Peroxidase antibodies?

[Jellybean82]

Hello everyone, I was wondering if anybody could help me. It's quite a long story so please bare with me! I had a baby about 14 weeks ago. At first I felt great but after 6 weeks I started to become extremely tired, dizzy and groggy. This lasted a couple of weeks and then I got severe brain fog too. Strange things started happening like pins and needles in my hands and feet, pounding heartbeat, static in my vision and tinnitus. I went to the doctor, the first one said it's a virus but sent me for an mri to rule out ms. Mri all clear. The second doctor said it was a post viral illness such as cfs and the final doctor I saw said it is postpartum depression 'without the feeling sad bit'. Well I can tell you I am definately not depressed so left the doctors office vowing to discover what ws wrong myself. I got a copy of my bloods and it showed weird results: High RBC & RDW, Low MCV & MCH. Looking online I saw this could be low b12 and iron. Haven't had my b12 checked but my ferritin level was 30 which is low normal. Anyway (sorry it's so long), I've been taking an iron and b12 suppliment and feeling a bit better but still get numbness and tingling and weird vision and tinnitus. I just received a phone call from the docs saying they reviewed my bloods and found peroxidase antibodies (280). My tsh when it was last tested 2 months ago was 2.51 with a t3 of 14.4. What does this mean and could it cause my symptoms? I'm getting so frustrated and it is so difficult getting help especially with two little ones to look after, I'm so desperate to find an answer. Thank you soooooo much in advance of any advice and sorry if I'm on the wrong board or something, I've never been on a forum before.

[goolarra]

If your thyroid isn't producing hormones, dietary changes, acupuncture and supplements really won't help.  Of course, any change in your lifestyle for the better might help temporarily.  However, we NEED thyroid hormones...every cell in our body depends on them for metabolism.  Keep in mind that thyroid hormones are not drugs; they're an exact replica of what our bodies make.  In that sense, they're more like a supplement.  Stay on top of it for a while until you're sure your thyroid function is returning.  Next time, write down your FT3 and FT4 results and get their reference ranges.  Best of luck.  

[Jellybean82]

I think she did test FT3 and FT4 but if I'm honest I can't remember the numbers. I don't think I feel unwell as such so might not take the medication just yet. By natural I mean dietary changes, acupuncture and supplements if necessary. Thank you very much for taking the time to answer my questions.

[goolarra]

Did she test FT3 and FT4 as well?

Yes, there's often a delay between labs and symptoms.  Labs improve, and it takes a while for us to feel better.  And, of course, the other way around is true, too.  That's just about the opposite of what you were indicating.  However, TSH is such a poor indicator of thyroid status that you really can't apply that to TSH.

Only you can decide whether you feel bad enough to take the meds.  There's no reason you can't discontinue meds later if it is PPT and your thyroid function comes back.  

What do you consider a more natural approach?

[Jellybean82]

Just an update really. Had my my thyroid tested again last week and the new results show a TSH of 8.5. My gp says it is subclinical hypothyroidism and has prescribed levothyroxine at 25mcg a day. I've pretty much lost my faith in my gps and when I asked her if this could be postpartum she looked it up on her computer but didn't really answer the question. I have a few questions for anyone who has time to answer. Is there a delay between symptoms and blood test results because I feel better than I did yet my blood results are worse, I thought that perhaps if there is a delay then the results are showing the couple of weeks where my symptoms were at their worst. My only symptoms now are slight tiredness and swelling in my throat with a husky voice. Do you think I should take the medication? is it likely to be postpartum? Will I do more damage if I decide not to take the medication and go a more natural medicated route? All advice greatly appreciated as ever.

[Jellybean82]

Thank you both so much for help, I will go back to the gp and ask for further tests. Thanks again.

[goolarra]

Your FT4 is a little bit on the low side.  It's at 42% of range, and the rule of thumb for FT4 is about 50%.  In my opinion, since you're not on meds, that's not a real concern.

Your doctor didn't test FT3, which is a very important piece of the puzzle.  FT3 correlates best with symptoms.

I think if I were you, I'd request another test, adding FT3 this time.  If you do have PPT, eight weeks ago, when those labs were drawn, you might have been in transition from the hyper phase to the hypo phase, and things might have changed a lot in the interim.  Be sure to have B-12 tested as well since numbness and tingling can be symptoms of low B-12 levels or pernicious anemia.  

All your symptoms could be symptoms of hypo, so I'd aggressively pursue this testing.

[Red_Star]

Okay well there are many more reasons for high RBC but may also be lab error.  In general, deficiency states take a few months to improve. In regards to severe vitamin B12 deficiency, this eats away at the myelin sheath (protects the nerves) and can take far longer to repair depending on the damage.

From Mayo Clinic...

Specific causes of high red blood cell count may include:

Anabolic steroids, which stimulate red blood cell production
Congenital heart disease
COPD
Dehydration
EPO doping (injections of erythropoietin (EPO) to enhance athletic performance)
Heart failure
Hemoglobinopathies (conditions present at birth that impair the oxygen-carrying capacity of red blood cells)
Kidney cancer
Kidney transplant
Living at a high altitude, where there's less oxygen in the air
Other types of heart disease
Other types of lung disease
Polycythemia vera
Pulmonary fibrosis
Smoking, which may result in low blood oxygen levels

[Jellybean82]

Thanks red star im sure im not dehydrated, don't have resp problems (as far as I know), live in London and don't smoke so it's very strange. I'm taking Feroglobin iron & b12 liquid.

[Red_Star]

Living at a high altitude. :)

[Red_Star]

Elevated RBC can be seen with dehydration so this may be nothing major going on. Other causes include respiratory problems, living at a high, polycythemia vera, smoking.  What form of vitamin B12 are you taking?

[Jellybean82]

Thanks for the reply, sorry I got that wrong it is T4! It says Serum free T4 level 14.4 range 9-22

[goolarra]

Elevated TPOab can indicate autoimmune thyroid disease (Hashimoto's thyroiditis), but it can also be associated with postpartum thyroiditis, which is considered a variant of Hashi's.  With PPT, there's often an initial hyper period just after delivery, followed by a return to normal levels and then a "temporary" hypo period.  This sometimes resolves spontaneously, but "temporary" can mean a couple of years.

What's the range on your T3?  Ranges vary lab to lab, so you have to post ranges with results. Are you sure that's a T3 and not a T4?  Also, does it say that it's a FREE T3 (FT3) or FREE T4 (FT4)?