“Why won’t my GP test my thyroid antibodies when I have thyroid auto-immune disease??”

I have recently …well the last 4-5 years become to specialise in thyroid health conditions. I have an autoimmune thyroid condition called Hashimoto’s myself and have seen hundreds of clients with a thyroid condition in clinic. Due to my specialty, I am seeing more and more clients online and I am becoming increasingly aware of these patients not having access to a full thyroid panel, especially getting their antibodies tested.

I request that my patients go back to their primary care physician and ask at my request for a full thyroid panel including antibodies, but more often than not, their GP will refuse?

I am very fortunate and grateful to work with some very supportive GP’s who will test for my local clients but my online patients are being knocked back and are having to pay for their testing through a functional lab so we can get the full thyroid picture, rather than getting the tests through their GP and Medicare. This is even more frustrating when they have a known thyroid autoimmune condition such as Hashimotos or Graves Disease! You would think that it would be standard practice to test for antibodies in these case, right? Wrong.

Autoimmunity, where the body starts making antibodies against its own body tissue, in this case against thyroid tissue. Autoimmunity is THE BIGGEST CASUE of hypothyroidism!!!! But thyroid antibodies are still not the first line test.

GP’s and endocrinologists alike are taught to only test for TSH (thyroid stimulating hormone), a brain hormone, not even a thyroid hormone…another anomaly in the whole thyroid testing farce……maybe a T4 if we are lucky….mostly never a T3 which is the active thyroid hormone that gets into our cells…essential to get this info too…. And then if in a very big range, or slightly high or low, wait 3 months and test again. Then if TSH has increased or decreased then other parameters may be tested , but often not antibodies….still…and all this time the immune system may be attacking and destroying thyroid tissue, but this is hardly ever tested .

I hazard to guess why this is the case.

One GP I have spoken to said that thyroid antibodies are not clinically significant??!! Come again??!! !! I mean how can they not be?? Then main aim of Naturopathic treatment of thyroid autoimmune disease is to reduce the autoimmune attack on thyroid tissue, decrease thyroid antibodies, regulate immune function and stop the immune attack on the thyroid , and body to bring the thyroid into the best possible state and even remission. I have seen over and over again the positive results of antibody reduction and immune regulation in thyroid autoimmune disease.

And yet antibodies are not tested.

Another reason is that there isn’t a whole lot that the medical system can do for autoimmune disease in general. If you are diagnosed with say Hashimotos thyroiditis, then you will be given thyroxine for life. Thyroxine is very chemically similar to the main inactive hormone that your thyroid makes, T4. Thyroxine can certainly support a struggling thyroid which is finding it hard to make its own hormones (usually due to the immune attack on the gland)…but it does nothing to bring antibodies down or stop the immune attack on the thyroid. So why check antibodies if there is no pill to fix this???

When I search the research papers, I only find reasons to test for antibodies and their clinical significance.

This is the standard flow chart of clinical guidelines that GPs will follow, but following this model will miss the early diagnosis of Hashimotos or Graves’s disease if antibodies are not routinely tested. If we catch thyroid autoimmune disease early and reduce the immune attack, we can prevent lifelong medication and possible remission especially in children and teens, an ever increasing population of thyroid diagnosis.

Other guidelines in this article:

https://www.racgp.org.au/afp/2012/august/hypothyroidism/

state that once diagnosis of antibodies has been confirmed, then:

“Where treatment is commenced, an initial dose of levothyroxine of 25–50 µg/day can be used with a target TSH level between 1.0 and 3.0 mIU/L. The TSH level should be measured in 6–8 weeks after commencement of therapy, and annual reviews once the TSH level is stable.6”

But again no mention of antibody testing.

I have found that on annual review, the TSH and T4 is tested but not T3 or thyroid antibodies.

So what can we do? I can’t see these guidelines changing anytime soon so we just have to lean towards more aware and/or Integrated GP’s. If you find one, never let them go!! We are fortunate to have functional testing but alas this is not covered by Medicare though most of my clients are more than willing to pay to get the full picture of thyroid function.

For thyroid healing and recovery to occur in thyroid autoimmune disease, it is imperative to halt the immune attack on the thyroid gland which causes destruction to thyroid tissue producing an inability of the thyroid to produce its hormones needed for vital body functions such as temperature and metabolism. The first step is knowing the degree of immune attack by testing thyroid antibodies and testing every 3 months to measure progress and effectiveness of the treatment.