What blood levels indicate Hashimotos disease?
Hashimoto’s Disease & Thyroid Hormone Treatment In Palm Beach County
West Palm Beach Endocrinologists Treating Patients Since 1985
Hashimoto’s disease, also known as Hashimoto’s Thyroiditis, is the most prominent thyroid disease in America. It is a genetically inherited disease that is nearly seven times more common in women than in men. Hashimoto’s Disease occurs due to the production of autoantibodies and immune cells by the body’s immune system, which can damage the thyroid cells and impair their ability to create thyroid hormones. The thyroid gland may also become larger in some patients, forming nodules and a goiter.
We offer high-resolution ultrasounds for same-day diagnostics. Call (561) 513-5100 or contact us online to schedule an appointment for Hashimoto’s disease treatment in Palm Beach County today.
What Are the Symptoms of Hashimoto’s Thyroiditis?
Many patients with Hashimoto’s disease may not show any symptoms for many years.
However, patients with Hashimoto’s disease are likely to develop symptoms such as:
- Fatigue
- Forgetfulness
- Dry skin
- Brittle hair and nails
- Constipation
- Sore muscles
- Weight gain
- Menstrual irregularities
- Sensitivity to cold
- Puffy face
- Hair loss
- Tongue enlargement
- Joint stiffness, and/or pain
- Depression
How Is Hashimoto’s Disease Diagnosed?
If you’re experiencing any of the symptoms of Hashimoto’s Thyroiditis, we recommending giving our endocrinologists at Palm Beach Diabetes and Endocrine Specialists PA a call. We will discuss your symptoms for you and perform the following blood tests to assess the following:
Thyroid stimulating hormone (TSH) Test:
Your pituitary gland produces a thyroid stimulating hormone (TSH), which controls the production of thyroid hormones. Thyroid hormones are responsible for maintaining your metabolic rate, muscle control, bone maintenance, brain development, digestive functions, and heart health. During a TSH test, we will perform a blood test to measure your levels of TSH. High levels of TSH in your blood is an indication that you have Hashimoto’s disease resulting in hypothyroidism.
Free T4 Test
T4 (also known as thyroxine) is a hormone produced by the thyroid. T4 is responsible for growth, metabolism, and many more of your body’s vital functions. Free T4 is when the hormone hasn’t bonded to any of the protein in your blood and thus can be used by any tissues or organs that need it. Typically, we will only perform a free T4 test if your TSH test shows abnormal levels. Low levels of T4 indicate Hashimoto’s disease and/or hypothyroidism.
Antibody Test
Because Hashimoto’s Thyroiditis is a result of antibodies attacking the thyroid gland, an antibody test can detect whether these antibodies are present.
In addition to blood tests, we will also use a high-resolution ultrasound to view your thyroid. This will help us detect whether there are any nodules or your thyroid is enlarged, also known as a goiter.
What Is The Difference Between Hashimoto’s Disease & Hypothyroidism?
While they are often used interchangeably, Hashimoto’s Thyroiditis and hypothyroidism are two different conditions. As mentioned above, Hashimoto’s disease is an autoimmune disease where antibodies attack your thyroid gland.
Hypothyroidism, on the other hand, is a condition in which your thyroid gland is underactive and doesn’t produce the proper amount of thyroid hormones.
However, these two conditions are linked. Due to the antibodies attacking your thyroid, stunting the production of hormones, Hashimoto’s disease can cause hypothyroidism.
How Is Hashimoto’s Disease Treated?
Our physician, Dr. Shital Patel specializes in Hashimoto’s disease treatment in Palm Beach County and will provide the professional help you seek. If your Hashimoto’s thyroiditis has resulted in hypothyroidism, you will need medicinal intervention.
Patients with hypothyroidism must take a pill containing thyroid hormone every day to replace the thyroid hormone they lack. Synthetic T4, called levothyroxine, is exactly the same as the T4 made by the body. Some patients may also require T3 therapy, which is another thyroid hormone that circulates in our bodies. This can be achieved by adding liothyronine or by taking Armour Thyroid or Nature-Thyroid, which has T4 and T3 in it. It is important that your physician bases appropriate treatment not only on blood tests but on symptoms, due to the broad normal range of thyroid levels.
Contact us online or call today at (561) 513-5100 to schedule an appointment for Hashimoto’s Disease & thyroid hormone treatment in Palm Beach County.
Do You Have Hashimotos?
Hashimoto’s Disease also known as Hashimoto’s Thyroiditis is an autoimmune disorder in which the immune system attacks the thyroid gland, eventually leading to hypothyroidism. Hashimoto’s does run in families as a genetic trait and seems to be more predominant in females. Proper Hashimotos testing is important for a diagnosis and will help in determining effecitve treatment options.
Blood tests to diagnos Hashimoto’s Disease:
- TPO: Thyroid peroxidase antibody
- TGab: Thyroglobulin antibody
- TSH: thyroid stimulating hormone
- Free T4
- Free T3
- Reverse T3
- Iron
- TIBC: Total iron binding capacity
- Ferritin
Thyroid Peroxidase Antibody (TPO) and Thyroglobulin Antibody (TGab)
The TPO and TGab are antibodies present in Hashimoto’ s. In about 70-80% of people with Hashimoto’s, the TPO antibodies are present. In about 15-20% of patients with Hashimoto’s disease the TG antibodies only are present. The presence of TPO and TG antibodies together is much less common at about 5%.
It is important to not only to test for TPO but also the TGab because a portion of the population with Hashimoto’s could be missed. Also the higher the level of circulating antibodies can contribute to more symptoms in Hashimoto’s, meaning that monitoring the antibody levels is helpful for treatment.
Thyroid Stimulating Hormone (TSH)
The TSH is a signal from the brain to the thyroid in order to get the thyroid to produce or not produce thyroid hormone. If the thyroid gland is under producing thyroid hormone then the TSH increases. If the thyroid gland is overproducing then the TSH decreases.
The reference range for TSH is misleading as many people can fall into range and have hypothyroid. If a person’s TSH is 2.0uIU/mL or higher, it is important to further investigate as this indicates hypothyroid, Hashimoto’s or decreased thyroid function.
Free T4 (FT4)
Free T4 is mainly made from the thyroid gland and it is a very stable molecule. It has a long half life, close to 7days and really has very little activity. Free T4 is needed to convert to Free T3, which is the most active of the thyroid hormones.
Free T3 (FT3)
Free T3 is the active form of thyroid hormone, so it is important to make sure it is in the proper range. A person with a good level of T4 but with a low T3 will still have hypothyroid symptoms.
This reference range for free T3 is very vast. Any free T3 under 3.0ng/dL is going to have hypothyroid symptoms. Having the free T3 at 3.8-4.4ng/dL is ideal for thyroid function.
Reverse T3 (RT3)
Reverse T3 is a inert, inactive thyroid hormone. In cases such as Hashimoto’s, T4 mono-therapy, starvation/caloric restriction diets to name a few, the FT4 will not convert to FT3 and instead to RT3 thus, causing the person to have more hypothyroid symptoms.
- Reference Range:
- Reverse T3 8-25 ng/dL
- Optimal: RT3 less than < 20 ng/dL
Iron
Often in Hashimoto’s disease the hemoglobin and hematocrit (the iron that is available for use right now) is normal but the total serum iron is low. When the total serum iron is low that can cause fatigue and symptoms associated with iron deficiency anemia (IDA). But as stated above, the hemoglobin and hematocrit are normal, which is what most doctors test for when looking for IDA.
- Reference Range:
- Adult female 40-190 mcg/dL (optimal 75-150 mcg/dL)
- Adult male 50-180 mcg/dL (optimal 75-150 mcg/dL)
Total Iron Binding Capacity (TIBC)
The TIBC tends to be elevated in Hashimoto’s disease. The TIBC is the ability for the body to bind/absorb iron. If the total serum iron levels are low then the TIBC would be elevated because the body is desperately trying to locate and bind iron.
- Reference Range:
- Optimal TIBC is 250-350 mcg/dL
Ferritin
Ferritin is a protein that binds to iron and can often be low in Hashimoto’s disease. Ferritin, like the serum iron is important in our iron-stores. If we do not have good iron-stores independent of hemoglobin/hematocrit then symptoms of iron deficiency anemia manifests. Also making sure your iron-stores are adequate is important should an accident occur where there is a lot of blood loss. Acute blood loss can be a serious disaster if one does not have enough iron-stores like ferritin and serum total iron.
- Reference range:
- Ferritin adult female 10-154 ng/dL (optimal 75)
- Ferritin adult male 20-345 ng/dL (optimal 100-250)
The blood tests listed above is a comprehensive list in order to properly diagnose and treat Hashimotos disease. Let us know if you have any questions.
