General Medicine

» Elaine Moore - Hashimoto's -- no antibodies? Hyper symptoms?

In response to Hashimoto's -- no antibodies? Hyper symptoms? posted by elysia2006:
Hi,
In Hashimoto's thyroiditis thyroid antibodies usually show up for quite some time before patients move into hypothyroidism. The thyroglobulin antibodies contribute to the thyroid cell destruction that causes hypothyroidism, and TPO antibodies develop in response to thyroid inflammation.
Mature lymphocytes aren't an unusual finding in hypothyroidism although they're not diagnostic for Hashimoto's.
You could have atrophic thyroiditis in which case you'd have blocking TSH receptor antibodies. However, I don't think that's the case as you'd also have TPO antibodies.
You could have hypothyroidism related to dietary factors, for instance, eating excess amounts of soy or goiterogens like raw cabbage, broccoli, almonds, squash, peanuts, peaches, etc.
Or if you're exposed to lithium, bromide, fluoride or chlorine, these elements can contribute to hypothyroidism. Excess dietary iodine in fast/processed foods can cause both hypothyroidism and hyperthyroidism.
Thyroid nodules often develop in people who are hypothyroid. Nodules are also quite common and their incidence increases with age.

Your first set of labs is normal with a shift toward subclinical hyperthyroidism because of your low TSH. Your 2nd set of labs in November is also normal although FT3 is near the high end of the range. This is common when nodules begin to produce excess thyroid hormone.

My guess is that you have a recurring hypothyroidism that may be related to diet or meds (some antidepressants and NSAIDs also contribute to hypoT) and that your gland has produced nodules in an effort to correct the hypoT. This is causing your lab results to fluctuate and you probably have symptoms of both hypoT and hyperT.

In most cases, your doctor would repeat your thyroid function tests every 3-6 months or sooner if your symptoms change. This way if you move into overt hypoT or hyperT, you can receive appropriate treatment. Best, Elaine