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Thyroid problem. Test results showed T4 92 and TPO-ab 1141. What does this indicate?

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General & Family Physician
Practicing since : 2003
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Doctor Vaishalee, as discussed before regarding my wife"s Thyroid problem , as advised by you i got the free T4 Test done and the result is .92 , and the TPO-ab test has a Result of 1141 , Pls let us know the implication of this , we will get the ultrasound also done
Posted Mon, 29 Jul 2013 in Women's Health
Answered by Dr. Vaishalee Punj 59 minutes later
Hi again,

The free T4 values are in normal range. This means that her thyroid hormones reserves are not still depleted.

The TPO-ab values are higher than normal. It means that your wife's immunity (in the form of antibodies) is attacking her thyroid gland. This is resulting in low production of T3 and T4 from the thyroid gland. In response to this low production the TSH values are getting high. The most probable diagnosis is Hashimoto's Thyroiditis. I think that your wife may be having auto-immune hypothyroidism. You may still get the ultrasound done to rule out nodules that may be a cause.

The treatment of Hashimoto's thyroiditis is lifelong thyroid hormone replacement. As I mentioned in my previous reply, she will need to titrate the dose of thyronorm upwards until her TSH comes back to normal. Then she will need to continue taking thyronorm at that dose and re-evaluate every year.

It is also important to follow-up with a thyroid hormone specialist or endocrinologist as she will need consultation from time to time regarding symptoms of hypothyroidism. Also she should make changes in her current dosage of thyronorm after consultation.

Also you need to be aware that auto-immune conditions can affect more than one organs at time. So yearly blood tests will be needed to rule out chronic medical conditions like diabetes, Pernicious anemia, adrenal insufficiency, Sjogren's syndrome, etc. These are just some examples of autoimmune conditions that she will need to watch out for.

Let me know if you need further clarification.

Dr Vaishalee
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