# Andros...question about my upcoming appointment....



## Gam87 (Feb 5, 2011)

Hi Andros, you answered some questions for me a few weeks ago and I wanted to follow up with some more questions. I am the one from Marietta that you directed to the Georgia Yahoo group. Well I made an appt. With a new doc based on some comments from the girls over there. I am hopeful that he will be able to help. To refresh, my last labs were:
TSH 1.5
FT3 2.8 (2.0-4.4)
FT4 1.45 (.82-1.77)
RT3 438 (90-350) H
TPO Ab 8 (0-34)
TSI 100 (0-130)

I am having tons of classic hyper symptoms (including racing heart....i woke up from a dead sleep the other night with 130 bpm) yet my FT3 looks more hypo since it is only about 30% of the lab range. So I am wondering what kind of treatment possibilities I should ask this doctor about. I don't really understand what you do when you have these normal or low normal labs yet you have TSI and clear hyper symptoms. Do you basically have to wait it out 
until your labs go out of range? Do you still suggest I get RAIU? What will that tell me? Are there any risks to it? What about an ultrasound? Sorry for having tons of questions...I just want to be as educated as possible when I go in there and be able to push for certain tests/treatment plans. Thanks so much for your help!


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## Andros (Aug 26, 2009)

Gam87 said:


> Hi Andros, you answered some questions for me a few weeks ago and I wanted to follow up with some more questions. I am the one from Marietta that you directed to the Georgia Yahoo group. Well I made an appt. With a new doc based on some comments from the girls over there. I am hopeful that he will be able to help. To refresh, my last labs were:
> TSH 1.5
> FT3 2.8 (2.0-4.4)
> FT4 1.45 (.82-1.77)
> ...


Hi and so good to hear from you! Here is the scoop as I see it. TSI is definitely the cause of hyperthyroid. If you have it, you are hyper. But, the binding and blocking antibodies will keep your labs in normal range and you may even feel hypo at times because of this but in truth you are not.

RAIU is very very important as hyperthyroid and cancer are bedfellows in many instances. I personally would not be satisfied w/ a sonogram as they have their limitations both technical and human-wise.

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

Graves' (hyper) and Hashi's cancer
http://www.thyroidmanager.org/Chapter18/18-cancothr.htm

Not to mention the fact that your FT3 is converting to RT3 which does mean that antibodies are blocking the receptor sites.

rT3
http://thyroid-rt3.com/whatis.htm

I am so so glad to hear from you and please do keep me updated.


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## Gam87 (Feb 5, 2011)

Thank you for the quick reply. So does the TSI indicate Graves? Do you think if I let this go would my labs eventually accurately reflect my symptoms?


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## midgetmaid (Jul 22, 2010)

TSI indicates hyperthyroidism. If it's over 130, some docs consider this positive for Graves.

Renee


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