Q: I am a 27 years old female who recently underwent a thyroid test, which showed TSH - 7.95 with normal T3/T4. My symptoms include significant hair loss, fatigue /shortness of breath, menorrhagia etc. My serum iron is 22 mcg/dl and ferritin is 7 ng/ml. I go through fluctuating periods of strong depression and then irritability and anxiety. I am currently taking thyronorm 25 mcg for the past two months. Does Hashimoto's thyroiditis cause this and is it the only form of autoimmune thyroid disease? Is anti-TPO antibody the conclusive test for Hashimoto's? Please advise me.

A:Your report suggests that you have subclinical hypothyroidism and, normally it is without symptoms and usually does not need medications. But in your case some of your symptoms may be related to this condition and therefore I would suggest you continue thyronorm and repeat TSH test after 6 weeks to modify the dose, if need be. In case this dose is ok, then your TSH should be in normal range. Autoimmune thyroid disease is a broad based diagnosis and includes other disease such as chronic atrophic thyroiditis as well. In a patient with high TSH and enlarged thyroid gland, positive anti-TPO is diagnostic of Hashimoto's disease. You can get anti-TPO while taking thyronorm, it will not have an impact, but with time, the levels of this antibody fall.