# Sticky  Hashitoxicosis General Information



## chopper (Mar 4, 2007)

I wrote a little piece about my experience with what some call Hashitoxicosis. It can be found at the link below.

If you suspect you have it, or have confirmed you have high TSI, high TPO and TG antibodies, you may want to check it out:

http://www.thyroidboards.com/hashitoxicosis


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## mememe (Mar 18, 2010)

What qualifies as "high" for these results? Do you mean if the results are over the "normal range", or if they are present at all? I'm confused since I've read over and over that we should have none of these at all, so in my mind, high would be positive. But in this case, I'm not so sure.:confused0024:


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## Andros (Aug 26, 2009)

mememe said:


> What qualifies as "high" for these results? Do you mean if the results are over the "normal range", or if they are present at all? I'm confused since I've read over and over that we should have none of these at all, so in my mind, high would be positive. But in this case, I'm not so sure.:confused0024:


It is true; a negative report (0) is what we want of the 3 listed above. But, the higher the result, the more suspicious they are . Especially related to cancer when it comes to the TPO and TgAb.

http://www.mdlinx.com/endocrinology...963/?news_id=811&newsdt=092010&subspec_id=419

http://www.labtestsonline.org/understanding/analytes/thyroid_antibodies/test.html


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## Tocra (Mar 25, 2011)

nasdaqphil said:


> I wrote a little piece about my experience with what some call Hashitoxicosis. It can be found at the link below.
> 
> If you suspect you have it, or have confirmed you have high TSI, high TPO and TG antibodies, you may want to check it out:
> 
> http://www.thyroidboards.com/hashitoxicosis


Wow, I think I suffer from this as well. I've been severely hypo for the last couple of years and now all of a sudden my thyroid is going nuts with fits of hyper for days sometimes, sometimes hours. I know when it will be a bad day because it will be painful in that area of my neck and my nodule will physically appear larger. This happened before it 07 but it was a whole lot worse. It did eventually calm down and became dormant for 4 years until a few weeks ago. I'm thinking of surgery as well but I am managing with Xanax and Thyroid Calm pills when it freaks. Both of which are very effective in my self-treatment. This combo seems to really calm it down (even for a few days sometimes) and will be pain free until it gets annoyed again. I'm going to see a new endo doctor and most likely a surgeon soon but have to wait.


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## Andros (Aug 26, 2009)

Tocra said:


> Wow, I think I suffer from this as well. I've been severely hypo for the last couple of years and now all of a sudden my thyroid is going nuts with fits of hyper for days sometimes, sometimes hours. I know when it will be a bad day because it will be painful in that area of my neck and my nodule will physically appear larger. This happened before it 07 but it was a whole lot worse. It did eventually calm down and became dormant for 4 years until a few weeks ago. I'm thinking of surgery as well but I am managing with Xanax and Thyroid Calm pills when it freaks. Both of which are very effective in my self-treatment. This combo seems to really calm it down (even for a few days sometimes) and will be pain free until it gets annoyed again. I'm going to see a new endo doctor and most likely a surgeon soon but have to wait.


Tocra................... glad you have posted. It would be very wise to get RAIU just to be sure you do not have cancer. We cannot second guess these things and I worry that you have been treating self w/o really having a true diagnosis.

Thyroid cancer symptoms
http://www.cityofhope.org/patient_care/treatments/thyroid-cancer/Pages/symptoms.aspx


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## Tocra (Mar 25, 2011)

Well the self treatment is while I wait to get to my new endo appt. The doc is booked solid but I might call again and see if I can get in earlier. I will also inquire about the RAIU. While I wait, my primary doc is getting my yearly ultrasound done followed by another FNA to make sure nothing changed. Last year my nodule was diagnosed as benign but to keep a close eye on it. I don't have any of the cancer symptoms except the pain but the pain comes and goes. And if it's cancer I will know soon enough. One thing for sure - it has grown. I just pray this new endo is good.


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## Andros (Aug 26, 2009)

Tocra said:


> Well the self treatment is while I wait to get to my new endo appt. The doc is booked solid but I might call again and see if I can get in earlier. I will also inquire about the RAIU. While I wait, my primary doc is getting my yearly ultrasound done followed by another FNA to make sure nothing changed. Last year my nodule was diagnosed as benign but to keep a close eye on it. I don't have any of the cancer symptoms except the pain but the pain comes and goes. And if it's cancer I will know soon enough. One thing for sure - it has grown. I just pray this new endo is good.


I understand the circumstances better now; thank you for clarifying. Yes..........you must do your best to take care of your self.

Here is hoping the endo "is" good and that you get the relief and medical intervention that you need. And I will pray for you and the endo.

This is serious in that we need to know exactly what the deal is here. Don't like the growing part either.


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## Respiratory (Apr 8, 2011)

I welcome all comments
I am 37 and first got diagnosed with Hyperthyroid when I was 27. It just came on, I believe due to stress. At the time the dr said i Had an auto immune disease, and I would probably go hypo or I may not. He said eventually my thyroid would burn itself out or correct. All this time I have seen several of the best endo dr's in my area. I went Hypo and started on 25 synthryoid, then In a bout a year went hyper, then hypo. I then started on 50 synthroid, and same thing. Then went to 75 synthroid, and have been on it two years. I just went hyper again. I went to the doctor , and I will go back in four weeks. He said even taking it out want 100 correct it. I don't want to do that because I have already gained so much weight. He said I would do this for the rest of my life. He said I had Hashimotos Thyroiditis, but when I researched it did not sound like that. My hr is very high, and I am having panic attacks. I am worn out. My fear is he will crash me out to hypo, and I will have to slowly come back up. You gain weight, can't get out of the bed, face is swollen . I feel awful. Has anyone else gone through this? I want stay hyper for more than 8 weeks I don't think, I usually don't. I need advice. I do have my labs, and as of 4/6/2011 I was still hyper but coming down.
I read the article in the first post, does this sound like what i am doing? I will stay hypo for a year or a little over before going hyper. I don't stay hyper but no more than two or three months or less


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## Andros (Aug 26, 2009)

Respiratory said:


> I welcome all comments
> I am 37 and first got diagnosed with Hyperthyroid when I was 27. It just came on, I believe due to stress. At the time the dr said i Had an auto immune disease, and I would probably go hypo or I may not. He said eventually my thyroid would burn itself out or correct. All this time I have seen several of the best endo dr's in my area. I went Hypo and started on 25 synthryoid, then In a bout a year went hyper, then hypo. I then started on 50 synthroid, and same thing. Then went to 75 synthroid, and have been on it two years. I just went hyper again. I went to the doctor , and I will go back in four weeks. He said even taking it out want 100 correct it. I don't want to do that because I have already gained so much weight. He said I would do this for the rest of my life. He said I had Hashimotos Thyroiditis, but when I researched it did not sound like that. My hr is very high, and I am having panic attacks. I am worn out. My fear is he will crash me out to hypo, and I will have to slowly come back up. You gain weight, can't get out of the bed, face is swollen . I feel awful. Has anyone else gone through this? I want stay hyper for more than 8 weeks I don't think, I usually don't. I need advice. I do have my labs, and as of 4/6/2011 I was still hyper but coming down.
> I read the article in the first post, does this sound like what i am doing? I will stay hypo for a year or a little over before going hyper. I don't stay hyper but no more than two or three months or less


Aha! I replied to your other post but I want to know what "you" think it is. I agree, I don't think you have Hashimoto's. I think you are hyperthyroid and have been flipping back and forth and each time you rebound, it comes back worse than ever?

Tell me; I am big on listening to your "inner doctor!" What do you sense about your situation and your body!










This would be a very important test for you to take.

TSI
Normally, there is no TSI in the blood. If TSI is found in the blood, this indicates that the thyroid stimulating immunoglobulin is the cause of the of a person's hyperthyroidism. 
http://www.medicineonline.com/topics/t/2/Thyroid-Stimulating-Immunoglobulin/TSI.html


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## Tocra (Mar 25, 2011)

Andros said:


> I understand the circumstances better now; thank you for clarifying. Yes..........you must do your best to take care of your self.
> 
> Here is hoping the endo "is" good and that you get the relief and medical intervention that you need. And I will pray for you and the endo.
> 
> This is serious in that we need to know exactly what the deal is here. Don't like the growing part either.


Yes me either. The pain coincides with the hyper symptoms but so far this week they have been very mild. Nothing like the past two weeks and I haven't had to use the Xanax much. I don't like taking it honesty but it's very useful when things go overboard. Hopefully my thyroid is calming down. I really appreciate your kind words and will keep you updated. BTW, I just had my ultrasound done. I should get the results back soon. Next is the endo... Hopefully he can help.


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## Andros (Aug 26, 2009)

Tocra said:


> Yes me either. The pain coincides with the hyper symptoms but so far this week they have been very mild. Nothing like the past two weeks and I haven't had to use the Xanax much. I don't like taking it honesty but it's very useful when things go overboard. Hopefully my thyroid is calming down. I really appreciate your kind words and will keep you updated. BTW, I just had my ultrasound done. I should get the results back soon. Next is the endo... Hopefully he can help.


Hope you can share the ultra-sound results when they come in. I am sure many of us will be most interested and may have some helpful comments.


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## Lizbeth11 (Aug 30, 2011)

I got on this forum just today to find out why I cycle between hypo and hyperthyroidism, and this is immediately what caught my eye! I know enough that I need to listen to my body and not go strictly by the numbers, and this was such an eye opener! I can't afford to get repeatedly tested and had relied on (hypo) symptoms to adjust my medication upward, but I got confused when I started feeling hyper again, something that hadn't happened since I'd started Armour Thyroid. I was diagnosed with Hashimoto's a couple of years ago, and my doctor did mention that a person could cycle between hypo and hyper, but for some reason I thought those days were over. Probably because of my age. I do remember being sluggish for a long while, then really energetic and not sleeping, also for quite a while. I (mistakenly) thought I'd reached a time when my thyroid was so depleted I'd not feel hyper anymore. Several years back I'd gone through a hyper period that resulted in severe weight loss and I was sent to an eating disorders unit, where they did lots and lots of tests and came up with nothing. When they gave me Prozac my weight shot up immediately. After a month of "treatment" (mostly antidepressants) I was heavier than I had ever been in my life. I was severely lectured for gaining weight, even though I ate only what the hospital gave me! Cut to present day. After finding a doctor who has treated a lot of thyroid patients and seemed to have a fair amount of knowledge on the subject, I am now taking Armour Thyroid. I was up to 180mg daily and had easily lost 30 pounds. I was feeling great and exercising and sleeping well and my brain fog had mostly dissipated. Then along came my current symptoms of sleeplessness and intense hot flashes (I'm post menopausal and don't normally have those anymore) I cut back my medication and am now taking only 60mg. I don't know how long this phase will last, and if and when to start going up on my thyroid medicine dosage. I know I probably need to see a doctor, but I wanted to have some anecdotal information first. Oh, and I also changed my diet to no sugar and no grains, and am wondering if that had anything to do with the onset of hyper symptoms. I don't know why it should, but who knows?


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## chopper (Mar 4, 2007)

Lizbeth11 said:


> I got on this forum just today to find out why I cycle between hypo and hyperthyroidism, and this is immediately what caught my eye! I know enough that I need to listen to my body and not go strictly by the numbers, and this was such an eye opener! I can't afford to get repeatedly tested and had relied on (hypo) symptoms to adjust my medication upward, but I got confused when I started feeling hyper again, something that hadn't happened since I'd started Armour Thyroid. The length of time between hypo and hyper seemed to last quite a while, but I (mistakenly) thought I'd reached a time when my thyroid was so depleted I'd not feel hyper anymore. Several years back I'd gone through a hyper period that resulted in severe weight loss and I was sent to an eating disorders unit, where they did lots and lots of tests and came up with nothing. When they gave me Prozac my weight shot up immediately. I was heavier than I had ever been in my life. (I was severely lectured for gaining weight, even though I ate only what the hospital gave me!) Cut to present day. After finding a doctor who has treated a lot of thyroid patients and seemed to have a fair amount of knowledge on the subject, I am now taking Armour Thyroid. I was up to 180mg daily and had easily lost 30 pounds. I was feeling great and exercising and sleeping well and my brain fog had mostly dissipated. Then along came my current symptoms of sleeplessness and intense hot flashes (I'm post menopausal and don't normally have those anymore) I cut back my medication and am now taking only 60mg. I don't know how long this phase will last, and if and when to start going up on my thyroid medicine dosage. I know I probably need to see a doctor, but I wanted to have some anecdotal information first. Oh, and I also changed my diet to no sugar and no grains, and am wondering if that had anything to do with the onset of hyper symptoms. I don't know why it should, but who knows?


Hi Lizbeth and welcome.

Adjusting your dose for the symptoms of the day does nothing really. The symptoms you are feeling now are a result of the hormone your thyroid produced 3, 4, even 6 weeks ago.

When you lower your dose like that you don't know if your body is putting out a lot or a little natural hormone on its own. T4 lasts a long time - like 6 weeks. T3, which Armour does have in it, lasts a short period of time but even so, adding or subtracting that short burst of T3 isn't really going to do much to control the symptoms.

Say you are taking 100 mcg of Synthroid every day for a year and decide today you are hyper feeling. That hyper feeling is not really a result of what is happening right now. 4 weeks ago your thyroid might have kicked into overdrive and dumped out some extra hormone which is why you are feeling it now. If you cut your dose now, you'll have no idea what your thyroid is really doing at this moment in time. That's one of the biggest problems with this disease. It's very difficult to titrate (adjust doses correctly).

Sounds like your thyroid is out of control.


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## Andros (Aug 26, 2009)

Lizbeth11 said:


> I got on this forum just today to find out why I cycle between hypo and hyperthyroidism, and this is immediately what caught my eye! I know enough that I need to listen to my body and not go strictly by the numbers, and this was such an eye opener! I can't afford to get repeatedly tested and had relied on (hypo) symptoms to adjust my medication upward, but I got confused when I started feeling hyper again, something that hadn't happened since I'd started Armour Thyroid. I was diagnosed with Hashimoto's a couple of years ago, and my doctor did mention that a person could cycle between hypo and hyper, but for some reason I thought those days were over. Probably because of my age. I do remember being sluggish for a long while, then really energetic and not sleeping, also for quite a while. I (mistakenly) thought I'd reached a time when my thyroid was so depleted I'd not feel hyper anymore. Several years back I'd gone through a hyper period that resulted in severe weight loss and I was sent to an eating disorders unit, where they did lots and lots of tests and came up with nothing. When they gave me Prozac my weight shot up immediately. After a month of "treatment" (mostly antidepressants) I was heavier than I had ever been in my life. I was severely lectured for gaining weight, even though I ate only what the hospital gave me! Cut to present day. After finding a doctor who has treated a lot of thyroid patients and seemed to have a fair amount of knowledge on the subject, I am now taking Armour Thyroid. I was up to 180mg daily and had easily lost 30 pounds. I was feeling great and exercising and sleeping well and my brain fog had mostly dissipated. Then along came my current symptoms of sleeplessness and intense hot flashes (I'm post menopausal and don't normally have those anymore) I cut back my medication and am now taking only 60mg. I don't know how long this phase will last, and if and when to start going up on my thyroid medicine dosage. I know I probably need to see a doctor, but I wanted to have some anecdotal information first. Oh, and I also changed my diet to no sugar and no grains, and am wondering if that had anything to do with the onset of hyper symptoms. I don't know why it should, but who knows?


Welcome to the board! Sounds like you have really been through it.

Sometimes if you lose weight, you have to titrate your Armour down. That's about the only reason I can think of for your recent hyper feelings other than low ferritin.

Ferritin (should be 50 to 100; the closer to 100,the better) 
http://www.thewayup.com/newsletters/081504.htm


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## Lizbeth11 (Aug 30, 2011)

ACK! Now what do I do? Do I go back up to the dose I was taking before I felt symptoms? Desperate, rhetorical questioning.

Has anyone heard about naltrexone therapy for autoimmune disease? I'm desperate to try SOMETHING. I feel so hot I'd like to crawl out of my skin, and sleep is so elusive.

And now I'm suspecting Sjogren's. Strange symptoms I've had on and off for years seem to point to this. Heard a report today that two markers are dry eyes dry mouth, which I've had all my life. Intermittent, unexplainable fatigue and feeling like I'm coming down with a cold, but I never come down with a cold.

DRATS!


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## Andros (Aug 26, 2009)

Lizbeth11 said:


> ACK! Now what do I do? Do I go back up to the dose I was taking before I felt symptoms? Desperate, rhetorical questioning.
> 
> Has anyone heard about naltrexone therapy for autoimmune disease? I'm desperate to try SOMETHING. I feel so hot I'd like to crawl out of my skin, and sleep is so elusive.
> 
> ...


When it comes to adjusting meds, the best thing is to get labs and confer w/your doctor. After all, you do want to get it right so that you feel good.

Free T3 and Free T4 are the only accurate measurement of the actual active thyroid hormone levels in the body. This is the hormone that is actually free and exerting effect on the cells. These are the thyroid hormones that count.
http://www.drlam.com/articles/hypothyroidism.asp?page=3

I have heard of the use of Naltrexone for autoimmune. I personally would not care to use such a pharmaceutical.

http://www.drugs.com/sfx/naltrexone-side-effects.html


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## Texaschick (May 26, 2012)

I have a question...I am new to this - was diagnosed in Feb. I read an article that left me confused...what is considered high TPO and moderate TPO? Thank you.


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## sjmjuly (Mar 23, 2012)

Texaschick said:


> I have a question...I am new to this - was diagnosed in Feb. I read an article that left me confused...what is considered high TPO and moderate TPO? Thank you.


I am no expert, but anything above normal, well, isn't normal. But, I think the higher they are the better chance for cancer? I could be totally wrong and this is just a guess. Mine were 439 (TPO) when diagnosed and went down to 290. I have seen some people with them in the 1,000's. 
I don't know what is considered low, moderate or high. Maybe someone else here would know.


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## chopper (Mar 4, 2007)

Im not sure if that is true with TPO Ab's. TG (Thyroglobulin antibodies), yes, it is a known marker for cancer but still does not mean you have cancer if TG is high.

The level of TPO will fluctuate with Hashimotos. Anything above normal is not normal. In fact, any at all is not normal. Moderate and High have no real meaning. Mine go from 900 to >3000 and the only thing I notice is that I feel a little shittier when the antibodies are raging high. The lower they are, the less symptomatic you are, typically but its different for everyone and they do change daily.

Anywhere over 800 or so is considered "pretty high". Once you get into the 2000+ range, you are really pretty high but most tests don't even go that high. It will just say something like "greater than 1500" or something like that.

TG = cancer marker for those who have had cancer in the past.
TPO is the most common Hashimotos antibody.
TSI is common in Graves and those with Hashitoxicosis.

You can have one, 2 or all 3 at the same time. I do but my TG is usually pretty low compared to the others.


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## Andros (Aug 26, 2009)

sjmjuly said:


> I am no expert, but anything above normal, well, isn't normal. But, I think the higher they are the better chance for cancer? I could be totally wrong and this is just a guess. Mine were 439 (TPO) when diagnosed and went down to 290. I have seen some people with them in the 1,000's.
> I don't know what is considered low, moderate or high. Maybe someone else here would know.


You should have a low titer of TPO but the well person should not have any TPO Ab.

Please read............

Anti-microsomal Antibodies- TPO Ab
Negative test is normal; you should not have any of these antibodies. And the healthy person does have a low titer of TPO.
http://www.nlm.nih.gov/medlineplus/ency/article/003556.htm

Alternative NamesThyroid antimicrosomal antibody; Antimicrosomal antibody; Microsomal antibody; Thyroid peroxidase antibody; TPOAb

This antibody, historically referred to as the anti-microsomal antibody, is established as a sensitive tool for the detection of early subclinical autoimmune thyroid diseases, follow up of the response to immunotherapy and identification of at-risk cases for autoimmune thyroid diseases [8].

http://www.biomedcentral.com/1471-5945/6/3

High TPO is "suggestive" of many things; including cancer so these things (all of them) should be ruled in or ruled out.


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## PinkLemonLady (Mar 27, 2013)

How would the TSI be listed on the lab? The last lab I had it shows as follows:

TPO >1000
TG 24

Then I have TSH autoantibody which is negative... is this the TSI?


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## Andros (Aug 26, 2009)

PinkLemonLady said:


> How would the TSI be listed on the lab? The last lab I had it shows as follows:
> 
> TPO >1000
> TG 24
> ...


TSI is Thyroid Stimulating Immunoglobulin.

You may find this link very useful.
http://www.aruplab.com/Testing-Info...d Stimulating Immunoglobulins (TSI) Assay.pdf


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## Tiffy1367 (Aug 28, 2013)

It would be fascinating to find out that is why my results were so odd and why I sometimes have mixed symptoms. Lately, I lost weight after gaining it suddenly. It just keeps cycling. Here's my story. I am new to thyroid problems. http://www.thyroidboards.com/showthread.php?t=9333


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## pomee (Aug 27, 2013)

Thank you so much for the incredible information. I haven't had the other two antibodies tested yet (just TPO Ab), and my Ab wasn't nearly as high as yours. But symptomatically, your experience sounds very similar to mine. 
My numbers are yo-yoing up and down, they've switched my dosage three times this year. And I keep suffering from long-term low-grade fevers. Normally my temp is around 97.5, but then I'll go a week or so at 99.5 and I get the heart palpitations, hyper feeling and just general freaked outness. 
Then, once that abates, I go back into achy, exhausted slumps. Both swings stink, but I agree Hyper is definitely more frightening.
Thanks again for all the great info. I'll have to check with my endo to see if she can be persuaded to test for the other two antibodies.


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## nathalie0807 (Jun 20, 2015)

Hello I am new to this forum, I am only a teenager but have been recently diagnosed with hashimoto's. My antibodies (tpo) is above 3000 and reading that this could indicate cancer worries me very much. I had an episode after my dosage was increased rather quickly by the hospitals here, where my heart hurt and I thought I was having heart attacks every hour. I could not eat or drink, I was short of breath and in and out of the ER. They gave me medicine for toxicosis and it only made me cry and hallucinate. My heart still worries me, since my body obviously is under a lot of stress due to the antibodies and what not.
I have been researching and it says that a theory is, hashi's is linked to other infections, so I will try to get some tests done as well as an ultrasound / scan of my thyroid.
Glad to be a part of this forum, it helps a lot mentally. I am sure there is something else lurking beneath my diagnosis, I just hope it is not cancer, and it is one of these curable infections...


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## Andros (Aug 26, 2009)

Substances not found in normal serum (scroll down to autoantibodies)
http://www.thyroidmanager.org/chapter/evaluation-of-thyroid-function-in-health-and-disease/
(Copy and paste into your browser)

TPO and thyroglobulin
http://onlinelibrary.wiley.com/doi/10.1111/j.1699-0463.1994.tb04888.x/abstract
http://www.wikigenes.org/e/gene/e/7173.html
(Copy and paste into your browser)

Understanding Thyroglobulin Ab.
http://www.labtestsonline.org/understanding/analytes/thyroglobulin/test.html
(Copy and paste into your browser)

Have you had an ultra-sound of your thyroid yet? I am so worried for you. That is very very high TPO and yes, it does suggest cancer.

Hopefully your parents are involved in your medical intervention?

It would be good to get Thyroglobulin Ab test also.

What symptoms have you been having that led to your diagnosis?

Welcome and sending many hugs your way!


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