Q: I am a 38 years old female, married for six years and trying to conceive. I was diagnosed with hypothyroidism eight years back. I started thyronorm 25 and taking Eltroxin (100 mcg) currently. My thyroid tests - free T3, free T4 and TSH are always within normal limits. My TPO is high (around 450). I have read that T4 medication can lead to undertreated thyroid (cellular level) and addition of T3 medication will relieve me of symptoms. Is it true? Why am I suffering from severe muscle aches with occasional backache and weight gain? I am planning to go for IVF. Are my high TPO levels likely to interfere with IVF success?

A:You have hypothyroidism and on replacement which is adequate. Goal of treatment in hypothyroidism is keeping TSH in normal range. T4 which is present in the tablets gets converted to T3 inside the cells with the help of enzymes and therefore there is no need of taking T3. Your symptoms are common in general public without hypothyroidism and are usually due to lack of physical activity or exercise. , and I would suggest you to do socorrect this. Women who have higher levels of anti-TPO may have poor maternal and foetal outcomes but that's rare and you should not worry about that. Treatment with thyroxine takes care of these complications. Selenium is a trace element and is useful for many diseases. Its role in decreasing anti-TPO levels is not proven.