what can I do about my high anti-thyroid antibodies

[houguy]

Hi Chris,

I'm a friend of Nelson's. He recommended that I get your input as you have a lot of thyroid expertise.

For about the last year I've been more tired and not my usual happy self. I recently had my annual full physical with labs. Labs showed my TSH to be at 4.06. It was recommended that I look further into thyroid tests. I then had some follow-up lab work which showed the following (I've attached my complete labs):

T4 free 1.09
reverse T3 serum 19.3
ferritin, serum 23 *
antithyroglobulin antibody 921.5 *
thyroid peroxidase antibody 268 *
triiodothyronine, free,serum 2.6

I had a GI bleed about 2 months ago. That may have impact on the ferritin? The thyroid related labs are a big surprise. I googled and I'm wondering about Hashimoto's thyroiditis. I look at other symptoms - I do have some areas of dry skin, and have been adding some fat in spite of a pretty good diet - but I've always been cold intolerant and had low heart rate (going back many years). I am going to get back with my MD but I would appreciate any feedback and recommendations as I would like to have an intelligent discussion with him about this.

 

[Vettester Chris]

Houguy, glad you joined! Thanks for posting. At a glance, I can tell your antibodies are elevated, but you could you please post the reference ranges on all of your labs, plus units of measurements? You are correct with Hashi's being the possible culprit. With doing your research you've discovered it's an autoimmune condition that attacks various enzymes and/or proteins in the thyroid, which in turn leads to overt hypothyroidism.

The good news is it can be treated in similar fashion as anyone without elevated antibodies. The treatment protocol would really need to be administered by a physician that will know how to titrate dosages correctly, and check it against labs, which will be an ongoing affair. Other labs that need to be factored: Iron serum, TIBC, ferritin, & a 4x cortisol saliva. Your Reverse T3 will be a little more helpful when you get the ref range and UM posted.

Also, as you continue to research, look at the benefits of Selenium and Iodine when Hashi's is in the mix. Some people have excellent results just by supplementing them. Vitamin D also plays a big role with all of this, so look into some therapeutic dosages (if needed) when talking with your doctor. Stopthethyroidmadness.com has a ton of great information .. check it out. Let me know what you think ...

 

[Nelson Vergel]

Thanks Chris for helping my friend. His attached blood work on PDF shows the ranges.

 

[Vettester Chris]

Nelson, thanks for pointing that out. I opened it up earlier and it prompted me to some other PDF on Grave's. Must have a ghost in the machine LOL. Anyways, labs are there, and it answers some of the questions.

OP, your Reverse T3 is excess when calculating the ratio with FT3. It's sitting at 13.5 .. Best to see that above 20 or even 25. It means T4 is converting more RT3 than you might desire. A variety of reasons can promote this scenario. It's the body's way of reserving energy when/if T3 isn't effectively reaching the cells, and/or other illnesses, stress, pathology, where the body needs to curb ATP.

Your iron serum IMO should come up to approx. the 130 range. Binding capacity is good, so transferrin will be effective to transport iron effectively. Your ferritin is definitely low, and in conjunction with the iron, you will IMO have difficulty getting T3 adequately into the body. The RT3 lab is a marker to tell you when issues like this are present. Again, this is all my opinion, run this by a qualified physician, but introducing any type of thyroid medication will be counterproductive until you get these areas addressed. Ferritin would be good at 100 to 150 area, somewhere in that range. Talk with your doctor about some form of elemental iron treatment with adequate levels of Vitamin C. You don't have to overload this endeavor. Be patient and monitor it.

The cortisol is obviously above range, but I honestly couldn't tell you much on that. The 4x 24 hour saliva test will be accurate, and it will give us a circadian profile with the pattern of your adrenals. These tests usually come with a saliva DHEA, which will also add to the talking points with your cortisol status.

In any case, I feel strongly that you get the iron/ferritin side dealt with first, along with getting the comprehensive cortisol kit completed and addressed "IF" it is problematic, you will then have a much better chance to make this successful. The last thing you need is T3 pooling because one or two supporting transport areas is suboptimal.

Again, the thyroid is complicated in that way, where active thyroid hormone is dependent on other areas like cortisol and iron to effectively reach the cells. This is even a factor in the deiodinase process with T4 to T3, so knowing there are autoimmune concerns, it would be good to have everything in check so that the process can function correctly if medications get introduced. Just my .02

 

[Nelson Vergel]

Here is some good info on increasing ferritin levels (from stopthethyroidmadness.com)

http://www.stopthethyroidmadness.com/ferritin/

 

[houguy]

Nelson, thanks for pointing that out. I opened it up earlier and it prompted me to some other PDF on Grave's. Must have a ghost in the machine LOL. Anyways, labs are there, and it answers some of the questions.

OP, your Reverse T3 is excess when calculating the ratio with FT3. It's sitting at 13.5 .. Best to see that above 20 or even 25. It means T4 is converting more RT3 than you might desire. A variety of reasons can promote this scenario. It's the body's way of reserving energy when/if T3 isn't effectively reaching the cells, and/or other illnesses, stress, pathology, where the body needs to curb ATP.

Your iron serum IMO should come up to approx. the 130 range. Binding capacity is good, so transferrin will be effective to transport iron effectively. Your ferritin is definitely low, and in conjunction with the iron, you will IMO have difficulty getting T3 adequately into the body. The RT3 lab is a marker to tell you when issues like this are present. Again, this is all my opinion, run this by a qualified physician, but introducing any type of thyroid medication will be counterproductive until you get these areas addressed. Ferritin would be good at 100 to 150 area, somewhere in that range. Talk with your doctor about some form of elemental iron treatment with adequate levels of Vitamin C. You don't have to overload this endeavor. Be patient and monitor it.

The cortisol is obviously above range, but I honestly couldn't tell you much on that. The 4x 24 hour saliva test will be accurate, and it will give us a circadian profile with the pattern of your adrenals. These tests usually come with a saliva DHEA, which will also add to the talking points with your cortisol status.

In any case, I feel strongly that you get the iron/ferritin side dealt with first, along with getting the comprehensive cortisol kit completed and addressed "IF" it is problematic, you will then have a much better chance to make this successful. The last thing you need is T3 pooling because one or two supporting transport areas is suboptimal.

Again, the thyroid is complicated in that way, where active thyroid hormone is dependent on other areas like cortisol and iron to effectively reach the cells. This is even a factor in the deiodinase process with T4 to T3, so knowing there are autoimmune concerns, it would be good to have everything in check so that the process can function correctly if medications get introduced. Just my .02

After all of that invaluable information, "Just my .02" is the understatement of the year. I really do appreciate such a thorough answer. I will get things started with my MD. I'm not sure if he is familiar with the saliva cortisol as he'd indicated only a familiarity with the challenge test (other than simple test that I had done). If he doesn't have the test, where can I get it?

And Nelson, thank you as well. You guys astound me with your knowledge and your resources.

 

[houguy]

BTW, what do you mean by "OP" and IMO" ?

 

[Tom Larabee]

BTW, what do you mean by "OP" and IMO" ?

OP = Original Poster
IMO = In My Opinion