# Hashitoxicosis and antibody results



## bjm2363 (Sep 6, 2010)

I got the lab work and the Uptake scan results. I am a little confused though because the lab work for Antibodies doesn't have TSI listed unless I am reading it wrong:
Scintigraphic and laboratory findings are most consistent with a mild productive Thyrotoxicosis. Consider Hasitoxicosis given discordant normal thyroid trapping in conjunction with low radioiodine uptake values at 4 and 24 hours. Grave's disease is unlikely here, given the low radioiodine uptake values. Recommend obtaining thyroid antibody studies to further evaluate for autoimmune thyroid disease.

9/02/10: TSH: .10 (.3 to 5.0) FT4: .85 (.7 to 1.48) FT3: 2.24 (1.71 to 3.71)
9/08/10: TSH: 1.0 FT4: .93 FT3 : 2.59 (same ranges as above)
Thyroglob: Ab <20 (<40) Anti TPO: <10 (<35) Thyroglob(q): 10.5* (<55)

*Thyroglob(q)
The presence of thyroglobulin antibodies interferes with thyroglobulin measurements. Even low levels of TG-Ab cause either falsely low or undetectable values. Undetectable serum TG results cannot be used to indicate the absence of tumor in patients with thyroglobulin antibodies.

I need help interpreting the above, were graves antibodies tested above and why would the doc take me off the beta blocker if he is indicating mild hyper in the letter to my PCP? Any thoughts on this?


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## lainey (Aug 26, 2010)

He didn't run the TSI, perhaps because he considers Graves' to be unlikely if your uptake was low--he seems to think it's more likely that you would be heading towards Hashi's.

However, the TSI would be nice to confirm/rule this out. It's hard to be definitive without it.

Your numbers are pretty normal at the moment. Hopefully he is recommending that you retest in a couple of months to see what direction things are going in.


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## bjm2363 (Sep 6, 2010)

I went for a second opinion with a doc I got from the Top Thyroid Doctor's website. This Endo said that I definitely have some type of Thyroiditis, but it is unclear as to whether it is Hashi's or Silent Thyroiditis. The fact that I had a low uptake indicates Thyroiditis, but he said antibodies were negative. So he is repeating the thyroid tests to check where I am at the present. He said the labs on 9/08/10 showed low- normal Thyroid levels and normal TSH. I can take the beta blocker as needed depending on my symptoms (heart-rate as settled to low 80's). However, I stopped taking it on Wednesday because in the beginning of the week I started to feel very tired, foggy brain, and having extreme trouble going to the bathroom (even taking miralax daily)! I feel very sluggish like I would be Hypo so it will be interesting to see what the labs show. The new Endo stated that sometimes thyroiditis can swing to low and not go back to normal, but remain low. Gosh, I don't know what is worse--the hyper stage and feeling so anxious with racing pulse or this sluggish, can't think, and just want to sleep stage. I am praying that the labs aren't normal because I would hate to feel this way for up to a year (doc said it may right itself after 1 year) and not get treatment ....ugggh..:sad0049: I should know something this weekend since he promised to call...


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## lainey (Aug 26, 2010)

Unfortunately it is difficult to treat someone who is swinging from hyper to hypo and back, because you no sooner start on meds for one stage, and your body can send you in the other direction.

Most doctors have you wait it out until your levels fall into a range where they can treat you with confidence. The alternative is something called "block and replace", where you take antithyroid drugs for hyper and replacement hormone at the same time, to get your levels to stay consistent. A very few doctors will do this--but it is something to ask about.


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## bjm2363 (Sep 6, 2010)

Thanks for the reply Lainey. The new Endo called last night and told me that even though my labs are borderline normal, he thinks I am now heading toward Hypo. He said my labs were:

TSH: 2.98
T4: 8.8
My sed rate was normal

**sorry, but I don't have the results yet to get the lab ranges. He is mailing them. I have to go back and see him in 6 weeks to determine where this thyroiditis is headed. Until then no meds except the beta blocker (if I get a hyper symptoms again). I have beat and the brain fog is annoying...it will be a long 6 weeks.
Does anyone know if the T4 listed is low? I believe it is total T4.


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