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TPO over 1,000 twice recently but no medication prescribed yet

My TPO was over 1,000 I guess that's peroxidase ab. Two doctors said just get another blood test in 2 months but no medication yet. I have no symtoms as of today. Does anyone think this is right ?
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Avatar universal
The most important information from a TPO ab test is whether or not you have a level of the antibodies that indicates the existence of Hashimoto's Thyroiditis.  That test result is a clear indication of Hashi's.  You may not be noticing symptoms as yet, because your thyroid function may not yet have been damaged enough to result in low levels of Free T3 and Free T4.  These are the biologically active thyroid hormones.  Free T3 is the most important because it largely regulates metabolism and many other body functions.  Scientific studies have shown that Free T3 correlated best with hypo symptoms, while Free T4 and TSH did not correlate at all.

There seems to be two basic approaches to treat a Hashi's patient.  One is to wait for thyroid hormone levels to be degraded enough to cause overt hypo symptoms, then prescribe a starter dose of thyroid meds, and increase as needed.  Sometimes this is in conjunction with testing only for TSH and not medicating the patient until TSH exceeds the old range limit.

The other approach is to be more proactive and start meds earlier, to keep Free T3 and Free T4 levels high enough to prevent symptoms.   I am not sure why many doctors choose to follow the first approach.  That would not be my choice.  It is not a matter of if, but when symptoms are going to start.  If you haven't been tested for Free T3 and Free T4, then I would not wait for two months,  I would suggest that you request those now,  You should also request testing for Free T3 and Free T4 each time in the office for tests.  If the doctor resists, then you should insist on it and don't take no for an answer.  If your Free T3 and Free T4 are in the lower half of their ranges, then you are moving toward hypo symptoms.

Keep in mind that a good thyroid doctor will treat a hypo patient clinically, by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important, not just test results, and especially not just TSH results..

Since hypo patients frequently are deficient in other areas as well, I suggest that you should also test for Vitamin D, B12 and ferritin.  Also, be aware that patients seem to have best results when these tests are in the upper half of their ranges.  

When test results are available, if you will get a copy of the lab report and post results and their reference ranges, members will be glad to help interpret and advise further.  
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Avatar universal
Also it is important that you get your FT3 and FT4 levels so that you have a baseline.

You say that you are basically symptom free. So if for no other reason, you should get your FT4 and FT3 levels tested so that you KNOW what levels you should NEVER get below.  This will be a good target to shoot for as Hashi's takes its toll and your dosage will have to change to keep pace.  

With a baseline, you and more importantly your Dr (and who know who will be your Dr 5 or 10 years from now) will know where to shoot to adjust your blood labs to hopefully find a symptom free area.  Most folks are not lucky to be able to get a baseline like that!

As stated above, you may already be trending lower than optimum even now. So this "baseline" may be if anything a bit low.  Don't let it get any lower.

Make absolutely positive you get a copy of the lab report. Then on it, and every subsequent lab report, write down what you are feeling at that time, what medication you are on and the dosage.  This trail of documentation is absolutely priceless.  

It will prove invaluable if you move away or have to get a new Dr.  Otherwise the new Dr may put you through a roller coaster of hell because they will only say look at TSH and try to adjust your dosage to some small range of TSH value. Which is in my opinion borders on malpractice!  yet that is what I'd say over 90% of the Dr's will do!

Just my recommendation.
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Avatar universal
Not sure if my previous comment got posted so here it goes again.
I'm in the process of educating myself in this disease, its all new to me.
I really appreciate your input. I organizing and writing down information and all blood test.
Its seems that reading can go up and down and trying to chase the correct medication is difficult.  Is the option of just having the thyroid deadened via a chip and then take mediation daily to do what a good thyroid should do  ? And again, I have no bad symtoms, what ever they are ?
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Avatar universal
Thanks for your input. Its all new to me and I'm trying to simply all these
reading and things, that could take a very very long time. I'm compiling a loose leaf book on everything. T3, T4, TPO, Hashi, symtoms etc etc

I'm mentioned on another post about just deadening the thyroid via a chip and then take medication (a pill) to do what the thyroid is supposed to do if it was completely healthy.
Does this sound practical or too drastic ?
Plus symtoms that are listed are all over the place and not consistent. Like most people could experience on and off. I have no symtoms right now, at least I think I don't. Thanks again for your comments.
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Avatar universal
Here is some info I think you will find interesting.


As for "deadening the thyroid" and then taking meds daily, I don't think that is the desired approach.  As Hashi's progresses through its expected cycle of destruction of the thyroid gland function, meds can be gradually increased as necessary to maintain Free T3 and Free T4 levels required to relieve symptoms.  Regulation of meds becomes a problem mainly when doctors only want to use TSH as the diagnostic.  That doesn't work.  Keep in mind these words from a good thyroid doctor, "the ultimate criterion for dose adjustment must always be the clinical response of the patient."  Symptom relief should be all important, not just test results.

If you want to know more about symptoms, this link lists about every hypo symptom I have ever heard about.  

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Avatar universal
Many thanks again for your input, I save/print each reply.

You mentioned "deadening the throid" is not a desired approach. Why, since it immediately ends chasing symtoms relief and contast monitoring of
T3/T4/TSH and all.

Do you have info on those individuals who chose this approach versus years  their of T3/T4 and all ?
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Avatar universal
Any chance you could send me info directly to my internet e mail address ?
Its    consultengineer  at  yahoo.com

I have to write it that way as if the address is all together I'm told it does not go thru.

I can't click on the web site you referred to via medhelp like it does on e mail.  Thanks Dave  make sure in your address its got  gimel
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Avatar universal
Is there any one with Hassi long term out there that has had their thyroid deadened via a radio active chip then taken medication that duplicates a health thyroid forever.   Any comments ?
Chasing T3, T4 free, TSH, TPO, blood test galore, monitoring symptoms and changing ones seems to me not the simplest cure. It may keep the doctors busy indefinitely but......?
Just getting others to comment, especially any one who's been thru it all.
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Avatar universal
Try copying and pasting the link into a blank address line at top of page..  Let me know if that doesn't work.
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Avatar universal
Also, you stated,  "You mentioned "deadening the throid" is not a desired approach. Why, since it immediately ends chasing symtoms relief and contast monitoring of T3/T4/TSH and all."

Thyroid patients that have had a thyroidectomy or RAI, for whatever reasons, wish that it was as easy as you made it sound.   The hardest part is just finding a good thyroid doctor, as I defined it above.  They are few and far between.  Then you need to still test and keep track of your Free T3 and Free T4 and symptoms and start with a relatively small dose of thyroid med and then gradually increase and adjust Free T3 and Free T4 as necessary to relieve symptoms.  I don't believe it is really as difficult as it sometimes seems, based on the stories of so many of our members who have not found that good thyroid doctor.  

Of course, the major difference is that with Hashi's the natural thyroid function is gradually diminishing, and has to be offset with gradually increasing doses of thyroid meds, so continued testing is a big part of the equation until the patient gets into his "sweet spot" with Free T3 and T4 adequate to relieve hypo symptoms.  Then it is a matter of responding to changes in blood levels of Free T3 and T4 and tweaking dosages.  

And don't forget all that is associated with a thyroidectomy or with RAI.  They are not simple and pain free.  So as I see it,  With Hashi's it just takes a bit longer to achieve and maintain symptom relief, rather than starting basically at very low levels and associated symptoms, after a thyroidectomy.  So I don't believe the decision is quite so cut and dried, unless the Hashi's patient has a big problem with nodules that are causing severe cycles of hypo/hyper. In those circumstances, some of our members have opted for surgery or RAI.  JMHO
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Avatar universal
Many thanks for your excellent answer. As I said before I print each.
There are my reference manual.
I really want to address those who have had the monitoring and adjusting
via blood test and medication changes. Then they did the chip in thyroid
option. What their personal feeling are.
I'm going into another web site   www.thyroidcoaching.com
Have you been on it and what do you think about it.
More question to follow in the future, thanks again.
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