Professional Village Compounding Pharmacy
Thyroid ultrasounds as well as blood tests are used to diagnose Hashimoto’s. Laboratory tests are available to check thyroid function and autoimmune thyroid markers.
If we were to perform blood tests in advanced untreated Hashimoto’s, we would find an elevated TSH, and low levels of T3 and T4. Thyroid Antibodies are also found in most cases of Hashimoto’s. The TSH is a widely used screening test, however is not the most reliable test for identifying Hashimoto’s, as it may fluctuate depending on the amount of thyroid hormone present, which is often the case in Hashimoto’s when thyroid tissue is broken down and thyroid hormone released into the blood stream.
Best Test for Hashimoto’s
In most cases of Hashimoto’s thyroiditis, blood tests will reveal one or two types of anti-thyroid antibodies. Thyroid peroxidase antibody (TPOAb) is the most common antibody present (in up to 95% of those with Hashimoto’s), and often antibodies against thyroglobulin (TGAb) are found as well (around 80%). These antibodies may appear decades before a change in TSH is detected.
Thus, TPO antibody screening is always crucial in suspected thyroid disease.
Elevated thyroid antibodies have been connected with feeling of distress, anxiety and depression in those with Hashimoto’s. Also, the higher the antibodies, the more likely you are to experience symptoms of hyperthyroidism, when the thyroid cells are broken down and stored hormone is dumped into the bloodstream, as well as hypothyroidism when we don’t have enough thyroid hormone.
Read more about this in my post The Many Faces of Hashimoto’s: http://www.thyroidpharmacist.com/1/post/2013/03/symptoms-of-impaired-thyroid-function.html
Additionally, the higher the TPO Antibodies, the higher your likelihood of developing overt hypothyroidism, and possibly additional autoimmune conditions.
There is a genetic predisposition to developing Hashimoto’s, and it tends to run in families. Thus, relatives of those with Hashimoto’s are at risk. Hashimoto’s thyroiditis can occur in two varieties: an organ wasting form (atrophic) associated with HLA-DR3 gene inheritance and enlarged thyroid (goiterous form) through HLA-DR5 inheritance. These genes are very common in the Caucasian population.
Well established environmental triggers for developing Hashimoto’s in those who are genetically predisposed include iodine intake, bacterial and viral infections, hormonal imbalances, toxins, as well as therapy with certain types of medications. Cigarette smoking, surprisingly, has been associated with a reduced risk of Hashimoto’s (more about this soon).
In people with Hashimoto’s only 50% of their identical twins presented with thyroid antibodies, meaning that genes alone are not the be all end all and that environmental triggers are extremely important.
Thyroid Events Amsterdam (THEA) Score
The THEA score is used to help estimate the risk of developing hypothyroidism within five years in people who have TPO antibodies and relatives of those with thyroid diseases.
Note: Higher antibodies are associated with a greater risk of developing hypothyroidism. To calculate your THEA Score, go to http://www.thyroidpharmacist.com/1/post/2013/06/hashimotos-and-tpo-antibodies.html