Hello,
Your symptoms as well as the test results are suggestive of
hypothyroidism mostly due to Hashimoto's thyroiditis.
Hashimoto's thyroiditis is an autoimmune disease in which the body immune cells attack cells of the thyroid. This is a common cause of thyroid hypofunction.
However, during the acute phase of the disease, thyroid hormones being released from the damaged thyroid gland result in an initial state of
hyperthyroidism. So patients may present earlier with thyroid gland enlargement make them feel throat tightness and swallowing difficulty.
Patient then go into a phase of thyroid hypofunction, so patients may complain of fatigue,
depression, difficulty in concentration, have dry skin and excessive sleepiness.
Diagnosis based on complete history, physical examination and investigations for exclusion of other causes of nodular goiter (benign or malignant).
Essential blood tests are
thyroid function tests:
T3,
T4 and
TSH.
Typically, there should be elevated
TSH and low
T3 and
T4 (may be normal or high initially, as in your case).
Diagnosis of Hashimoto's thyroiditis is helped by the finidng of thyroid autoantibodies. Which are high in your blood test results.
Thyroid US and scan are recommended as needed, and US is also used to guide a FNAC. Histological studying of the thyroid tissue may be needed and diffuse infiltration of the thyroid gland with inflammatory cells is characteristic for Hashimoto thyroiditis.
Treatment is usually medical with hormone replacement according to symptoms and lab results. While surgery is kept for complicated cases.
Whether this was the cause of your early symptoms years before the diagnosis is made is a difficult question to be answered. But there are cases of chronic thyroiditis that may have subclinical
hypothyroidism with constantly elevated TPO antibody.
Thyroid peroxidase (TPO) antibody is used to detect antibodies against the thyroid gland in conditions similar to Hashimoto's Thryoiditis. Most people with chronic thyroiditis (70%-90%) are positive for TPOAB test.
In any circumstances what is known is that serial follow up testing to keep your thyroid hormone level within the normal range (with replacement therapy when needed) would improve your symptoms.
I would advise you to follow up with your doctor and please keep us updated.
Best regards.
This answer does not substitute for direct medical consultation.
Dr. Safaa Mahmoud.
MB BCh, MSc Internal Medicine. MD Medical Oncology.
PhD Experimental Medicine and Biochemical Science.
