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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Elevated ESR, CRP, Anti-TPO, LDL, Cholesterol. Diagnosed To Be Auto-immune Thryoid. Treatment?

Hi, my wife had a raised ESR of 49, ANA positivity in dilution of 1:80 for past one year and a recent increse in CRP of 15. she was being thought of as an auto-immune patient and the cause was not known. Few days back, we stumbled upon high levels of Anti-TPO antibodies- 1000IU/ml and Anti-TPO antibodies-389.1. Her T3 is 2.8, T4 is 1.2 and TSH-1.1380. 18 months ago the Lipid profile is well within the limits. Lipid profile shows LDL of 142 and cholesteol of 198. QUESTIONS. 1. With these data, can we arrive at the diagnosis of Auto-immune thyroid disease like Hashimoto s. 2. If so, any treatment can be instituted to control Auto-immunity? 3. She is very diet conscious and uses oil like olive oil and exercises regularly. Lipids deranged can increse the risk od cardiac problems in the background of inflammation in the body?? 4. Clinically, she has no symptoms except mild hairfall and cold extremities at times. 5. We are planning to have a child and what precautions should we take to have a safe delivery and pregnancy right from the beginning. chances of infertility?? 6. Can you please give your recommendations. It will be highly appreciated since slowly the parameters are getting deranged.
Sat, 9 Nov 2013
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General Surgeon,  's  Response
Hello sir ,
Good u have given the complete reports of ur wife . I ll try to solve all the queries regarding the same
Ans 1 - The antibodies titre indicates ur wife had auto immune disease , and through these investigations confirm ur diagnosis as hashimotos .
Ans 2 - As the thyroid report of the patient is within normal limits i advice no as such treatment is given to hashimotos . If he developed thyroid related symptoms , thyroid hormones replacement can be considered . Auto immune throid disease , no specific treatment is there
Ans-3 Lipid derangement is in slightly higher level , so diet control and regular exercise reduce the symptoms no medications reqired . It increases the risk if its above normal level during that medication is helpful LDL > 150 & Cholesterol >200
Ans 4- Hashimotos ultimately leads to hypothyroidism , as u mentioned mild hairfall and cold extremities indicate early stage of hypothyroidism , If symptoms u consult doctor so that thyroid replacement can be considered
Ans 5 - For start of family make sure her thyroid hormones are within normal limits , if Maintainng thyroid within normal helps to have safe pregnancy and no poroblem to fetus
Ans 6 - Get every 3 months thyroid and lipid profile investigations , and during pregnancy make sure thyroid hormones are within normal limits
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Elevated ESR, CRP, Anti-TPO, LDL, Cholesterol. Diagnosed To Be Auto-immune Thryoid. Treatment?

Hello sir , Good u have given the complete reports of ur wife . I ll try to solve all the queries regarding the same Ans 1 - The antibodies titre indicates ur wife had auto immune disease , and through these investigations confirm ur diagnosis as hashimotos . Ans 2 - As the thyroid report of the patient is within normal limits i advice no as such treatment is given to hashimotos . If he developed thyroid related symptoms , thyroid hormones replacement can be considered . Auto immune throid disease , no specific treatment is there Ans-3 Lipid derangement is in slightly higher level , so diet control and regular exercise reduce the symptoms no medications reqired . It increases the risk if its above normal level during that medication is helpful LDL 150 & Cholesterol 200 Ans 4- Hashimotos ultimately leads to hypothyroidism , as u mentioned mild hairfall and cold extremities indicate early stage of hypothyroidism , If symptoms u consult doctor so that thyroid replacement can be considered Ans 5 - For start of family make sure her thyroid hormones are within normal limits , if Maintainng thyroid within normal helps to have safe pregnancy and no poroblem to fetus Ans 6 - Get every 3 months thyroid and lipid profile investigations , and during pregnancy make sure thyroid hormones are within normal limits