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Normal T4 and TSH but high TPO
Hello. I am a 63 year old female in good health. My hormone Dr. put me on naturethroid and says I have Hashimoto's based upon the blood test with TPO being 40. My T4 is normal at 1.19 and the TSH is normal at 1.9. I question whether this is a real problem. Should I ask for other tests before I take pills. I hate taking drugs and this is the first. I have been on these for about 3 months and I have noticed that I perspire excessively. I go to the Dr, later this week. I question the diagnosis based upon one test. Do you think I have Hashimoto's Disease? Is there another way to combat my elevated TPO reading or is my thyroid glad misfunctioning permanently? THX
COMMUNITY LEADER
Both weight issues and muscle/joint aches/pains are both symptoms of hypothyroidism.
I think of myself as being healthy, as well, in spite of my illnesses. Treated properly, they don't have to keep us from living a normal life.
You might try splitting your NatureThroid into 2 doses, as I described above and see if that helps level out the way you feel.
When asking for T3 test, make sure you specify FREE T3, or you will get Total T3, which is obsolete and of little value. Any doctor prescribing a med with T3 in it and not monitoring Free T3 is bordering on malpractice, in my opinion.
I think of myself as being healthy, as well, in spite of my illnesses. Treated properly, they don't have to keep us from living a normal life.
You might try splitting your NatureThroid into 2 doses, as I described above and see if that helps level out the way you feel.
When asking for T3 test, make sure you specify FREE T3, or you will get Total T3, which is obsolete and of little value. Any doctor prescribing a med with T3 in it and not monitoring Free T3 is bordering on malpractice, in my opinion.
THX. I will ask for more tests. The T4 is free. There was no T3 done. I think of myself as healthy, but weight is a problem and I do have knee pain, much attributed as normal for my active life. Maybe it's my thyroid. I take one dose a day in the morning on an empty stomach - 32,5 mg. Just ate 2 Brazil nuts - LOL
COMMUNITY LEADER
What was the reference range for the T4 and was that Free or Total? Ranges vary lab to lab and have to come from your own report.
Your doctor should also have tested you for Free T3, which is the active thyroid hormone, along with Free T4 and TSH.
The reference range for TPOab is, typically, < 34 or < 35, so your level is relatively low and since TPOab can also be present in small amounts with other autoimmune diseases, there's another antibody test that can be done to diagnose Hashimoto's, as well, and since you're in doubt, you could ask your doctor to order it. It's called Thyroglobulin Antibodies (TGab). Both TPOab and TGab should be run since some people have one or the other, some have both. The absence of TGab would not confirm that you don't have Hashimoto's, but its presence would confirm that you do have it.
You could also ask for a thyroid ultra sound, which would show whether or not you have swelling/inflammation in your thyroid, which would also be the basis for a diagnosis of Hashimoto's, along with your elevated TPOab.
Do you have any symptoms of hypothyroidism? The ones listed above are the main ones, but there are many others.
What dose of NatureThroid are you on? Are you taking it all in one dose or splitting it into multiple doses/day? Most of us a medication with T3 find that splitting it into multiple doses works best. T3 med gets into the system quickly and is gone within a few hours, so taking it all in one dose can give you a "buzzed" feeling, but then it wears off. If you take the med in 2 doses, you keep your levels steady all day. While I don't take NatureThroid, I do take a T3 med and I take one dose when I get up in the morning, the second dose at/around noon.
FYI - trying to treat the antibodies is a lesson in futility; I've taken selenium for years and while it does help with FT4 to FT3 conversion, it never did anything to lower my antibody count. That happened after there was so much damage done that my goiter disappeared... with nothing left to chomp on, the antibodies went into remission.
Your doctor should also have tested you for Free T3, which is the active thyroid hormone, along with Free T4 and TSH.
The reference range for TPOab is, typically, < 34 or < 35, so your level is relatively low and since TPOab can also be present in small amounts with other autoimmune diseases, there's another antibody test that can be done to diagnose Hashimoto's, as well, and since you're in doubt, you could ask your doctor to order it. It's called Thyroglobulin Antibodies (TGab). Both TPOab and TGab should be run since some people have one or the other, some have both. The absence of TGab would not confirm that you don't have Hashimoto's, but its presence would confirm that you do have it.
You could also ask for a thyroid ultra sound, which would show whether or not you have swelling/inflammation in your thyroid, which would also be the basis for a diagnosis of Hashimoto's, along with your elevated TPOab.
Do you have any symptoms of hypothyroidism? The ones listed above are the main ones, but there are many others.
What dose of NatureThroid are you on? Are you taking it all in one dose or splitting it into multiple doses/day? Most of us a medication with T3 find that splitting it into multiple doses works best. T3 med gets into the system quickly and is gone within a few hours, so taking it all in one dose can give you a "buzzed" feeling, but then it wears off. If you take the med in 2 doses, you keep your levels steady all day. While I don't take NatureThroid, I do take a T3 med and I take one dose when I get up in the morning, the second dose at/around noon.
FYI - trying to treat the antibodies is a lesson in futility; I've taken selenium for years and while it does help with FT4 to FT3 conversion, it never did anything to lower my antibody count. That happened after there was so much damage done that my goiter disappeared... with nothing left to chomp on, the antibodies went into remission.
Just don't take too many brazil nuts. I ate 6 in one setting and was really out of it. LOL I'd say perhaps 2 or 3 a day would be fine. :)
Medscape states the following...
"Conditions associated with elevated serum TPOAb levels include the following:
Hashimoto disease (90%-100%)
Graves disease (50%-80%)
Other autoimmune diseases (eg, type 1 diabetes mellitus) (40%)
Pregnancy (14%)
Sporadic multinodular goiter, isolated thyroid nodule, and thyroid cancer"
Medscape states the following...
"Conditions associated with elevated serum TPOAb levels include the following:
Hashimoto disease (90%-100%)
Graves disease (50%-80%)
Other autoimmune diseases (eg, type 1 diabetes mellitus) (40%)
Pregnancy (14%)
Sporadic multinodular goiter, isolated thyroid nodule, and thyroid cancer"
thank you for the response, but am still unclear as to whether this is a correct diagnosis based upon one part of a blood test. I have Brazil nuts in my fridge - Here I come! THX
Various studies show selenium can lower TPOAb. This depends on the person but it's worth trying out. I dropped 80 IU eating brazil nuts daily for 6 months.
Excerpt from National Endocrine and Metabolic Diseases Information Service (NEMDIS) - Hashimoto's Disease...
"Many people with Hashimoto's disease have no symptoms at first. As the disease slowly progresses, the thyroid usually enlarges and may cause the front of the neck to look swollen. The enlarged gland, called a goiter, may create a feeling of fullness in the throat but is usually not painful. After years, or even decades, the damage to the thyroid causes it to shrink and the goiter to disappear.
Not everyone with Hashimoto's disease develops hypothyroidism. For those who do, the hypothyroidism may be subclinical—mild and without symptoms. Other people have one or more of these common symptoms of hypothyroidism:
fatigue
weight gain
cold intolerance
joint and muscle pain
constipation
dry, thinning hair
heavy or irregular menstrual periods and impaired fertility
depression
a slowed heart rate"
Excerpt from National Endocrine and Metabolic Diseases Information Service (NEMDIS) - Hashimoto's Disease...
"Many people with Hashimoto's disease have no symptoms at first. As the disease slowly progresses, the thyroid usually enlarges and may cause the front of the neck to look swollen. The enlarged gland, called a goiter, may create a feeling of fullness in the throat but is usually not painful. After years, or even decades, the damage to the thyroid causes it to shrink and the goiter to disappear.
Not everyone with Hashimoto's disease develops hypothyroidism. For those who do, the hypothyroidism may be subclinical—mild and without symptoms. Other people have one or more of these common symptoms of hypothyroidism:
fatigue
weight gain
cold intolerance
joint and muscle pain
constipation
dry, thinning hair
heavy or irregular menstrual periods and impaired fertility
depression
a slowed heart rate"
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