# Got my lab results. Think it's Hashimoto's



## CorralesNM (Nov 6, 2011)

Can anyone help with these? (I see my endo on Tuesday, and I know she'll help, but was hoping someone here could help clarify what I think I'm seeing.)

Thyroxine (T4) Free: 1.37 ng/dL (Range .82 - 1.77)
TSH 4.280 uIU/mL (Range 0.450 - 4.500)
Hemoglobin A1c 5.9 (Range 4.8 - 5.6)
Triiodothyronine, Free, Serum 2.5 pg/mL (Range 2.0 - 4.4)
Thyroid Peroxidase (TPO) Ab 217 IU/ml (Range 0 - 34)
Antithyroglobulin Ab 49 IU/mL (Range 0-40)

Because of the high antibodies, I'm really thinking this is Hashimoto's.
Does that sound right?

Corrales (Maureen)


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## Andros (Aug 26, 2009)

CorralesNM said:


> Can anyone help with these? (I see my endo on Tuesday, and I know she'll help, but was hoping someone here could help clarify what I think I'm seeing.)
> 
> Thyroxine (T4) Free: 1.37 ng/dL (Range .82 - 1.77)
> TSH 4.280 uIU/mL (Range 0.450 - 4.500)
> ...


High TPO Ab are "suggestive" of Hashimoto's. What does the doctor have to say?

Will the doctor be ordering an ultra-sound? Thyroglobulin Ab is sort of high.

cancer TPO and thyroglobulin
http://onlinelibrary.wiley.com/doi/10.1111/j.1699-0463.1994.tb04888.x/abstract
http://www.wikigenes.org/e/gene/e/7173.html

Understanding Thyroglobulin Ab.
http://www.labtestsonline.org/understanding/analytes/thyroglobulin/test.html

Let us know when you confer w/your doctor.


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## northernlite (Oct 28, 2010)

Maureen -

I think you are right and will be diagnosed with Hashimotos. I was with a similar pattern to my numbers although my TSH was above the range at diagnosis.

If you are symptomatic, and are not on thyroid replacement, you should push for it. I would be very symptomatic where your numbers are now. The new range for TSH should have a max of 3.0 and your TSH exceeds that. My FT4 has always been "in range" even when diagnosed so that has not been a good indicator for me on whether or not I need medication.

Your FT3 is pretty low in the range and is probably the cause of your symptoms if you have them.

I would push for a trial of Levothyroxine (T4) if you are symptomatic. 25 mcg is probably a good place to start.


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## CorralesNM (Nov 6, 2011)

Hi Northernlite,
I am really symptomatic. 
If you don't mind, I need to repeat here the course of whatever it is I have. On Oct. 14 of this year, I went in for an annual physical: My symptoms were a 10-pound weight gain over a year and an inability to stay asleep through the night - I kept waking up at 1 or 2 and falling back asleep sometimes around 4. I (not the doc) attributed my weight gain to my resuming eating simple carbs (breads and such) and the inability to stay asleep to ongoing stress (I am married to a man with a form of schizophrenia and am primary caregiver), although the waking pattern was different. My vision was also blurry when working on the computer - I didn't mention this to her.
On Oct. 18, of this year, my TSH was 7.1, and my primary doc started me on 25mcg of Levothyroxine. She had not palpated my thyroid on that initial visit. I'm not finding fault with her.
On Nov 4, I had gained 7 pounds (and no I wasn't eating anything additional), I felt like I'd lost my mind: I couldn't remember anything. I couldn't read (still having trouble there). And I remembered things that didn't happen. And my emotions were completely out of control. I'd get angry then start weeping. I'd panic that I was dying and then start weeping. I called the doc and was told to go to Urgent Care but stay on the med.
I posted on this board and on another and discovered that getting the dosage right might take some time, but I'd feel better.
On Nov. 6, I was still emotionally labile, and I'd developed a tic on my right side, and I still couldn't think. I couldn't access that part of my brain that could tell me I might be having a reaction to the med. Instead, I went to a place where I decided that I had always felt like this, that I had never been happy, not if I really looked at, and there was no point in calling my therapist (who is terrific and really helpful) because I'd been in and out of therapy for 40 years, and nothing had ever helped, and nothing had ever changed.
From that, I went immediately to the drugs we have in the house because of my husband's schizophrenia, and I thought how easy it would be just to stop this. Now.
Somehow - and I like to think it was God - there was a tiny bit of my brain that said this could be a very unusual reaction to the Levothyroxine, and against my doc's advice, I stopped the drug and called an endo. Was able to get in to see her on Nov. 21. She told me I may have had a problem with the binder on the generic, and she told me she could provide samples of Synthyroid to see if I handle that, and she said she would also prescribe Armour, that she has quite a few patients on it, and they do quite well. Finally, she told me that my TSH was subclinical and if I opted not to medicate that would also be okay.
Since seeing her, my vision is more blurry, my thinking is coming back bit by bit, but nowhere near what it was before, I am still depressed (but I have alerted my therapist, and I also told the endo exactly what happened to me), and most annoying is I am freezing. My temperature varies from 95.1 to a high of 97.8 - and the 97.8 was only once. Generally, it doesn't go beyond 97, and that's only in the morning, by the afternoon my temp is down to 95.5 or so.
I have no appetite, and I have to force myself to eat, which my dogs love because once I cook, I can't finish what I'm eating, and I share my extras with them.
I will see my endo again this Tuesday, and I will most definitely go on medication. I am seriously terrified of the Levothyroxine and concerned about the Synthyroid because I find it difficult to believe I could have had such a bad reaction to simply the binder of the Levothyroxine, so I opt for Armour.
I'm sorry this post was so long; it helps me to write everything down (it's what I do for a living - write and edit).
I have a question. I have read about a thyroid storm, in which a person goes into a dangerous level of hyperthyroidism. Does anyone know if there is an equivalent for hypothyroidism? And could the Levothyroxine brought that on?
I am so terrified of having a similar reaction that I may opt to stay unmedicated until after the holidays. It was really really scary.
 Thanks to anyone who has read all the way through this. I know it's fairly long for a board post, but it really helps for me to get a handle on what's been going on with me.:hugs:
Maureen

P.S. Forgot to mention my endo did palpate my thyroid, told me it was very easy to feel, and that it felt lumpy like Hashimoto's.


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## northernlite (Oct 28, 2010)

My advice is to be careful. At TSH=7.1, 25 mcg was probably not enough medication. I started at a TSH of 8.4 and have titrated up from a beginning dose of 50 mcg.

The body has it's own mechanism for making T3. It doesn't work in a lot of people and the combo medications or T3 supplements are absolutely necessary for health. But if your conversion mechanism is working well, you may have more problems going directly to a combo medication (and you may not!).

The soundest advice I have seen on here is to work your way through the T4 titration and verify with blood work what your body is doing and how it is converting with FT3 bloodwork every 6-8 weeks. It will be apparent both physically and via lab work how your body is doing and whether or not you are someone that needs to add T3 to your mix. And unfortunately, some people do feel worse at the beginning of the titration process particularly if your dose of T4 is too low. I have no experience in adverse reactions to T4 medications but know it is a relatively safe drug for the majority of us.

I personally believe that us early Hashi patients have the best T3 conversion and the least need for a combo medication. We still have a lot of natural thyroid function still working for us, we are usually just a bit low on T4. I think the struggle is greater in those who have had their thyroid removed or chemically ablated.

I have watched a couple people on these boards in the last 6 months jump fairly fast and unsuccessfully into the combo meds. I think it is a more difficult thing to balance if your system produces it's own T3 fairly well (and maybe some of its own T4 too). Then you are really struggling to get the right balance of both medications with your body producing some and your medication providing the other. That is where my caution statements come from.

All that being said, every "body" is different, every response is different and you have to find the mix that works for you. I am one year into this game and although I think I could use a slight tweak up, overall I feel fantastic. It is a wonderful experience as your medications get you near normal. I feel better than I have in years and I have watched symptoms that my doctor said "were not thyroid related" just disappear.

Hang in there and try to be patient with whatever you and your doctor choose.


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## bigfoot (May 13, 2011)

northernlite said:


> I have watched a couple people on these boards in the last 6 months jump fairly fast and unsuccessfully into the combo meds. I think it is a more difficult thing to balance if your system produces it's own T3 fairly well (and maybe some of its own T4 too). Then you are really struggling to get the right balance of both medications with your body producing some and your medication providing the other. That is where my caution statements come from.


Awesome advice. I tried taking Cytomel T3 and even low doses (5mcg, 2.5mcg) seemed to be too much. Was waaay over-stimulating. As you pointed out, some of us still have our thyroids and they work to some extent. I have a relative who had their thyroid removed after years of Hashi's problems & goiter and the addition of Cytomel T3 has been like night/day. Really about each individual case.


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