Blood results

[dreamBIG]

After many weeks of waiting, I finally received my blood results!  Now, can someone help me decipher what they mean? 

Thyroid: TSH normal but anti-thyroid antibodies are positive
Vitamin D: 16 - low (normal 32-100)
ANA: positive at 1:160, but the rest of the antibody panel is negative
ESR: 15
CRP: <0.4
Both the ESR and CRP is are normal, including anti SS-A and anti SS-B antibodies
RA factor: negative
complement levels (C3 & C4) are normal

My rheumy also noted that she suspects that I have autoimmune thyroiditis, and wants me to have more extensive testing of my thyroid function and wants me to see my PCP or endocrinologists.  She does not think I have a systemic autoimmune disease such as sjogrens or lups.  She underlined systemic, as if to point that out.  Is there a different type of autorimmune disease other than systemic?  THANKS!!!

[dreamBIG]

P.S. just found out my pattern is speckled

[irish]

I think that your doctor is trying to make a point with you. The autoimmune bloodwork against the thyroid are positive. That would mean that you have Hashimotos. In other words antibodies are trying to kill off your thyroid.

What I think she is saying is that now you know the true story. No positive SSA-SSB so it is only the thyroid. Find an article that talks about sjogrens symptoms with negative bloodwork. Hashimotos hangs around with sjogrens. Good luck. Irish

[Scottietottie]

Hi 

Hashimotos can play havoc with your system too. A good endocrinologist would be good to have on your team. Sometimes people with Hashi'd do best with a slightly suppressed TSH because 'normal' can differ between people. It's an individual thing too. Important to get it monitored and treated though. I'm sure you've read in here about people being sero-negative for SjS but still getting a dx.

For more about thyroids try the health forums at About.com. Their thyroid forum is good!

Take care - Scottie 

[DragonflyC]

Thyroid issues can cause many of the same symptoms as Sjogren's: dry eyes, dry mouth, joint pain, fatigue, etc.  I highly recommend the website thyroid.about.com which is run by a patient advocate.  I don't agree with everything the site says, but it's a great resource in general. Here's the page with some basics and symptoms: http://thyroid.about.com/cs/basics_starthere/a/symptoms.htm

As for that "normal" TSH, you really need to find out the number.  Most people feel best when their TSH is between .5 and 2 (for me, it needs to be right around 1).  Many labs and doctors, however, are using an outdated normal range of .5--5.5 even though the AACE changed their recommendation years ago.  Here's their press release if it turns out that your doctor is one of the many unaware of how best to treat thyroid disorders (doctors listen to other doctors more than to patients): http://www.aace.com/public/awareness/tam/2003/explanation.php

From the press release: "the National Academy of Clinical Biochemistry (NACB) guidelines believes that a sustained TSH level above 2.5 mIU/L might not be normal" and "'The target TSH level should be between 0.3 and 3.0 uIU/mL.' By inference, any patient with TSH outside this range has an "abnormal" level which should be carefully followed but not necessarily treated. Some authors, however, treat marginally abnormal TSH when coupled with positive TPO titers because of high conversion rates to clinical hypothyroidism." 

I've had more luck working with my general practitioner than with an endocrinologist to deal with my thyroid, but some people have found having an addition doctor on their team helpful.

Best wishes,
C.

In other words, some organizations believe that a person's TSH should not be above 2.5.  While some still believe up to 3 is normal, patients with anti-thyroid antibodies may still need treatment even if their TSH is in range.