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Old 01-10-2013, 09:18 PM   #1
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What medication would you ask for high Anti TPO/TSH?

Hello,

I just received my blood test results: (38 yr old male)

T4 Free pmol/L (Referance Value = 8.0-18.0) = 11.7
TSH mIU/L (Referance Value = 0.40-4.40) = 4.49
Anti-TPO IU/mL (Referance Value = 0.00-9.00) = 69.00 H

Should I be concerned and should I go see an Endocrinologist?

Thank you!

PS> I also have had for at least 10 years now, mood disorders, some depression, and lately very irritable.

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Old 01-10-2013, 09:41 PM   #2
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Re: What medication would you ask for high Anti TPO/TSH?

With your TSH slightly high and positive antibodies, this is only going to get worse with time. I think your depression and moodiness/irritability are likely related, and you need to start thyroid replacement. An endocrinologist or a good GP who understands thyroid disease could treat you. The TPO antibodies are an indication of autoimmune thyroid disease (Hashimoto's). Once your medication dose is optimal, you should feel better. This usually takes a few weeks to accomplish and requires follow-up labs to get the dose just right.

 
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Old 01-12-2013, 02:03 PM   #3
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Re: What medication would you ask for high Anti TPO/TSH?

Quote:
Originally Posted by thyroiddepressn View Post
Hello,

I just received my blood test results: (38 yr old male)

T4 Free pmol/L (Referance Value = 8.0-18.0) = 11.7
TSH mIU/L (Referance Value = 0.40-4.40) = 4.49
Anti-TPO IU/mL (Referance Value = 0.00-9.00) = 69.00 H

Should I be concerned and should I go see an Endocrinologist?

Thank you!

PS> I also have had for at least 10 years now, mood disorders, some depression, and lately very irritable.
You need to go to a thyroid savvy md. An endo is not always necessary. Many of us are treated by knowledgable FPs and IMs. I saw five endos and fired all of them. I get treated by an internal medicine md.

You are hypothyroid and the source is the autoimmune thyroid disease. Hashimoto's. The treatment is thyroid hormone supplementation. You need it now in my opinion. They started me on 50 mcgs of a t4 only medication and then titrated me up every 4 weeks post blood work until we got things right.

There are three main types of thyroid medication:
T4 only like Synthroid.
T4/t3 combos line Armour thyroid
T3 only like cytomel.

What you need will depend on you personal body chemistry. You will need to work with an md that takes into account symptoms in addition to blood work. You need to find your optimal levels. This will be somewhere in the 60-80% of normal range where your symptoms go away.

My family and I found that a daily symptom log was essential in treating our thyroid issues optimally. Welcome to that autoimmune thyroiditis family by the way. It is genetically dominant so given that you have it, I can almost guarantee you are not alone. Ask around in your family, mom, sisters, aunts, grandmothers... Why? Women are 80% more likely to get it.

I have it, my mom and her four sisters have a thyroid autoimmune disease. And my mom's mom had it. My great grandmothers had signs including a grapefruit sized goiter... But no official diagnosis back in the day.

Hope this helps.

MG
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Old 01-14-2013, 03:40 PM   #4
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Re: What medication would you ask for high Anti TPO/TSH?

Hi there,yeah my mom does take synthroid, for years now. I have an appointment Feb 1 with an endo, hope he listens, these old school doctors can be real stubborn.

 
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Old 02-01-2013, 04:06 PM   #5
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Re: What medication would you ask for high Anti TPO/TSH?

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Originally Posted by ladybud View Post
With your TSH slightly high and positive antibodies, this is only going to get worse with time. I think your depression and moodiness/irritability are likely related, and you need to start thyroid replacement. An endocrinologist or a good GP who understands thyroid disease could treat you. The TPO antibodies are an indication of autoimmune thyroid disease (Hashimoto's). Once your medication dose is optimal, you should feel better. This usually takes a few weeks to accomplish and requires follow-up labs to get the dose just right.
Hi there,

So I saw my endo today, and he noticed a very very small bump or lump in my throat, cant remember what he called it. He was a very arrogant doctor but looked and sounded knowledgeable. I had printed all your answer from this board as well as underligned the important stuff along with my symptoms but really did not even bother looking at anything. My Family Doctor had already written on the paper that was given to him that I was suffering from chronic mild depression, chronic anxiety and very irritable, loss of energy, etc.

He said I did have Hasimoto's but explained to me that just means that I am more prone to getting low thyroid. He also said that since my symptoms range from both sides (Meaning that some symptoms are present to people with Hypothyroidism and others with Hyperthyroidism) he concluded that many of my anxiety issues (Which I've had for over 15 years) are to do with emotional issues and not with low thyroid.

I mentioned to him about me doing a T3 Free Test and he just brushed it off. He said I am borderline low thyroid. He also made his receptionist make me an appointment for a throat scan, forgot the right word... to see what that lump is/? and he said if it's something serious than he would put me on medication to fight that and for nothing else.

1) Do I go get another opinion from a more professional place, somewhere where they can actually sit down and look at the stuff you bring them and talk to you about it? I did not even have time to ask him about the .03 to 3 decrease range for low thyroidsm...

2) Should I go see a Psychotherapist since I have all these symptoms (Low Depression, mood swings, very irritable, forgetfulness, low energy, lack of sleep (Sleeping only 5-6 hrs a night), Anxiety due to bills, etc, No energy to do anything but stay at home and read, surf the net, tv...

 
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Old 02-01-2013, 04:09 PM   #6
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Re: What medication would you ask for high Anti TPO/TSH?

Quote:
Originally Posted by mkgbrook View Post
You need to go to a thyroid savvy md. An endo is not always necessary. Many of us are treated by knowledgable FPs and IMs. I saw five endos and fired all of them. I get treated by an internal medicine md.

You are hypothyroid and the source is the autoimmune thyroid disease. Hashimoto's. The treatment is thyroid hormone supplementation. You need it now in my opinion. They started me on 50 mcgs of a t4 only medication and then titrated me up every 4 weeks post blood work until we got things right.

There are three main types of thyroid medication:
T4 only like Synthroid.
T4/t3 combos line Armour thyroid
T3 only like cytomel.

What you need will depend on you personal body chemistry. You will need to work with an md that takes into account symptoms in addition to blood work. You need to find your optimal levels. This will be somewhere in the 60-80% of normal range where your symptoms go away.

My family and I found that a daily symptom log was essential in treating our thyroid issues optimally. Welcome to that autoimmune thyroiditis family by the way. It is genetically dominant so given that you have it, I can almost guarantee you are not alone. Ask around in your family, mom, sisters, aunts, grandmothers... Why? Women are 80% more likely to get it.

I have it, my mom and her four sisters have a thyroid autoimmune disease. And my mom's mom had it. My great grandmothers had signs including a grapefruit sized goiter... But no official diagnosis back in the day.

Hope this helps.

MG
Hi there!

So I saw my endo today, and he noticed a very very small bump or lump in my throat, cant remember what he called it. He was a very arrogant doctor but looked and sounded knowledgeable. I had printed all your answer from this board as well as underligned the important stuff along with my symptoms but really did not even bother looking at anything. My Family Doctor had already written on the paper that was given to him that I was suffering from chronic mild depression, chronic anxiety and very irritable, loss of energy, etc.

He said I did have Hasimoto's but explained to me that just means that I am more prone to getting low thyroid. He also said that since my symptoms range from both sides (Meaning that some symptoms are present to people with Hypothyroidism and others with Hyperthyroidism) he concluded that many of my anxiety issues (Which I've had for over 15 years) are to do with emotional issues and not with low thyroid.

I mentioned to him about me doing a T3 Free Test and he just brushed it off. He said I am borderline low thyroid. He also made his receptionist make me an appointment for a throat scan, forgot the right word... to see what that lump is/? and he said if it's something serious than he would put me on medication to fight that and for nothing else.

1) Do I go get another opinion from a more professional place, somewhere where they can actually sit down and look at the stuff you bring them and talk to you about it? I did not even have time to ask him about the .03 to 3 decrease range for low thyroidsm...

2) Should I go see a Psychotherapist since I have all these symptoms (Low Depression, mood swings, very irritable, forgetfulness, low energy, lack of sleep (Sleeping only 5-6 hrs a night), Anxiety due to bills, etc, No energy to do anything but stay at home and read, surf the net, tv...

 
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Old 02-02-2013, 07:10 AM   #7
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Re: What medication would you ask for high Anti TPO/TSH?

Thyroiddepressn;

So I saw my endo today, and he noticed a very very small bump or lump in my throat, cant remember what he called it.

Thyroid lumps very common in hashi's sufferers are known as nodules. I have two of them now, but more can grow at any time. When the whole thyroid grows and enlarges it is known as a goiter.

He was a very arrogant doctor but looked and sounded knowledgeable. I had printed all your answer from this board as well as underligned the important stuff along with my symptoms but really did not even bother looking at anything. My Family Doctor had already written on the paper that was given to him that I was suffering from chronic mild depression, chronic anxiety and very irritable, loss of energy, etc.

He said I did have Hasimoto's but explained to me that just means that I am more prone to getting low thyroid. He also said that since my symptoms range from both sides (Meaning that some symptoms are present to people with Hypothyroidism and others with Hyperthyroidism) he concluded that many of my anxiety issues (Which I've had for over 15 years) are to do with emotional issues and not with low thyroid.

Ugh! This is a very typical uniformed non-thyroid savvy endocrinologist response. It is possible the the emotional issues have another source, but the thyroid mess can and in my opinion most likely is making it all worse!

I mentioned to him about me doing a T3 Free Test and he just brushed it off. He said I am borderline low thyroid.

The statement about T3 shows his ignorance in thyroid issues. I would not settle on him as your long term thyroid consultant and partner.

He also made his receptionist make me an appointment for a throat scan, forgot the right word... to see what that lump is/?

Thyroid ultrasound most likely. If there are specific nodules of 1cm or greater in size a fine needle aspiration ultrasound guided biopsy will/should be recommended and performed. This was a good call, but any md can order one. My endos didn't it took a thyroid savvy internal medicine md for me.

It wouldn't hurt to shop around for a more thyroid savvy md to replace this one. But stick with him until you find that replacement and get copies of EVERYTHING!

As to seeing a psychologist some can be helpful by saying it is not in your head but physiological instead. They also can be helpful with stress management techniques and other things. It is nice to have someOne to listen to you.

I used this board for it. I knew my thyroiD was the issue. I just had to get someone to listen to me and treat me. As to me, I make the MDs listen to me, but I can be a bit stubborn and dominant. Speak up and say excuse me I have a family history and other issues to discuss. Please give me a minute. If they do not listen, follow it up with Your Fired. That and the following expression is great stress relief....


MG
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Last edited by mkgbrook; 02-02-2013 at 07:12 AM. Reason: Grammar fix

 
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Old 02-02-2013, 10:16 AM   #8
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Re: What medication would you ask for high Anti TPO/TSH?

Right! I will see what happens with the ultra sound and what he says, and at the same time I am looking for some very well rated endos in my area! He's definitely getting fired soon.

 
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Old 02-02-2013, 01:47 PM   #9
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Re: What medication would you ask for high Anti TPO/TSH?

Yes, MG is right...first of all you have a tsh of 4 something,you have antibodies, you have symptoms, a nodule AND a family history.This is what you could say to him and see what he says.Then say this to the next doc!

 
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Old 02-02-2013, 03:06 PM   #10
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Re: What medication would you ask for high Anti TPO/TSH?

I went through five endos and never found one that I would feel comfortably to treat me knowledgably. I did find a great internal medicine md that is part of an integrative medicine practice. She and her partners are all up on the latest American association of endocrinology standards, ignore the lab ranges, and listen to your symptoms too! Wow! What a concept. Do not be disappointed if you can not find and endo to treat you with consideration and the care you deserve. Most are diabetes specialist. When I need one of those I will dig up an endo. That is just my personal opinion after having to fight five years of symptoms prior to treatment.

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Old 02-03-2013, 08:50 AM   #11
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Re: What medication would you ask for high Anti TPO/TSH?

In my opinion, your current symptoms may all or mostly be related to the thyroid problem. I would treat the physical, hormonal problem with thyroid replacement now, wait until you get to optimal dose levels, and see what if any of the mood problems persist. I agree the anxiety is a bit unusual, but I think depression/anxiety are two sides of the same coin and coexist in many people. If you feel you need a therapist to help you cope with life situations, by all means, do that.
The thyroid nodule needs followup, but is extremely common in Hashimotos. A GP can order a thryoid scan, but if a biopsy of the nodule is required, you will most likely need an endo.
I totally disagree with the decision not to treat your low thyroid now. Why keep you miserable and wait for it to get worse? That could take another year of your precious time. I would seek a second opinion, and a third and fourth if needed, until you find a Dr that will treat you. I also would ditto everything MKGbrook posted.
I would expect with treatment that when your TSH gets under 1.5 you will feel much better, be productive and have a better outlook on life! Could be accomplished in 2-4 months, depending on your response and how high a dose you might need. Some people begin feeling better within a few days of starting thyroid, but it takes a few weeks to get to optimal.

Last edited by ladybud; 02-03-2013 at 08:55 AM. Reason: aqdded last sentence

 
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Old 02-03-2013, 09:26 AM   #12
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Re: What medication would you ask for high Anti TPO/TSH?

Just a quick note. I wouldn't necessarily look for an endocrinologist. An "integrative doctor" may be more helpful. Go to a compounding pharmacy in your area, and ask the druggist for the names of any doctors who prescribe T4 and slow release T3 or ERFA Thyroid. These will be the docs who will be more knowledgeable on thyroid stuff. Ask the druggist who he would go to.

 
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Old 02-04-2013, 06:26 AM   #13
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Re: What medication would you ask for high Anti TPO/TSH?

Thanks guys, I agree with all of you. First of all, my brother is sending me to his private doctor that's in a new style type of clinic where you go and spend a whole day and they run every single test on you, you pay a bit but it's very worth it, not like these old school doctors who are stuck on stupid and arrogance.

But after I get my ultra sound tests do you suggest I take them to him, unless he gets them mailed to him automatically, or would you try and take them to the new doctor, how should I make the switch easier?

 
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Old 02-04-2013, 09:50 AM   #14
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Re: What medication would you ask for high Anti TPO/TSH?

yes, I would take the results to a new doctor, for sure, as long as you have them in your possession. Also any tests the other guy ran. I would think the other doc wouldn't even have to know but he doesn't sound like he knows what he's doing anyway!

 
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Old 02-04-2013, 01:05 PM   #15
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Re: What medication would you ask for high Anti TPO/TSH?

Hi thyroiddepressn,

Another great physician resource is a Naturopath MD.

I hardly ever post anymore due to so many that can put things in words better than me. But I was reading and saw your thread and wanted to add my support to you. (The "Story" thread at the top of the board describes my thyroid journey so I won't restate it here.)

Absolutely, too low OR too high thyroid levels can cause anxiety, depression and any other emotional imbalance. Thyroid is a hormone and when the hormones are out of balance...you know the story.

To your new doctor, yes, take your latest test results. It may save duplicate testing and expense.

And take the name, address, FAX & phone number of each place or doc that did testing, and at your new doc's office just request the form to fill out so the new doctor can request your records. Then you have no reason to go back to the other doc at all.

If you want, and I would, you can leave any further testing be ordered by the new doctor if it is deemed necessary, and cancel any tests or appt. with the old doc. You don't owe anything at all to a doctor that is dismissive and won't listen to you.

Then after each appt. request copies of at least your test results and doctor notes for your own records.

Once your thyroid is in balance any anxiety or other emotion that was from the imbalance should settle down. I leave my emotions off my symptom list when tlaking to docs because they can't fix that. (That's just me).

A counselor can help us learn new coping skills and self-calming methods, and there are a slew of self-help books, exercise, etc. to help us if we need. If we need a psychotherapist they are also available. It's impossible to distinguish what is anxiety over having a health problem undiagnosed or from the hormone imbalance. The emotions present the same way: anxiety and depression.

I still have to have my TSH suppressed under 1.0 or I have all of the hypothyroid symptoms. But a good doc can help you find your own optimal level. I look forward to reading the results of seeing your new doctor.
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