Treating Hashimoto's?

[diva832987]

I was just told that I had a high titer of anti-TPO antibodies as result of some blood tests to find out why I am so tired and have edema.  All cardiac test OK.  My TSH, T3, T4 were all "normal" or smack in the middle of the range, however I am exhausted and have put on weight.  I asked my physician if she would treat me with LT4 and she said not at this time.  Is it reasonable to think that LT4 could help me?

[Red_Star]

I've had elevated liver enzymes for years and still do due to my naughty thyroid gland. :) My ratio isn't that out of whack though.

[goolarra]

T3 is the only form of the thyroid hormones that cells can use for metabolism.  So, even if your thyroid is working just fine (adequate T4 is being produced, and yours looks pretty good), you can be hypothyroid at the cellular level if your T3 levels aren't adequate.  It's way, way down in the range, so it's likely that you are hypo at the cellular level.  

Once we have one autoimmune disease, we're more likely to get a second (does the fun never end?), so it could be that the thyroid and the liver are working together.  

Good luck with your liver scan, etc. and update us, please,  on how you make out..  

[diva832987]

Thanks so much for this information!
Yes, the AST/ALT ratio (0.3) indicates some form of low grade hepatic inflammation possibly viral or autoimmune and not indicative of cirrhosis or liver cancer.

I have had elevated LFT on and off throughout my life - Im now 50.  The reason I had the blood tests is because I thought I might be hypothyroid - exhausted, hair loss, nails breaking, weight gain, etc.  Was surprised to find out about the anti-TPO.  I'm finding as I read that anti_TPO may also be increased in other autoimmune diseases such as autoimmune hepatitis.    I'm scheduled for a liver scan and some other tests in early August.  

It's difficult to determine what came first:   the hyroid or the liver.  
Again, thanks for taking the time.....  :)

[goolarra]

Your FT4 is a little low in the range.  It's at 40%, and the rule of thumb for FT4 is around midrange.  However, your total T3 is very low in the range.  TT3 is considered an obsolete test.  FREE T3 is much better since it tells the amount of T3 avaialable to your cells.  Of the total amount measured in TT3, much is chemically bound and unavailable to cells.

It's FT3 that correlates best with symptoms.  Do you have hypo symptoms?

Many other autoimmune diseases can cause elevated TPOab, usually only marginally elevated.  If you'd like confirmation, you can ask for a thyroglobulin antibody (TGab) test to see if those are elevated as well.  Some of us with Hashi's are TPOab positive, some TGab positive and some both.  Also, a thyroid ultrasound will help confirm if nodules are present.

T4 is the "storage" form of the thyroid hormones.  It's made in the thyroid and basically floats around in your bloodstream until it's needed.  However, cells cannot use T4 until it is converted to T3.  Most of that conversion happens in the liver.  I notice that both liver enzymes (AST and ALT) are elevated, which can indicate liver dysfunction.  I'm wondering if your very low TT3 could have anything to do with the high liver enzymes???  That might be a question to raise with your doctor.

[diva832987]

other autoimmune diseases that can cause a raise of the TPO?

[diva832987]

TSH  1.19 (0.40 - 4.50)
FT4   1.2  (0.8 - 1.8)
Total T3 87 (76-181)
anti TPO   311    (<35)

Alk Phs              136    (33-130)
AST                    71      (10-35)
ALT                   298     (6-40)

Hemo A1C     ND

[diva832987]

Ill get results and post.  Very much appreciate the feedback.

[Barb135]

Just being in a range is not good enough.  Levels have to be best for YOU.

As goolarra pointed out, we'd need to see your actual lab results in order to be helpful.

There is no way to "prevent" Hashimoto's; sounds like you might already have it.

Please post labs, with reference ranges.

[Red_Star]

"There is also the difficulty of interpreting a serum of concentration of TSH in isolation. A concentration at or near the upper limit of the reference range, particularly if associated with a normal T4, may indicate autoimmune thyroid disease. A consensus exists for early treatment of such patients with thyroxine if anti thyroid peroxidase antibodies are present in the serum, because the risk of overt thyroid failure in future years is high, and it makes sense to anticipate morbidity rather than risk loss of follow up."

Drs Anthony D Toft and Geoffrey J Beckett, "Thyroid function tests and hypothyroidism", British Medical Journal, 8 February 2003, 326:296-7.

[hashigirl1972]

I have read about subclinical hypothyroid meaning that you can have symptoms of hypothyroid before it actually affects your lab results.. In modern medicine they won't treat you until your actual "lab results" indicate hypothyroid even though your antibodies can be attacking your thyroid much sooner.. There is some controversy in this in mondern medicine but it makes since to me that if you have antibodies attacking your thyroid that you could experience symptoms before they show up on lab results..

I've heard of different things you can do as "preventative" measures to keep from getting "worse" but these methods are not substantiated by scientific evidence.. it really is individually based.. You could research subclinical hypothyroid and experiment with different protocols to see if they alleviate your symptoms OR you could wait and see if the antibodies end up causing a lab result of "hypothyroid" to indicate medical treatment..

I hope you feel better..

[goolarra]

Please post your actual thyroid test results including reference ranges which vary lab to lab and have to come form your own lab report.

Elevated TPOab (do you have those results as well?) indicates Hashimoto's thyroiditis, autoimmune thyroid disease.