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Hypothyroid problem

When i first test my thyroid my t3 and t4 comes normal and tsh level is 71.58
Then i take medicine of thyroxine of 50 mg
Then aftr 15 days i tested again
And my t3 t4 comes  normal and TSH comes 9.3
Anti tpo is >1300
Then it is d chance that i have to take thyroid medicine for few months not for the whole life
3 Responses
Avatar universal
Your test results for TSH and TPO ab indicate that you have an autoimmune disorder called Hashimoto's Thyroiditis.  With Hashi's the autoimmune system erroneously identifies the thyroid gland as foreign to the body and produces antibodies to attack and eventually destroy the gland.  As this is happening the pituitary gland senses low thyroid levels and produces increasing amounts of TSH in an attempt to stimulate the thyroid gland to produce hormone.  

To properly assess your test results we need for you to post actual results and their reference ranges shown on the lab report.  

With the Hashimoto's  you will need to take replacement medication from now on.   And that will be higher dosage than current.  Will explain more when you post your test results and ranges.  
2 Comments
At first T3 total 0.91 (0.60-1.81)
T4 total 7.80 (5.01-12.45)
TSH 71.58 (0.35-5.50)
Then i take thyroxine medocine of 50 mg for 15 days then results are
T4 free FT4  1.37(0.89-1.76)
TSH ultrasensitive 9.371  (0.550-4.780)
Anti TPO >1300 ( <60.00)
At first T3 total 0.91 (0.60-1.81)
T4 total 7.80 (5.01-12.45)
TSH 71.58 (0.35-5.50)
Then i take thyroxine medocine of 50 mg for 15 days then results are
T4 free FT4  1.37(0.89-1.76)
TSH ultrasensitive 9.371  (0.550-4.780)
Anti TPO >1300 ( <60.00)
Avatar universal
Perhaps the first thing to explain is that Total T4 is a measure of the total amount  of serum T4.  Most of that is bound to protein and thus inactive.  Only the small portion not bound to protein, called Free T4,  is biologically active.   The same goes for Total T3.    So you should always make sure to test for both Free T4 and Free T3 each time you go for tests.     Also, to avoid false high test results it is best to delay taking that day's thyroid medication until after the blood draw for tests.  

TSH is a pituitary hormone that is supposed to accurately reflect thyroid hormone levels, and thus a person's thyroid status.   In reality TSH is affected by so many things that it is useful as a diagnostic only when it is at extreme levels.  Your high TSH was indicative of the possibility of Hashimoto's Thyroiditis, which was confirmed by the Anti TPO test.   To offset the loss of natural thyroid hormone production resulting from the antibodies' attack on your thyroid gland you have to take thyroid medication to provide the thyroid hormone needed for your body to function.  The 50 mcg  starting dose is just that: a starting dose.  You will need to continue to increase dosage gradually until hypothyroid symptoms are relieved.  Thyroid med dosage should never be adjusted based on TSH levels.  This is explained in a recent, excellent scientific paper  that concluded:   "Hypothyroid symptom relief was associated with both a T4 dose giving TSH-suppression below the lower reference limit and FT3 elevated further into the upper half of its reference range. "   When taking T4 meds like thyroxine,  Free T3 levels frequently do not increase  like T4 levels, so achieving an adequate Free T3 level often requires the addition of T3 to your med.   Also note that 2 weeks is too short of a time to get the full effect of a T4 med on serum thyroid levels.   It takes at least 4 weeks to achieve over 90% of the effect of the med dosage, so followup testing should not be done except after at least 4-5 weeks after a dosage change.  

In addition, hypothyroidism is not just low thyroid hormone levels.  Hypothyroidism is correctly defined as "insufficient T3 effect in tissue throughout the body due to inadequate supply of, or response to, thyroid hormone.   Even with adequate levels of serum thyroid hormone,  there are a number of variables that affect the response to thyroid hormone, and thus the Tissue T3 Effect.   Some of the main variables are Reverse T3, cortisol, Vitamin D, B12 and ferritin.  So Reverse T3 should be tested at least at the beginning to assure it is not a problem.  A Free T3 should be done from the same blood draw to be able to calculate a ratio of Free T3 to Reverse T3.  Either low or high cortisol adversely affects thyroid metabolism.  Vitamin D, B12 and ferritin should also be tested and supplemented as needed to optimize and also get best effect from thyroid hormone.   Vitamin D should be at least 50ng/mL. B12 in the upper end of its range, and ferritin should be at least 100.

So you need to get all these additional tests done:  Free T4, Free T3, Reverse T3, cortisol, Vitamin D, B12 and ferritin.  If you can get those done, and then post results and reference ranges here, we will be happy to help interpret and advise further.   And remember not to take your 50 mcg of thyroxine until after the blood draw for tests.   Do you think you can get these tests done?   Do you think your doctor will be receptive to all this testing and then treat clinically, as described, to relieve hypothyroid symptoms?
Avatar universal
How  did you first diagonose that u  hv hypothyroidism?
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