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Do I Need Treatment For Hypothyroidism Despite Having Normal TSH And T4 Levels?
Question: I was just diagnosed with mild Hashimoto's Disease (TgAb at 403; TPOAb 5.8) with echo confirming gotier but normal T3, T4, TSH figures. As I am currently on Tambocor, Xarelto, and Tenomin for acute AF & PV issues, I have been informed standard HD medication (Levothyroxin/ Synthroid, et. al.) should not be taken due to impact on arrythmia. Any recommendation or suggestions on alternative treatment for confirmed hypothyrodism would be appreciated. Thank you-
Brief Answer:
No treatment required at the moment
Detailed Answer:
Good day,
Noted your concern. It is not clear why a Tg Ab and TPO Ab was ordered when your T4/T3 and TSH are normal. ( I realize that in some countries, they are part of thyroid panel).
When your TSH and T4 are normal, you do not require replacement with Levothyroxine. At the moment you do no have hypothyroidism eventhough there is a small future possibility of hypothyroidism as the Tg antobody is positive.
Please be aware that normal people also can have Tg/TPO antobody positivity. As the antibody is positive, you will have to repeat TSH and Free T4 (FT4) after 3 months. At the moment, i can assure you that, no treatment is required for thyroid as long as T4 and TSH are normal.
Regards
Binu
No treatment required at the moment
Detailed Answer:
Good day,
Noted your concern. It is not clear why a Tg Ab and TPO Ab was ordered when your T4/T3 and TSH are normal. ( I realize that in some countries, they are part of thyroid panel).
When your TSH and T4 are normal, you do not require replacement with Levothyroxine. At the moment you do no have hypothyroidism eventhough there is a small future possibility of hypothyroidism as the Tg antobody is positive.
Please be aware that normal people also can have Tg/TPO antobody positivity. As the antibody is positive, you will have to repeat TSH and Free T4 (FT4) after 3 months. At the moment, i can assure you that, no treatment is required for thyroid as long as T4 and TSH are normal.
Regards
Binu
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your quick reply. As the goiter on my right side is now prominent and I had been experiencing, with increasing intensity over the past 2 years, most of the common and increasingly intense symptoms associated with Hypothyroidism, I went in for the panel.
According to my local endocrinologist, blood test and ultrasound definitively confirmed HD, but no action suggest at this time but rather check for any advancement in several month's time. Could there be a link between my on-going cardiovasular disease (had 2nd AF ablation surgery last month in 6 month period) and the AF medication taken for this, and my thyroid issue?
According to my local endocrinologist, blood test and ultrasound definitively confirmed HD, but no action suggest at this time but rather check for any advancement in several month's time. Could there be a link between my on-going cardiovasular disease (had 2nd AF ablation surgery last month in 6 month period) and the AF medication taken for this, and my thyroid issue?
Brief Answer:
Amiodarone can cause thyroid illness
Detailed Answer:
Quite possible. If you ever used CORDORONE ( Amiodoarone) for Atrial fibrillation at some point of time, there is a fair chance of developing thyroid illness in the future. It could be hyperthyroidism ( common) or hypothyroidism. I presume, you had a diffuse goiter and ultrasound showed altered echotexture. This is confirmatory of Hashimotos thyroiditis. However, if you have thyroid nodules in ultrasound, you need a needle test.
Amiodarone can cause thyroid illness
Detailed Answer:
Quite possible. If you ever used CORDORONE ( Amiodoarone) for Atrial fibrillation at some point of time, there is a fair chance of developing thyroid illness in the future. It could be hyperthyroidism ( common) or hypothyroidism. I presume, you had a diffuse goiter and ultrasound showed altered echotexture. This is confirmatory of Hashimotos thyroiditis. However, if you have thyroid nodules in ultrasound, you need a needle test.
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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