Question: I just received a 0.4 ng/dL (0.7-1.8 ng/dL normal range for this lab) and a TSH of 104 mIU/L. (I do not YET know the TT3 or FT3 reading, not results of anti-body tests.) Originally, before Lithium therapy, I do not think I had an antibody test but the FT4, FT3 and TSH were all well within the normal ranges. The TSH had slowly crept up though. My only symptoms that I notice are constipation that was relieved by Miiralax and maybe slightly more sensitivity to cold - hard to tell since I have always felt uncomfortable in drafts. I was told to start on 50 MCG Levothyroxene today and double dose in 7 days.

I have been taking Lithium Carbonate for two years. In March, my TSH was 4.2. I was supposed to re-test in late September but dd not until last Friday. I used to be on 900 mg/day of Lithium Carbonate ER but in March, I switched down to 450 mg/day.

What do you make of this? Am I in danger of Hoshimoto's Disease? (So far I only received info from a primary doc and my psychiatrist's assistants which is no more than I stated. BTW I also had a complete metabolic panel test performed with all results within the normal ranges, and the primary doc performed a manual thyroid exam and felt no abnormalities.)

I very seriously considering staying permanently off the Lithium if autoimmune antibodies are found to be present at a high level. I am worried whether there are longterm worrisome consequences of Hoshimoto's disease. In particular, whether it can lead to other autoimmune disorders or it is only associated in a non-causal way with them. Is this known?

I just took my first 50 microgram dosage of Levothyroxine.

Thank you for your very helpful reply.

regards, XXXXXXX

Thank you Doctor!

I received antibody results: TPOAb level of 957.5 IU/mL and TgAb level of 2214 IU/mL. These numbers appear very high. I assume I should suspect lifelong thyroxine supplementation?

regards, XXXXXXX