# Question of Thyroid peroxidase vs. Thyroglobulin AB



## lsmorris (Sep 26, 2016)

I recently had lab work done with a new physician. Back in 2009 I was diagnosed with Hashimotos through a thyroid ultrasound and elevated TSH levels. Anyway I checked my recent labs online and am curious.....Is it normal to have elevated Thyroid peroxidase results and normal Thyroglobulin AB results? Here is the break down of my recent lab results.

Thyroid Peroxidase 560 (range 0 - 34)

Thyroglobulin AB <20 (range 0 - 40)

TSH 3.34 (range .46 - 4.68)

T3 Free 2.98 (range 2.77 - 5.27)

T4 Free 1.29 (range .65 - 1.86)

In May my previous physician ran just a TSH which was 2.32 (.46 - 4.68) and T4 free 1.00 (.65-1.86)

Overall I have just been feeling really low energy and getting migraines like crazy. I Am currently taking 150 mcg of levothyroxine daily.

I did also have my vitamin D tested 34.3 (30-100 range) B 12 was 587 (239-931 range) I also had a CMP which all came back within normal limits and Magnesium was 1.8 (1.6-2.3 range)


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## Lovlkn (Dec 20, 2009)

> Thyroid Peroxidase 560 (range 0 - 34)
> 
> Thyroglobulin AB <20 (range 0 - 40)
> 
> ...


Yes - not having thyroglobulin is a good thing. The TPO suggests an autoimmune disorder. Likely hashimoto's in your case with your current lab's

Your labs look quite hypo. Are you currently taking thyroid hormone replacement?


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## lsmorris (Sep 26, 2016)

I am taking 150 mcg of levothyroxine. The last doctor would not do anything with the dose because my TSH is in normal range. I am hoping the new doctor will be more open to other treatments other than just the levothyroxine.


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## joplin1975 (Jul 21, 2011)

Although it's not 100% accurate, TPO is most closely related with Hashi's while Tg is more closely related to thyroid cancer.

Has your doctor ever talked about adding cytomel?


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## lsmorris (Sep 26, 2016)

My previous Doctor was unwilling to prescribe anything other than the levothyroxine. I am hoping the new doctor will consider cytomel or switching to Armour or Natur throid.... Does adding T3 lower antibodies? I have never had them tested and know little about how to manage them. When I was diagnosed with Hashimotos all the did was TSH and a thyroid ultrasound.


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## lsmorris (Sep 26, 2016)

I just got the reverse t3 results back.. They are high at 26.3 (9.2-24.1). So I would really benefit from something like cytomel or NDT product right? Should I have my cortisol tested?


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## jenny v (May 6, 2012)

Dropping your Synthroid dose and adding in Cytomel would be a good step. Then you can monitor if your rT3 drops and if it doesn't, sometimes straight Cytomel only helps. Is your doctor open to adding T3?


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## lsmorris (Sep 26, 2016)

I hope so... I see her on Wednesday. She is a new Dr. in town that does traditional and integrative medicine. I am hopeful. She actually ordered more blood work than any other Doctor has been willing to do.


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## lsmorris (Sep 26, 2016)

Well, I went to see the new doctor today. I am not sure what to think yet. She did agree that my thyroid labs are hypo.... But she wants to increase my levothyroxine to 175 Mcg and have me take selenium to lower my antibodies. She said if my labs aren't better after six weeks she would switch me to WP thyroid. I guess it's a start. She didn't just blow me off, but not exactly what I was hoping for. She also would like me to start taking butterbur for my headaches. At this point I feel so miserable I am willing to try anything :-/


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## Lovlkn (Dec 20, 2009)

How much selenium is she suggesting you take?

I tried adding 200mg daily and saw a slight improvement in FT- 3 levels. That's what she's trying first. Not sure how that works when you have such a high RT-3

Have you ever had your Ferritin tested ? A good idea when considering adding T3 to the mix.


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## lsmorris (Sep 26, 2016)

She said 200 MG a day. It's been years since I have had my ferritin tested, so I will check to see if she will add it to my next labs. Also, I am on propranolol for headaches... I was reading that this medicine can raise reverse t3 levels. I am thinking about just quitting this medicine, since its not really necessary.


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## lsmorris (Sep 26, 2016)

How long should it take to see a difference from an increase in levothyroxine? I went from 150 to 175 a little over a week ago. I am also taking the 200mcg of selenium daily. I am actually feeling worse. All of my joints are aching, headaches, MORE weight gain. I am really frustrated, and am not sure what to do from here. I have read it takes like 6 weeks for things to stabilize, but shouldn't I be starting to feel a difference before then? Or at least not feel worse?


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## jenny v (May 6, 2012)

Some people feel a difference pretty quickly (usually on NDT, though, not levo), but most of us take a while to feel better. I usually notice a difference about a month after a dose change. It stinks that it takes so long but you have to be patient and not increase too quickly or you could go hyper and have to start all over again. It's also not uncommon to feel worse before you feel better. Hang in there!


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## lsmorris (Sep 26, 2016)

Thank you! Just tired of feeling so yucky all the time.


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## creepingdeath (Apr 6, 2014)

If you don't feel better in a few weeks I doubt T4 only is the hormone for you.

There should be no feeling worse.

That reverse T3 test says it all.

At least in a month or so you have a chance to try something different.

Something most are still fighting to have a chance at.

I was the same as you but with debilitating symptoms which got worse with any increase and no change with the half dozen T4 only brands I tried over a two year period.

My antibody results are always higher than the range can go with both tests regardless of what type hormone I take. Above 1000 for TPO and above 900 for AB.

5 ultrasounds in the last 5 years shows I have no nodules or cancer.

Desiccated thyroid and my present PCP saved my Life.

GOOD LUCK

And let us know how your felling from time to time.


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## Lovlkn (Dec 20, 2009)

How do you take your levothyroxine? At least 1 hour from food and with a full 8 oz of water?

What other medications or supplements do you take? Do you eat alot of any one food or soy?



> TSH 3.34 (range .46 - 4.68)
> 
> T3 Free 2.98 (range 2.77 - 5.27)*((4.02-4.64))*
> 
> T4 Free 1.29 (range .65 - 1.86) *((1.255-1.55))*


When was your levothyroxine taken in relation to these lab?

I've edited (( )) in bold to show you where 1/2-3/4 of range is. You are clearly hypo and your doctor is correct to increase your thyroid hormone. Give this a try for 6 weeks and retest. If stopping the propranolol and adding the selenium do not raise your FT-3 in line with your FT-4 then ask again for some Cytomel.

How much Propranolol do you take daily?


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## lsmorris (Sep 26, 2016)

Thank you everyone. I am hoping in a month I either there will be improvement, or the doctor will be willing to make a change. I was taking 40mg of propranolol twice daily. I did stop it when my thyroid dose was increased. I take my levothyroxine right after I get up (around 6 am) with a full glass of water. I don't have an appetite when I first wake up, so I usually eat around 9:15am (first break at work).

I have been under some extra stress at work so I know that is having an impact on everything as well. I will definitely keep you posted. It is nice to be able to talk to people that understand how thyroid issues affect every part of your body...


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## lsmorris (Sep 26, 2016)

So I went back and had my labs drawn. Now I am hyperthyroid!

Tsh .09 range (.45-4.68)
Free T4 1.95 range (.65-1.86)

I am starting to have some hyperthyroid thyroid issues (heart racing and short of breath going up stairs). But still have joint pain and fatigue. I'm waiting for the free t3 and reverse t3 tests to be completed. The machine they need to test it is down.

Anyway, since I knew there was going to need to be a change in medication, I asked if O could be switched to the wp thyroid like we had discussed at the last appointment. She prescribed it to me, however the dose seems really high. She prescribed 130 mg once a day. Does this seem like normal dosing? I am taking 175mcg of levothyroxone right now. The pharmacist made a comment about the dose being high. I just wanted to get your thoughts about this. Thank you!


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## Lovlkn (Dec 20, 2009)

If you are currently testing hyper you should be reducing your levothyroxine and try to stabilize before switching Meds.


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## creepingdeath (Apr 6, 2014)

Seems like a large dose of WP thyroid to switch to.

But then again I never tried WP thyroid.

When I switched to desiccated thyroid I stopped the synthetic and started out on the lowest dose of Armour thyroid.
Slowly increasing every month as suggested on the hormone's instruction sheet till symptoms subsided and free T3 & free T4 were within 3/4 of the range on lab tests.

I can tell you that it was the difference between night and day for me.

I became warm again within just a few weeks.

Synthetic did absolutely nothing but make me suicidal.


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## lsmorris (Sep 26, 2016)

So far I have been feeling ok with the new dose. Maybe even a little better, but it’s only been 3 days. Got the freer t3 results back. They improved to 3.92 (2.77-5.20). But still low in the range right? Waiting for reverse t3 to come back.


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## joplin1975 (Jul 21, 2011)

Yes, definitely better, but you should have it a bit higher.


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## Lovlkn (Dec 20, 2009)

Awhile back you mentioned taking propranolol for headaches. Propranolol is often used to lower FT-3, not raise as you suggested in a post.

Hopefully by stopping the Propranolol and going back to your original levlthyroxine dose you will stabilize.


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## lsmorris (Sep 26, 2016)

My reverse t3 results came back as 34.5. (9.2-24.1). I did stop taking the propanolol over six weeks ago. I did talk to my doctor abou the high WP thyroid dose and because I was sweating a lot and had an elevated heart rate, she told me to take half of the 130mg dose for a couple of weeks and then go back to the full dose and see how it goes. I don’t know if it is just because I am just hopeful, but I think I am feeling more energy than I have in a long time.


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