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  • Start of Hashi or already atrophic?

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    Old 11-21-2013, 05:17 AM   #1
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    Question Start of Hashi or already atrophic?

    I'm left puzzled by the conclusion of my endo "We don't comment on what we can't treat" and by the lack of guidance I received.

    In 2011 an Immunologist found TPOab when testing diverse options re my Urticaria/Angioedema at the time. It was labelled idiopathic, I think it might have been a stress reaction based on my mum going through breast cancer.

    The amount was not high, he recommended regular monitoring.
    TPOab 372 / TSH 1.76 / fT4 14.8

    The part which I find hard to follow is the lab description of HIGH levels and LOWER levels without being able to find a definition where HIGH starts. E.g. 372 is about 10x over the reference range (0-35) and I know there are TPOab in the 5 digit areas, but a definition would be helpful.

    I was kind of exited about this clue, as I always thought that I have a rather sluggish metabolism/potential underperforming thyroid: weight gain, feeling cold, low blood pressure.

    Recently, I developped really bad muscle pain/weakness, was hardly able to walk up 2 floors or lift a leg to enter a bus. Feeling tired, unmotivated, no libido at all, losing appetite, irregular period, feeling depressed, gained between 25-35kg over 10 years). When I found that muscle weakness could be a sign of Hashi, I thought it's time to retest; now in 2013 my values are TPOab 771.8 (doubled over 2 years) / TSH 2.92 (increased by 1.2) / fT4 16.9 / fT3 4.4

    GP thought this is ok and offered B12 injections for my energy levels. I graciously declined as I didn't see the point without testing for B12 deficiency and rather took the Endo referral.

    Endo thought my values are fine, commenting that any of my symptoms could have another cause. Only when I mentioned my father had something with his thyroid she agreed to an Ultrasound (my father had an overactive thyroid removed after a nodule was discovered, unfortunatly he doesn't have more details).

    My scan result is great: normal homogenous echo texture, normal vascularity, two tiny cysts, isthmus normal but ... the combined volume is only 4.2 ml which is the size of a 9 year old (I'm 47 years at 96kg) , but the endo found this as well totally normal - they come at all shapes and sizes...

    I asked as well, if there could be any other metabolic reason for my muscle weakness which had been meanwhile successfully cured by a naturopath by substantially increasing my magnesium intake. No answer just discontent re naturopaths. I need to take since my teens magnesium otherwise I get calf cramps. But I never thought a minute that suddenly my magnesium must have vanished.

    My question is basically - where do these values leave me...

    Is this already thyroid atrophy? I don't have any earlier TPO/fT3/4 values but a TSH dip in 2009 to 0.81 where my Eosinophils were as well above ref range at 0.9 (not sure if related) all my other blood counts are continuosly fine and I'm not glucose intolerant. I have hay fever since about puberty, so not sure if I'm 'collecting' autoimmune disorders.

    If not, did my thyroid just stop to grow at one stage which might explain my weight battle since my teens.

    But if my TSH and TPOab futher climbs towards a Hashi attack - where does that leave me with only a 4.2 mL gland - could this be killed off in one go? My GP and endo seem not concerned, but I'm a) not happy with my current situation and would just like to understand all this better and know what my options are, especially given that some sources think that it's valid to take action at a TSH of close to 3. I measured as well my axilliary basas temperature and it was so far 9 out of 11 days under 36.3C/97.34F.

    Thanks for any hints and guidance, love to learn from your experiences.

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    Old 11-21-2013, 10:49 PM   #2
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    Re: Start of Hashi or already atrophic?

    You need to post the reference ranges for free T4/3. Your values have to be compared to the range, and ranges vary from lab to lab.

    That said, you have antibodies, TSH above 2, and plenty of symptoms. There should be no question of starting treatment. Endos are the most likely to deny it, as you discovered. Look for a more cooperative doctor, preferably not and endo.
    "We can complain because rose bushes have thorns, or rejoice because thorn bushes have roses." Abraham Lincoln

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    Old 11-22-2013, 01:39 AM   #3
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    Re: Start of Hashi or already atrophic?

    Apolgies, here are the missing reference ranges:

    TSH 2006 1.58 mU/L (0.3-4.0)
    TSH 2009 0.81 mU/L (0.4-3.5)
    TSH 2011 1.76 mU/L (0.4-3.5)
    TSH 2013 2.92 mU/L (0.4-3.8) remark Euthyroid

    fT4 2011 14.8 pmol/L (9.0-19.0)
    fT4 2013 16.9 pmol/L (10.0-22.0)

    fT3 2013 4.4 pmol/L (2.5-6.5)

    TPOab 2011 372 IU/mL (0-35)
    TPOab 2013 771.8 IU/mL (<5)

    TGab 2011 <20 IU/mL (0-40)
    TGab 2013 2.1 IU/mL (<4.5)

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    atrophy, hashimoto's, tsh level

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