Thyroid Peroxidase Antibody and TSH levels

First off, thank you for all of the great content and resources.

I am curious if you would have any feedback - follow-up questions I can ask my doctor, side effects to look out for, past experience/guidance - given my situation below.

I get routine blood work primarily to ensure my lipid panel is in check (family history, on meds). I consistently have high levels of thyroid peroxidase antibody and TSH. My doctor wants me to start Synthroid and recheck levels in 3 months. I have no problem doing this - going to pharmacy as soon I send this. While I do not have any symptoms of hypothyroidism, I do have family history of autoimmune disease and one instance of thyroid cancer (grandfather).

I check the box for all 7 of the health priorities you write about. Currently running a 4-day, strength-focused program with plenty of GPP. I take a statin and a low-dose blood pressure medication. I have not noticed any indicator that performance or health is lacking. Weights in gym typically trend upwards, and I can usually train up to better-than-average if I switch focus (e.g., half marathon).

Thanks for any feedback you have.

How high did your lab values get?

Why did your doctor recommend starting levothyroxine treatment if you currently have no signs or symptoms of hypothyroidism?

THYROID PEROXIDASE AB
579 IU/mL

TSH
5.57 mIU/L

I assume that because the last, and only, two times I been in for a check-up, the TSH has been high. This is the first time I’m seeing a TPO value. I moved about 14 months ago so don’t have a relationship built up with this primary care physician.

Thanks again!

If you have no symptoms at all, a TSH of 5.5, and are not pregnant/planning to get pregnant, I’m not sure I’d be starting levothyroxine replacement in this situation.

There may be more to the picture that your doctor is considering that I’m not aware of, however.

Just thought I would come back and share the outcome. (No, not pregnant. I was the guy that mentioned his previous 300+ cholesterol at the San Antonio seminar)

I followed the doctor’s orders, but I also scheduled a check up with an endocrinologist. Ultrasound confirmed that my thyroid was enlarged with the visible signs of Hashimoto’s. So I will be on some level of levothyroxine for life, which is only a little inconvenient since I like eat breakfast almost as soon as I wake up. According to the endocrinologist, some doctors choose not to treat until TSH levels are higher, but with the visible signs already, I should go ahead with medication. I may not experience symptoms now, but thyroid function would continue to deteriorate without medication.

Another benefit of the levothyroxine is that my LDL dropped 20 points in the 3 months on the medicine. Probably the biggest drop since I started atorvastatin many years ago. Doctor attributed this to overall higher metabolism (I also lost roughly 5 pounds without changing any diet/exercise routine). I always attributed my high cholesterol to genetics, but this Hashimoto’s has likely been a factor for some time.

Thanks again for the great content!