What Does The Following Thyroid Profile Test Indicate?

Posted on Mon, 30 Mar 2015

Question: I have been suffering with hypo thyroid since 12 years and taking thyronorm 100 daily one table. Before Hypo I have hyper for 8 years. when I stopped medicine, it went to hypo.

Answered by Dr. Ajish TP (27 minutes later)

Brief Answer:
Please upload your reports

Detailed Answer:
Hi,

Welcome to HCM. Thanks for posting your concerns about your thyroid disease.

Have you had either radio iodine treatment or surgery for hyperthyroidism, that usually make you hypothyroid after treatment? Or you were only on anti thyroid drugs - like carbimazole or methimazole?

Please upload your latest thyroid function reports, so that we can help you with managing your hypothyroidism.

Regards
Dr Ajish TP
Consultant Endocrinologist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ajish TP (51 minutes later)

I am on neomaercazole from 1996 to 2003 and doctor adviced me to stop the medicine. I stopped it for about 2 years then slowly I put up weight so I again did the test and TSH is 70 so I visited doctor and he said now I have hypo so I started taking thyronorm 100mcg from 2005 onwards and not stopped it. My thyroid TSH is under control from then onwards. I regularly do the test of TSH every 6 months and it always stays at between 2-3. Recent test I did it in FEB and TSH is 2.6.

Answered by Dr. Ajish TP (8 minutes later)

Brief Answer:
You have to continue with same medications

Detailed Answer:
Hi,

Welcome back. Thanks for sharing the information. Neomercazole is actually the brand name of carbimazole.

Hyperthyroidism after treatment can go for hypothyroidism. Additional investigation we do in this type of cases are:

1. Anti TPO antibody and anti thyrogobulin antibody
2. Ultrasound of thyroid.

If the levels of antibodies are high or your thyroid ultrasound is showing abnormal thyroid gland, you probably have to take thyroid hormone replacements (Thyronorm) life long.

The dose of the medication (Thyronorm) is adjusted by the level of TSH. Most endocrinologist prefer to keep it between 0.5 and 3 miu/ml. Since your TSH is in this target, you need to continue the medication and follow up every 6 months with TSH.

Regards
Dr Ajish TP

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ajish TP (1 hour later)

Hi,
Below are the details on anti bodies tests done for me. Please advise.

T3- 122
T4-13
TSH-2.6

ANTI MICROSOMAL ANTIBODY (AMA) E.L.I.S.A 77.98 U/ml
Reference Range:Negative : <=35 Equivocal : 36 - 49 Positive : >=50 (AMA are also called asAnti-TPO Antibodies). U/ml

ANTI THYROGLOBULIN ANTIBODY (ATG) E.L.I.S.A 98.21 IU/ml
Reference Range:Negative : < 225 Equivocal: 225 - 325 Positive : > 325 IU/ml
Technology: Solid Phase Enzyme Immunoassay

Answered by Dr. Ajish TP (13 minutes later)

Brief Answer:
Coninue same medications

Detailed Answer:
Hi,
Noted your reports.

Your thyroid function is normal. TSH is on target , T3 T4 high normal - suggesting optimal dose of thyronorm. You just need to continue same dose of thyronorm and repeat your thyroid function every 3-6 months.

Antibodies - Anti TPO and AMA are same test - which is elevated (positive), thyroglobulin antibody is negative. You are having hypotyroidism due to hashimoto's disease (positive antibodies). This suggest you need to continue the medication, probably life long.

This is not a serious condition, but you need to be on treatment.

Wishing you good health.

Regards
Dr Ajish TP

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar