4 level up a bit.

I think it would be a good idea to see an endo.  But, I'd preinterview them over the phone first (probably through a nurse) to get an idea how good they are at thyroid - unless, of course, you can get a personal reference from another thyroid patient.  Many endos just want to do diabetes and really don't keep up on thyroid at all.  Some of them are really useless as thyroid doctors.  If you'd like, I'll give you an idea of some questions to ask.

Hope this isn't all too confusing...