# Please - do I have Hashi's??



## ifthespiritmovesme (Jan 8, 2014)

TPO 17 <35

THYROID STIMULATING IMMUNOGLOBULINS ACTUAL/NORMAL 64 % <140

THYROGLOBULIN 93.7 2.0 - 35

THYROGLOBULIN AB <20 2.0 - 35

THYROXINE BINDING GLOBULIN 21.2 13.5 - 30.9

Ok, I've been sure of my problems and able to communicate this to my physicians.Now I am lost - what the heck do these antibodies indicate? Please, no links for me to follow. Do these results indicate Hashi's?

Doubling Levothyroxine to .050,resulted in my TSH going from 1.70 to 0.43, my FT4 went from 1.0 to 0.9.My FT3 increased slightly. What the H___ is going on?

PLEASE give me your opinions, guesses, anything at all.

Thanks much in advance


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## Lovlkn (Dec 20, 2009)

Have you had a sonogram of your thyroid?


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## ifthespiritmovesme (Jan 8, 2014)

Yes - 3 nodules on the right side. FNA in March resulted inb "No cancer"


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## surge (Aug 15, 2012)

Hmm. this is a good question. Something is afoot. It's not yet a slam dunk for Hashi's, but certainly, you're in the running. If I'm your endo, (which I should probably mention I am not. Not your endo, not anyone's endo...not a doctor, at all.) I don't call it Hashi's yet. Not by the numbers.

But the strange response to meds is almost more indicative than the antibody tests to me. This is a typical hashis story to me, that the labs don't seem to sync with the symptoms. I think it'll be hard to find a doc willing to give you more T4 with that tsh, but, well, your t4 certainly looks like you need more t4. At least you have that number to back you up. I do remember there's a particular antibody that binds and monkeys with the test results. I don't remember the name, but I know Andros has info on it that she's talked about/linked to previously. Can you search her replies or search some of the information files, like maybe in the lab results section? Anyway, I guess I wonder if that is part of the problem, meaning your lab results aren't actually that useful. Now, what you do with that hunch, I have no idea.


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## ifthespiritmovesme (Jan 8, 2014)

Thanks,Surge. I have followed all of Andros links,but they don't really answer my confusion

I've been certain (and correct) about everything till now. Round and round we go . I asked to see an ENT - he wants me to see Endo again. {problem is, they think TSH results are EVERYTHING.) I just told my PCP I will NOT live with this problem any longer. May 9 I'll write my congressman, By June 1st, I'm either on my way to being fixed, or I am not going on. I am done. I've been so sick for decades without ANY help. I will not live like this anymore.My BP falls really low (78/42) and my heart rate jumps up to 90 with afib and me passing out. I am really pushing to see a private integrative physician. (I'm a Veteran dealing with the VA). I really need to have some idea what is happening to me/ This BP and the antibodies are frankly freaking me out. Xanax gets me thru my days at this point. It has just gotten too much for me to deal with.


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## ifthespiritmovesme (Jan 8, 2014)

By the way - how do they come to a Hashi's diagnosis. I thought antibodies confirmed it???


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## bigfoot (May 13, 2011)

I'm not really up on how the VA works internally (or doesn't work), but I think your idea to get outside their little box and see someone else is an excellent one. You absolutely need somebody who is going to look at the whole picture. Whether that's a more 'alternative' MD, DO, or ND. Heck, even just an open-minded MD. Also, I don't know if they've tested for this or not, but they can check Reverse T3 level with labs. If you have a lot of Reverse T3, it can be a big sign that your body isn't properly converting the T4 -> Free T3 (active form), but instead shunting it over from T4 -> Reverse T3 (inactive form). This Reverse T3 binds and ties up the T3 receptors, basically making it very tough for the Free T3 to be absorbed where it is needed. So on paper you wind up looking great, but in real life feel completely awful. They also call this "Euthyroid Sick Syndrome" or something to that effect.

You mentioned having a spike in your pulse, a low BP, A-fib, and passing out -- have they sent you to see a cardiologist? I would think that would be a good consult, at least to rule in (or rule out) any heart issues.

Here's some other stuff to look into. Some of these can mimic thyroid stuff or run alongside with it:

- 24 hour Cortisol testing (either saliva or urine collection, broken into different time periods).

- Sex hormones like low testosterone (or even high E2 Estradiol).

- Lyme disease, EBV/Mono, infectious diseases.

- Liver problems such as hepatitis, GI problems, Celiac disease, gluten sensitivity (not the same as Celiac).

- Random stuff like C Reactive Protein, Sed Rate, RA Factor.

- Vertigo, especially BPV.

- Metal toxicity, other environmental issues, allergies.

- Hashimoto's Encephalopathy (aka "SREAT"). Lots of weird stuff can happen with this one.

- Other autoimmune workups if needed - RA, Lupus, Sjogrens, etc.

- Cardiologist, Neurologist, Infectious Disease consults.

As you know, TSH is not really a good diagnostic tool. The Free T3 and Free T4 is really where it's at. If you're dealing with an autoimmune thyroid issues, those binding, blocking, and stimulating antibodies can be a real PITA. Problem is, when you get labs done, it's just a snapshot in time. Tomorrow, next week, or next month they could be totally different. And the 50 mcg of T4 they gave you isn't much if you're truly hypothyroid (whether or not the labs reflect that). Then again, I've read that with heart issues, they do start lower with T4 at 25 mcg. Whether you're able to handle taking any T3 (whether as Cytomel or a combined T4/T3 such as Armour or Nature-Throid), which may or may not help, is something you'd want to look into with that heart stuff. Again, it kinda comes back to getting a cardiologist to look at you. Hell, even a neurologist consult would be a good idea, too.

Argh -- I just love how they throw some Xanax at you and send you on your way. Maybe that works as a short-term band-aid solution to get you by, but it does absolutely *nothing* to investigate and address the root causes of things going on. It's also not supposed to be used long-term. <rant off>


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## ifthespiritmovesme (Jan 8, 2014)

Thanks Bigfoot - really helpful info. I've had some of what you mentioned (sed rate and metals),but much of it are tests that are not authorized (I've been denied,delayed and dismissed for the most part) At least now I can start asking for more tests, since my letter to the director at least got me the antibody tests that were denied for so long. I'll try again, since they now cannot say I don't have a problem.

Yeah,all the Xanax does is make me dumb and sleepy. I actually feel really drunk when I take it with my muscle relaxer, so that's not a solution I am particularly happy with. I have a few months worth socked away - my way of making sure this problem is alleviated one way or another. I am so tired of fighting for every little thing, and sick of being sick.

Thanks again...


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## joplin1975 (Jul 21, 2011)

ifthespiritmovesme said:


> By the way - how do they come to a Hashi's diagnosis. I thought antibodies confirmed it???


Many doctors use the presence of antibodies, but the "gold standard" is biopsy with the presence of hurthle cells indigenous to autoimmune thyroid disease.

Just looking at your antibodies, I would be thinking more along the lines of early Grave's Disease.


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## ifthespiritmovesme (Jan 8, 2014)

Oh,wow. Isn't Graves associated with HypEr ? My sister had graves - buggy eyes and all. had a goiter too. I don't,and my metabolism is definitely slow. I have a low body temp and low BP.....I've been hypo for 35+ years...crap


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## joplin1975 (Jul 21, 2011)

Generally, yes, but remember thyroid issues do not follow a straight path.

The fact that you have TSI, TBG and very low levels of TPO sort of makes it look Grave's like.

Have you had a radioiodine uptake scan (RAIU)? That might be helpful.


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## ifthespiritmovesme (Jan 8, 2014)

No - I'll have to fight for that too, probably. Doesn't that kill the thyroid? I saw an ENT yesterday. He checked my vocal chords - they're inflamed,as usual in hypo people. Wants to send me back to Endo. If they talk to me,it better be by phone, because if I see him in person,I'll be tempted to break his nose.


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## joplin1975 (Jul 21, 2011)

No, it does not kill the thyroid.

There's RAI, which uses the iodine isotope 131 and that isotope will kill the thyroid.

Then there's RAIU, which uses the iodine istope 123 and at very, very low levels. This isotope is only used as a "marker" (or, more or less like a contrast dye) so they can see how well your thyroid is functioning. The more uptake, the more hyper you are. The lower the uptake, the more you lean toward hypo. It can also detect nodules and if the nodules are "cold" (non-functioning) or "hot" (hyper functioning).


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## ifthespiritmovesme (Jan 8, 2014)

Well, I'll try to get that test then. God,this is so difficult when they look at TSH and say you're fine,and are so resistant to testing for anything....Maybe 'll get lucky and they'll use the 131 by mistake...

Thank you so much for all your help and info. Now to continue the fight.


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## lainey (Aug 26, 2010)

For the record, you need to be off meds for 6 weeks before an uptake scan. These are revealing for structural issues (nodules, which you have had biopsies) or functional issues--it will tell if your thyroid is "functioning" normally or not.

With both sets of antibodies, this test is not always that revealing.

What your issue is, with all sets of antibodies, is often called "hashitoxicosis"--there is a separate thread here with people in the same boat as you. People with stimulating and blocking antibodies often struggle to get results from replacement medication, as the antibodies alternately stimulate and block the thyroid--their numbers tend to be pretty variable on their own.

Generally, in this situation a doc will discredit the TSI because it is not over the %value of the lab. The options generally are: wait for the thyroid to burn out or find a doc that will treat it seriously with RAI or surgery.

Read more here:

http://thyroidboards.com/forums/forum/20-hashitoxicosis-forum-only-for-those-with-high-tpo-ab-tg-ab-and-high-tsi/


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## ifthespiritmovesme (Jan 8, 2014)

Thank you,Lainey. I'll have to read through the post there to see if I can glean more info. Right now, though, I'm taking a couple Xanax and going to bed. Just too upset and overwhelmed to function right now

Thank you again..


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