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Suggest treatment for Hashimoto's disease

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Posted on Mon, 26 Oct 2015
Question: 1. My thyroid peroxidase antibody value is 100 what can this mean
2.My DHEA is 0.06 and every time i try to increase my Thyroxin it works for a few days then i revert to my previous state The same happened with T3

Thanks
XXXXXXX Redman
doctor
Answered by Dr. Shafi Ullah Khan (56 minutes later)
Brief Answer:
Autoimmune Hashimoto Disorder, needs thyroxine replacement.

Detailed Answer:
Thank you for asking

I read your question and i understand your concern. You have higher levels of anti thyroid peroxidase antibody levels. Likely cause for that is thyroid issues like hashimoto's disease, Graves diseases ( common in hyperthyroidism) or multinodular goiter.

Now the increased levels of DHEA levels at your age vary from 28 to 185 mcg and your levels are 60 mcg so they are in perfectly normal range.

Its just the imbalance of thyroid and likely autoimmune disorder that is causing this imbalance. Adrenal glands are less likely involved. If there was some hyperplasia of adrenal glands small thyroxine would have worked longer due to excess of epinephrine in blood.

All you need now is tailored thyroxine supplements. 1.7 mcg per kg is the dose needed in a day. So if you are average 70 kg you will need 120 mcg of thyroxine minimum. Talk to your endocrinologist and let them sort it out for you.

I hope it helps. Take good care of yourself and don't forget to close the discussion please.

Regards
Khan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shafi Ullah Khan (3 hours later)
XXXXXXX

Thank you very much for your answer.

I am sorry I quoted the uk units for DHEA and I thinkl converting nmol/l to mcg gives the following answer 0.06 nmol/l = .0021mcg which is I imagine seriosly low?

An answer regarding this close to zero level in itself and the impact it could have on my thyroid and vica versa would be much appreciated as soon as you have the time.

My medical experiences in the UK so far would leave me to believe that my thyroid is in Buckingham Palace with the Queen and my adrenal glands are on holiday in New York. I really would appreciate further comments fro you

Regards

XXXXXXX
doctor
Answered by Dr. Shafi Ullah Khan (6 hours later)
Brief Answer:
Need correlation and DHEA supplementation as well

Detailed Answer:
Thank you for getitng back to me

Higher levels of DHES are alarming mostly as they indicate adrenal hyperactivity. If you have a hormonal imbalance i would like you to get a complete adrenocortical hormones elevation slike 24 hours urinary corticosteroids, dexamethasone suppression., ACTH assays etc. DHEA levels decrease due to many factors including thyroid hormones supplements like thyroxine. Other things like insulin, corticosteroids, a long list of drugs, antiepileptics, anti lipemics like statin analogs and cholestyramine altogether lower the levels of DHEAS. FIsh oil and vitamin E also can cause levels to decrease.

meet an endocrinologist and let them sort out hormonal imbalance of all steroidal as well as androgenic hormones and consider you for the DHEA supplementation therapy if need be.

Nutshell, you need a competent endocrinologist to tailor your thyroid hormones as well as these androgenic hormones.

I hope it helps. Should you have any more queries please let me know, i would love to answer them for you.

Regards
Khan


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Shafi Ullah Khan

General & Family Physician

Practicing since :2012

Answered : 3613 Questions

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Suggest treatment for Hashimoto's disease

Brief Answer: Autoimmune Hashimoto Disorder, needs thyroxine replacement. Detailed Answer: Thank you for asking I read your question and i understand your concern. You have higher levels of anti thyroid peroxidase antibody levels. Likely cause for that is thyroid issues like hashimoto's disease, Graves diseases ( common in hyperthyroidism) or multinodular goiter. Now the increased levels of DHEA levels at your age vary from 28 to 185 mcg and your levels are 60 mcg so they are in perfectly normal range. Its just the imbalance of thyroid and likely autoimmune disorder that is causing this imbalance. Adrenal glands are less likely involved. If there was some hyperplasia of adrenal glands small thyroxine would have worked longer due to excess of epinephrine in blood. All you need now is tailored thyroxine supplements. 1.7 mcg per kg is the dose needed in a day. So if you are average 70 kg you will need 120 mcg of thyroxine minimum. Talk to your endocrinologist and let them sort it out for you. I hope it helps. Take good care of yourself and don't forget to close the discussion please. Regards Khan