Ce koga morda zanima, tule je kratek izvlecek clanka v angleskem jeziku, ki
omenja, da so simptomi hipotiroze lahko prisotni kljub TSH v normalnem obmocju, vendar v prisotnosti protiteles.(zdi se mi, da je bilo kar nekaj sporocil na to temo, da so testi v normalnem obmocju, simptomi pa kljub temu prisotni). lp Lidija
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(vir: http://thyroid.about.com/cs/expertinterviews/a/t4t3woliner_2.htm)

Another controversial situation is one in which a patient has a normal TSH, but many symptoms of hypothyroidism. Patients with “sublaboratory hypothyroidism” often present to physicians with a long checklist of symptoms and multiple articles (often printed out from the internet) desiring treatment with thyroid hormone. 11 Despite their “normal” pre-treatment TSH test, some patients do indeed receive thyroid hormone therapy, and do “feel better” with this therapy. When therapy is withdrawn, symptoms regress and patients feel worse. Restarting therapy, despite suppressing their TSH, makes them feel better once again.12 Lastly, despite a “suppressed TSH”, most of these patients do not experience untoward effects of subclinical hyperthyroidism when they are closely followed clinically (follow up physical exams), and with testing (EKG / Echocardiograms for possible heart disease and AXIAL DEXA Bone Density Scans for possible osteoporotic bone disease).13

There are many possible reasons for why patients may have resistance to thyroid hormone and exhibit symptoms despite having a normal TSH. Thyroid Peroxidase and Thyroglobulin Antibodies can interfere with the thyroid hormone function in the peripheral tissues while not affecting the suppressive effect of thyroid hormone on the TSH.14 The T3 receptor has 4 different gene variants with different types of receptors expressed in the brain than in the peripheral tissues.15 Lastly, there are some patients who have difficulty converting T4 to the active T3 hormone because of selenium deficiency or other conditions that interfere with human iodothyronine selenodeiodinases.16 In any of these cases, the TSH might appear normal despite clearly abnormal thyroid hormone function.
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Spoštovani!

Zdravljenje Hashimotovega tiroiditisa, ki je v evtirotični fazi, mora biti individualno. Simptomi hipotiroze (premajhnega delovanja ščitnice)- utrujenost, zaspanost, motena koncentracija, upočasnjena presnova, pridobivanje telesne teže, upočasnjen srčni utrip……), se lahko pojavijo tudi pri različnih drugih boleznih (slabokrvnost, okužbe, premajhno delovanje nadledvičnih žlez, depresija….), zato je potrebno individualno presoditi ali bolnik potrebuje zdravljenje ali ne?

Lep pozdrav!