# Only Red Flag is Thyroglobulin Antibodies



## txspring

Here are the labs I have. Are these results saying I am "okay" thyroid wise? I haven't met with the internist yet. But, that is the impression I got from her note. Tell me if I'm chasing my tail here, please! I appreciate any insight you can provide.

~ Dana

October 2, 2013

TSH - .839 (.450 - 4.5)
Throxine (T4) - 11.1 (4.5 - 12.0)
T3 Uptake - 30 (24 - 39)
Free Thyroxine Index - 3.3 (1.2 - 4.9)

Initial Symptoms: hair loss (not clumps, just shedding A LOT more) and urinating more often

March 21, 2014

TSH - .687 (.450 - 4.5)
Throxine (T4) - 11.4 (4.5 - 12.0)
T3 Uptake - 31 (24 - 39)
Free Thyroxine Index - 3.5 (1.2 - 4.9)

Additional Symptoms: Hair loss, muscle weakness and tingling, eye blurriness and pressure, throat pressure, higher resting heart rate (80-100), some heart palpitations and feeling out of breath even with little movements, jittery feeling inside, sometimes low grade fever.

April 4, 2014

Thyroglobulin, Antibody - 1.1 (0-.9) high

C-Peptide, Serum - 3.5 (1.1-4.4)

Thyroid Stim Immunoglobulin - 58% (0-139)

GAD-65 - <1.0 (0.0-1.5)

ANA Direct - Negative (Negative)

Thyroid Peroxidase (TPO) Ab - 9 (0-34)

Triiodothyronine, Free, Serum - 3.3 (2.0-4.4)

Anti-Myelin Assoc. Gly. IgM - <1:10 Titer Negative

Cortisol AM - 10.9 (2.3-19.4)

(I just did the saliva version of this today)

Celiac Panel

Deamidated Gliadin Abs, IgA - 2 units (0-19 negative)

Deamidated Gliadin Abs, IgG - 1 unit (0-19 negative)

t-Transglutaminase (tTG) IgA - <2 (0-3 negative)

t-Transglutaminase (tTG) IgG - 2 (0-5 negative)

April 4, 2014 Ultrasound

She spent all of three minutes doing the u/s. There was an emergency case come in and she rushed out. Given the pressure I feel in my throat and that I can even see it looks enlarged, is it possible she missed something?

Findings:
Right lobe 5.3 x 1.4 x 2.2 cm heterogeneous without focal lesions, hypervascular

Left lobe 5.2 x 1.4 x 1.9 cm
Heterogeneous without without focal lesions, hypervascular

Impression:
Both lobes of the thyroid are without discrete thyroid masses evident.


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## Andros

TPO Ab
Mild to moderately elevated levels of thyroid antibodies may be found in a variety of thyroid and autoimmune disorders, such as thyroid cancer, Type 1 diabetes, rheumatoid arthritis, pernicious anemia, and autoimmune collagen vascular diseases. Significantly increased concentrations most frequently indicate thyroid autoimmune diseases such as Hashimoto thyroiditis and Graves disease.
http://labtestsonline.org/understanding/analytes/thyroid-antibodies/tab/test
(Copy and paste into your browser)

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)

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.

Negative test results means that the autoantibodies are not present in the blood at the time of testing and may indicate that symptoms are due to a cause other than autoimmune. However, a certain percentage of people who have autoimmune thyroid disease do not have autoantibodies. If it is suspected that the autoantibodies may develop over time, as may happen with some autoimmune disorders, then repeat testing may be done at a later date.
http://labtestsonline.org/understanding/analytes/thyroid-antibodies/tab/test
(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)

You appear hyperthyroid and you have several red flags; not just one. You have TPO, you have TSI @ 58% when you should not have any of either one. Thyroglobulin Ab is high.

It is very important that cancer be ruled out here and TSI is definitive of hyperthyroid activity. Many times the 2 go hand in hand. Hypervascular "suggests" an independent source of blood supply.

If I were making the decision, I would see an ENT.

Please let us know what transpires and I have posted some links that you may wish to read.

Sending hugs,


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## txspring

Oh Andros! Thank you so much. I've been waiting, hoping someone would chime in and give me some direction. It's such a helpless feeling to feel like something is wrong and not know what to do about it. I thought I remembered you posting on other threads that having any antibodies is not normal, but I just wasn't sure. I will read these links and see an ENT. Thanks again.


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## Andros

I am so glad you are going to see an ENT about all of this. Please let us know when your appt. is set up!

Sending caring hugs,


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## txspring

My sister recommended hers and she lists thyroid issues and surgery on her website. So, hopefully she is good. I have an appointment for 4/21.


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## txspring

I am seeing the ENT on Monday. I have just received some other lab tests and my estrogen is low. Any thoughts?

Estradiol - 33.4 (43.8-211) LOW

Estrogens, Total - 61 (156-350) LOW

Free Testosterone (Direct) - .2 (0-2.2)

FSH, Serum - 4.2 (1.7-7.7)

Pregnenolone, MS - 77 (<151)

Progesterone - 4.5 (1.7-27)

Salivary Cortisol

8AM - .287 (.025-.6)

12PM - .119 (<.010-.330)

4PM - .017 (.010-.200)

11PM - .021 (range is for midnight <.010-.090)


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## Andros

Right now; the energy should be focused on your thyroid situation. If that is corrected, oftentimes the other hormones return to normal.

Good luck tomorrow and please let us know!

Hugs,


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## txspring

Thank you. I will let you know how it goes!


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## txspring

Ent thinks I should see an endocrinologist. She checked my hearing because of the "woozy" feelings I have and it is all fine.

Thyroid is definitely enlarged. Mentioned hashimotos and says it makes you swing back and forth between hyper and hypo which would explain why I dont always have the hyper symptoms? She didn't think the antibodies were " That high", so whatever! It's all so confusing!

I have my next appt with the internist on may 1.So, I guess we will discuss it all then.


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## txspring

I had a really good appointment with my internist yesterday. It is nice to come in to your appointment with a list of questions and have the doctor address ALL of them before you even have to ask. She spent 45 minutes with me and I feel much better emotionally, just having some more direction on what to do and also validation that there is something going on.

She commented several times that she could clearly see how enlarged my thyroid was and that it appears to be getting bigger (compared to my last appt). This coincides with the fact that my throat pressure feeling is worsening and I feel it all the time now. I can even see how it looks bigger now and when this all started I couldn't really see anything.

Basically, my thyroid is really "pissed off". These were her words. J It is spurting out too much thyroid hormone which makes me feel jittery and warm and like I'm running around (when I'm not). Then, I "crash" from this because my body is working too hard. Sound familiar?

Here are the "highlights" from my appointment:

· My heart rate is high and my pulse is bounding almost all the time. So, she is having me monitor that and will put me on beta blockers to protect my heart if need be. This part is mostly just annoying and unnerving, so I just need to watch it and let her know if it is getting worse. It was "nice" that my pulse was 95 in her office so she could see what it is doing.

· The ultrasound of my thyroid that I had done a month ago was not normal. I thought it was normal because the report I saw didn't really give any kind of diagnosis on it. I don't have any nodules, which is good, but it is large and heterogeneous, which means it's texture is bumpy (not as it should be) and hypervascular which means lots of blood flow.

· My labs from April pretty much ruled out (as much as you can) other big issues, like MS or Lupus. I also don't have any sensitivities to gluten or other things that she wanted to check.

· Many of my other symptoms - dizziness, muscle weakness - can also be explained by the fact that my estrogen and progesterone are extremely low. My thyroid is likely causing this. Basically, when it's off, it really screws with you.

· Dr. is re-running some of my tests from March and adding some - Reverse T3, Free T3, TPO Ab, TSH, Free T4, Total T4

· Dr. wants me to see an endocrinologist to:

o Find out specifically what disorder I have.

o Get a biopsy (fine needle).

o Make sure she's not missing anything, like pituitary gland problem

Thanks for reading. If you have any input or things I should look into, let me know.


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## joplin1975

I think that sounds like a really great comprehensive plan.


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## txspring

Thank you, Joplin!


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## txspring

Here are my lab results from May 1 (my old results are above):

TSH - .664 (.45-4.5)

Free T4 - 1.48 (.82-1.77)

Reverse T3 - 24.6 (9.2-24.1) HIGH

T4 - 10.8 (4.5-12)

TPO Ab - <6 (0-34)

Free T3 - 3.4 (2.0-4.4)

What does the high reverse T3 mean?


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## Andros

In your case that could mean that your body is putting out too much thyroxine and a "blocking antibody to the receptor site" is probably diverting it to where it is converting to rT3.

Speculation; of course!

You got very lucky with that good doctor. Just finished reading that post.

Hugs,


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## txspring

Thank you, Andros! I have endo appt June 23. He has been recommended by several people, I hope they're right!


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