One of the most difficult situations is having an underlying thyroid problem that does not show up on standard thyroid blood tests. You may have to actively interview endocrinologists, as well as holistic doctors, osteopaths, and other practitioners, to find one who will treat you if you have a normal TSH level, with thyroid antibodies and symptoms. Many doctors will not, however, treat patients who present clinical symptoms of hypothyroidism and test positive for Hashimoto's antibodies but have a normal TSH level. The researchers speculated that such treatment might even be able to stop the progression of Hashimoto's disease or prevent the development of hypothyroidism. In this study, German researchers found that treatment with levothyroxine for Hashimoto's autoimmune thyroiditis - where TSH had not yet elevated beyond normal range - could actually reduce the chance and severity of autoimmune disease progression.

The practice of treating patients who have Hashimoto's thyroiditis but normal-range TSH levels is supported by a study reported in the March 2001 issue of the journal Thyroid. The dysfunction may not be significant enough to register as an abnormal TSH level, but the presence of antibodies may generate symptoms and is predictive of thyroid problems down the road. This presents a problem because elevated thyroid antibodies even in the presence of normal TSH levels mean that you have autoimmune thyroid disease and that your thyroid is in the process of autoimmune dysfunction. Even though autoimmune problems are most frequently the cause of thyroid conditions, many physicians do not routinely conduct the antibody tests that diagnose autoimmune thyroid disease. Alternatively, you can order TSH, free T3, and free T4 testing, known collectively as the Comprehensive Thyroid Profile II, from HealthCheckUSA.