Blood results re thyroid

[Chocolatepeanuts]

Hi there, looking for some advice...Ive been hypothyroid now for about 10 years, TSH was 14 at one point but had been well under control recently.

Recent symptoms have included occasional hand tremors and heart palpitations and I wondered if i had gone hyper. My most recent bllod results show a TSH of 0.12, the lowest it's ever been, and anti thyroid peroxidase antibodies at 83 (should be

Hi, I have Hashi's and an underactive thyroid. My antibodies are consistently in the hundreds (have been for 3 years now) no matter what I do. High numbers of antibodies mean they are attacking your thyroid tissue and destroying it. As it is destroyed it releases more hormone into the blood and can make you temporarily 'hyper' until the flare up passes, and your TSH will be lower as a result. (More active hormone means that the TSH will lower as the pituitary tells your thyroid that more hormone isn't needed and tries to down-regulate hormone production).

Whilst this destructive phase is going on (can be for years) your TSH can swing about wildly. Next week it may be a lot higher again. I'm afraid you have an autoimmune disease which will eventually result in the destruction of your thyroid's ability to produce hormone and this is an ongoing process, so that what worked dosage-wise last month or last year may not work now. What dosage are you on currently? I presume you take Levothyroxine.

Thanks so much @crunchycarrot for your informative post. I took take levo, 100 mcg or mg (iIcan never remember sorry!) I couldnt work out the antibody thing so touve helped clear that up. When i was firstly diagnosed my tsh swung about a bit but has been settled for a long time. I wonder what could have triggered this? Since posting orginally I feel totally hypo again, just wiped out.

Out of interest do you see an endocrinologist? Again i was discharged years ago when things settled down.

You're welcome! Micrograms is what it is.

Well, many things can trigger changes - menopause is one, childbirth another, or being under increased stress, perhaps some other medication taken (such as steroids or anti-depressants). Vitamin/mineral deficiences can also result in poorer utilisation of thyroid hormones.

No I don't see an endo, no point as I am 'euthyroid' now i.e. my labs show I am in the normal range. However I don't feel 'normal' and still suffer from various hypo symptoms. I've switched to taking liothyronine (the active thyroid hormone, also known as T3) as opposed to taking levothyroxine (also known as T4, the inactive hormone one's body must convert to T3 for it to be effective).

If you want more help with your situation I highly recommend Thyroid Patient Advocacy forum, they'll help get to the bottom of why things have changed for you and how you can go about helping yourself (because thyroid illness is definitely one that requires self-education, as I've found out!). Plenty of experienced people there.

Do you have your T3 and T4 levels? I don't know much about antibodies but having Hashis myself, I know that to feel well I need my T3 in the top 1/4 of the reference range and the T4 about halfway between top and bottom of normal. How do yours compare?

Yes I do (I test privately via finger prick kits so I know exactly what my levels are), but I am one of those who don't convert T4 to T3 well, and thus my T4 has always been high in the range. Unfortunately taking Levo simply pushed it higher and didn't benefit me. My T3 was in the lower part of the range, however, which shows poor conversion.

Now that I take liothyronine, my T4 is almost non-existent (because I don't take a T4 containing med like Levo, and my thyroid tissue is clearly nearly completely destroyed by antibodies). That doesn't matter as long as one has enough T3. I'm still tweaking that to get it right, but if you're taking T3 only lab tests are meaningless and you need to go by how you feel, symptom relief, and monitoring temperature, pulse rate and BP.

You're legally entitled to a print out of your lab results, ask at reception. It's good to be as informed as possible as to what's going on with your health.