It turns out that thyroid hormone management is not quite that simple and several studies have shown that treating based on the TSH ultimately leads to low levels of T3, reduced quality of life and weight gain due to a slower metabolism (7). Give Levothyroxine or Synthroid to the patient and monitor the TSH to "normal" levels. The current (and insufficient) treatment paradigm can be summed up in basically one sentence:
Part of this problem is due to the reliance upon the TSH as the de-facto lab test to determine thyroid function. Unless you evaluate your thyroid lab tests entirely and with the "optimal" levels in mind, you will end up undertreated and may remain symptomatic. This idea of "optimal" thyroid lab tests extends beyond just anti-TPO levels. Normal thyroid lab tests but still have hypothyroid symptoms? While you have glandular damage it's actually possible to have episodes where thyroid hormone pumps into the body due to the damage and may cause symptoms of hyperthyroidism.īelow I've included a chart which tracks the TSH and FT4 levels over time in autoimmune thyroiditis and Hashimoto's disease. The signs and symptoms above should be a warning that this process is happening and worsening symptoms indicate that the disease may be progressing.
This process largely occurs due to thyroid gland damage. If these symptoms are ignored, or proper treatment isn't instituted then these symptoms may evolve into overt symptoms of hypothyroidism. Ultimately many of these symptoms get lumped into the "category" of depression, and many physicians may recommend the use of anti-depressants instead of the correct treatment to manage thyroid function and reduce autoimmunity. Īs you can see these symptoms are very non-specific.Īs a result, many of these symptoms tend to be ignored (usually by Doctors), leading them to test for non-specific conditions such as anemia. It also means the earlier you get started to treat the condition the more of your thyroid gland you can save and protect. This is actually a good thing because it means that you have a chance to treat the condition and manage some of the symptoms yourself. The presence of these antibodies changes management completely due to the reasons provided above. The autoimmunity and inflammation in your thyroid are important for several reasons:ġ) Your thyroid controls multiple functions in your body including your metabolism (1) ( Low metabolism leads to weight gain, fatigue, and a low body temperature).Ģ) Your thyroid helps influence other hormones in your body (low thyroid leads to hormonal imbalances like low progesterone (2)).ģ) If this autoimmune condition, if left untreated, can result in permanent damage to your thyroid gland (this also means that not all cases of elevated anti-TPO's need to be treated).Ĥ) Symptoms of autoimmune thyroiditis do not necessarily match regular cases of hypothyroidism (meaning it can be difficult to diagnose).ĥ) This autoimmune condition may result in episodes of episodes of hyperthyroidism (3) and episodes of hypothyroidism due to glandular damage
#CID EPISODE 1219 HOW TO#
Obviously, this isn't ideal, and we are going to talk about how to diagnose, manage and treat this condition throughout this article but I want to focus on a couple of other topics before we get there.įirst, you need to realize that the presence of these antibodies indicates that your immune system is NOT working properly.Īutoimmunity is also associated with some degree of inflammation (this varies based on the individual but it is always present). Putting this together it means your immune system is attacking your own body.