kokotg Posted March 23, 2021 Share Posted March 23, 2021 (edited) I went to the NP for my standard yearly blood work the other day. I'm hypothyroid and have been on 88mcg of levothyroxine for forever (or for 8 years anyway). She usually just tests my TSH, but when I pointed out that my neck has been sort of puffy lately, she added on thyroid peroxidase. So my TSH is under 1, but the peroxidase came back high (44) and she just added "we will monitor" to the notes line. So I don't remember ever having this tested before, and I have no idea what to do with this information (I guess I could just chill out and wait for the monitoring to happen, but that's not my usual MO)...is it weird or normal that it would be high when my TSH is great? Other than my puffy neck (which she thought was too low to be thyroid related anyway) I have no particular hypothyroid symptoms lately (other than a hard time losing weight, but that's certainly nothing new). Do I HAVE to go to an endocrinologist? Last time I did, she didn't do anything different from my regular NP, and she pouted at me and scolded me if I had gained a pound since my last appointment. I mean, obviously I wouldn't go back to THAT one... Edited March 23, 2021 by kokotg Quote Link to comment Share on other sites More sharing options...
Shoeless Posted March 23, 2021 Share Posted March 23, 2021 Elevated TPO is associated with Hashimoto's thyroiditis and Graves disease. Your TPO is elevated, but still in the lower range of elevated. Low TSH and high TPO usually indicates Graves disease, from what I recall, but I don't know if that holds true if your TSH is lowered artificially via the levothyroxine. It's good that you feel well, but it sounds like you might be at the very beginning of a thyroid issue. Swollen neck plus elevated TPO would make me question autoimmune inflammation. When do you go back for more labs? I don't think you necessarily have to see the endo if you feel like your are getting answers and good treatment from the NP. I'd want to see a full thyroid panel run, and not just a spot check of 2 thyroid values. 1 1 Quote Link to comment Share on other sites More sharing options...
***** Posted March 23, 2021 Share Posted March 23, 2021 IDK much about thyroid, but on Instagram, see carrievitt for all kinds of thyroid and hashimoto info. I joined so I could remember to send her link to a friend. Best of luck... 1 Quote Link to comment Share on other sites More sharing options...
kokotg Posted March 23, 2021 Author Share Posted March 23, 2021 11 hours ago, MissLemon said: Elevated TPO is associated with Hashimoto's thyroiditis and Graves disease. Your TPO is elevated, but still in the lower range of elevated. Low TSH and high TPO usually indicates Graves disease, from what I recall, but I don't know if that holds true if your TSH is lowered artificially via the levothyroxine. It's good that you feel well, but it sounds like you might be at the very beginning of a thyroid issue. Swollen neck plus elevated TPO would make me question autoimmune inflammation. When do you go back for more labs? I don't think you necessarily have to see the endo if you feel like your are getting answers and good treatment from the NP. I'd want to see a full thyroid panel run, and not just a spot check of 2 thyroid values. Thanks! I'm supposed to go back in 6 months. She did full thyroid panel when I first started seeing her, but she's just been checking TSH since them since nothing's really changed. My TSH is much lower than it was last time I was there in July, so I'm not sure what's up with that--it's still in range (like .6 something), but it's usually between 1.5 and 2. Anyway, I guess if I keep feeling okay otherwise I can wait 6 months and see what's up then? Quote Link to comment Share on other sites More sharing options...
Shoeless Posted March 24, 2021 Share Posted March 24, 2021 8 hours ago, kokotg said: Thanks! I'm supposed to go back in 6 months. She did full thyroid panel when I first started seeing her, but she's just been checking TSH since them since nothing's really changed. My TSH is much lower than it was last time I was there in July, so I'm not sure what's up with that--it's still in range (like .6 something), but it's usually between 1.5 and 2. Anyway, I guess if I keep feeling okay otherwise I can wait 6 months and see what's up then? The TSH can fluctuate a bit for all sorts of reasons. There probably is also some variation in TPO values as well. So, I think it's fine to wait a little, get more labs, and see what they say. Personally, I would want to have labs redrawn in 3 months not 6, because I'd a) want the peace of mind and b) want to get ahead of a problem before it becomes a bigger issue. Don't let yourself feel like garbage if you can avoid it. Keep a careful eye on how you are feeling and get in sooner if you feel off. I know that when my thyroid values change, I don't always realize it until I feel REALLY bad. 1 1 Quote Link to comment Share on other sites More sharing options...
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