Why do I need to examine TSH with HAMA for hashimoto's thyroiditis?

Question

Hello doctor,

I have been having issues with my thyroid for several years, about four, I believe. I have been diagnosed with Hashimoto's and have been on treatment for about a year and a half. I had an ultrasound done because I was having pain on the right side of my neck, and the results showed, aside from a small cyst on my right lobe of around 3.5 mm, that the right lobe itself is a bit smaller than my left (3.9 x 1.2, whereas my left is 4.6 x 1.4) and has hypoechogenicity.

My doctor did not seem to care about that at all, and instead said she wanted me to get some lab work done and ordered a test called TSH with HAMA. She told me what it was, but it still confused me.

Could you possibly explain to me what this test is used for and why she would have decided to order it?

Please help.

Thank you.

Answer 1

Hello

Welcome to icliniq.com.

I understand your concern.

Let me briefly explain to you how Hashimoto's thyroiditis works. Basically, in Hashimoto's thyroiditis, the thyroid is attacked by antibodies produced by the body. This is a diseased state because the body is producing antibodies against its own antigens or proteins. So these antibodies go and attack the thyroid specifically.

Hence, they can be called autoantibodies to the thyroid. In Hashimoto's, when these thyroid antibodies attack the thyroid gland, they basically destroy the thyroid's walls. The thyroid hormone stored within these walls is released into the circulation. Then the thyroid cells are destroyed, so hormone production eventually decreases or stops.

So, in thyroiditis, especially Hashimoto's, two phases are seen; the initial one, which is because of the release of thyroid hormone into the circulation, you have hyperthyroidism, and then after the thyroid gland is completely destroyed, there is no production of the hormone, leading to hypothyroidism.

Human anti-mouse antibodies are antibodies that can attack the thyroid gland in Hashimoto's. In your position, she wanted to check for the presence of these antibodies initially by supplementing thyroid hormone.

Let me know if you have any further queries.

Thank you.