# Does this only mean Grave's or possibly something else??



## th66 (Mar 9, 2013)

Hi,
I'm new here...
I have had a variety of sudden uncomfortable symptoms, with the worst being a woozy drunk feeling, panic and anxiety, bladder urgency, for almost 2 years. Had the "million dollar workup" and I am perfectly healthy. Took the doctors a year to notice I had a positive ANA with very high thyroid antibodies. I have seen 3 endocrinologists because my blood levels are smack in the middle of normal range, so no one will help me. I have seen some of the best endocrinologists at UCLA as well as cedars. One of them at our visit says I have Hashimotos AND graves. STrange that the other doc did not mention that. He tested my TSI and it came back at 389, with the range being 0-139. He believes that the 2 autoimmune diseases are playing a tug-o-war and thats why my blood levels stay normal. I saw the next doctor who had many more years experience, and he said I only had Hashimotos...not graves. I'm very confused by this. Would the TSI show that high with just hashimotos? why would a doctor thnk differently if the test is right there?
On my latest labs, here's what it says...
Anti-thyroglobulin antibodies(anti-Tg) - 4.5 ( > or = 2.0 positive)
Anti-TPO - 176 (HIGH) (normal= < 9.0)
TSH Receptor Antibody (TBII) - 1.2 (1.1 - 1.5 U/L = equivocal)
Free thyroxine by dialysis and Mass spectrometry - 1.1 (normal 0.8-1.7)
TSH-ICMA - 2.2 (normal= 0.5 - 4.8)
T-3 , serum - 102 (normal= 55-170)
TSI - 389 % (HIGH) (normal = 0-139)
can anybody make anything out of this?
thank you


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## Andros (Aug 26, 2009)

th66 said:


> Hi,
> I'm new here...
> I have had a variety of sudden uncomfortable symptoms, with the worst being a woozy drunk feeling, panic and anxiety, bladder urgency, for almost 2 years. Had the "million dollar workup" and I am perfectly healthy. Took the doctors a year to notice I had a positive ANA with very high thyroid antibodies. I have seen 3 endocrinologists because my blood levels are smack in the middle of normal range, so no one will help me. I have seen some of the best endocrinologists at UCLA as well as cedars. One of them at our visit says I have Hashimotos AND graves. STrange that the other doc did not mention that. He tested my TSI and it came back at 389, with the range being 0-139. He believes that the 2 autoimmune diseases are playing a tug-o-war and thats why my blood levels stay normal. I saw the next doctor who had many more years experience, and he said I only had Hashimotos...not graves. I'm very confused by this. Would the TSI show that high with just hashimotos? why would a doctor thnk differently if the test is right there?
> On my latest labs, here's what it says...
> ...












If I may; I would like to insist that you get RAIU (radioactive uptake scan) if you have not done so. With such high TPO and the presence of Thyroglobulin 
Ab, there is a strong risk of cancer so please do that.

Not so sure about the 2 autoimmune disease explanation but I am sure that the binding, blocking and stimulating antibodies are blocking receptor sites and wreaking havoc on your numbers.

There is certain criteria for Graves' and I hope you don't have them. If you don't, you are simply in a hyperthyroid state. Hashimoto's can cause that as well as cancer of the thyroid.

Here is the criteria as well as other information.

If you have any TSI, even if it is below the range, that is "definitive" for hyperthyoid. As to the reason, that's another story. It could be because of cancer, Hashimoto's or Graves'.

Hashimoto's is diagnosed by FNA. If certain Hurthle Cells indigenous to Hashi's are present, then you have Hashi's.

Histologic diagnosis of Hashimoto's
http://emedicine.medscape.com/article/120937-diagnosis

Hashimoto's Hurthle cells
http://www.pathconsultddx.com/pathCon/diagnosis?pii=S1559-8675(06)71549-2

The criteria for Graves' is clinical. You must exhibit..........goiter, exophthalmos, pretibial myxedema and thyrotoxicosis as per Dr. Robert Graves' of the 1800 era. 3 out of the 4 qualify.
(3 chapters) http://www.thyroidmanager.org/chapter/graves-disease-and-the-manifestations-of-thyrotoxicosis/

I take it you are on no medication at this time? Can you list your symptoms when you have the time, please?


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## th66 (Mar 9, 2013)

HI,
LIST OF SYMPTOMS
BLADDER PAIN/URGENCY
RED BUMPS AND LINES SCATTERED ON UPPER BODY- NOT ITCHY
TINNITUS
MUSCLE TWITCHING IN EYE LIDS, UPPER ARMS, AND SIDES BY RIBS
ELBOW/FORARM MUSCLE PAIN
HIP PAIN (BOTH SIDES)
CURRENTLY, RIGHT HIP/LEG PAIN DOWN TO ANKLE
RAPID HEART RATE FROM 104-114 BEATS PER MINUTE
GRINDING OF TEETH IN DAY
LIGHTHEADED/DIZZY
WOOZY/DRUNK FEELING IN HEAD
ADRENALIN RUSHING FEELING IN HEAD
NAUSEA
PANIC/ANXIETY/NERVOUSNESS
HEADACHES
INCREASED ANXIETY TO HEIGHTS
SUDDEN ANXIETY TO DRIVING FAST, OR FAST MOVING RIDES, ETC&#8230;
ACNE
INSOMNIA
WEIGHT GAIN
HANDS FALL ASLEEP WHILE SLEEPING
SOMETIMES CONSTIPATED/ OTHER DAYS "GO" ALL DAY LONG
NECK PAIN (LEFT SIDE ONLY)
SUDDEN EXTREME SENSITIVITY TO MANY MEDICATIONS

I had an ultrasound on my thyroid, and all they saw was hashimotos.
I have been tested for Lupus, MS, etc..., and all seems fine.
This all came on 1 day...all of the sudden, except for the hip/joint pain.

Thanks for all your info. I appreciate it.


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## StormFinch (Nov 16, 2012)

As Andros said, an RAI-U would confirm Graves. You could also have a TRAb run which is a reliable predictor for it. As far as the symptoms go, both those belonging to Graves and Hashi's can and do cross over, so they could be from either. Some could also belong to low D and/or magnesium since thyroid problems cause deficiencies in those and other areas.


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## Andros (Aug 26, 2009)

th66 said:


> HI,
> LIST OF SYMPTOMS
> BLADDER PAIN/URGENCY
> RED BUMPS AND LINES SCATTERED ON UPPER BODY- NOT ITCHY
> ...


You are definitely hyperthyroid. It would be in your best interest to be on a beta-blocker and antithyroid med until you decide what direction to take w/this.

Many of us have gained weight w/hyperthyroid. Symptoms can and do cross over.

You are very ill and in dire need of medical intervention. Ultra-sound results rely on a "lot" of things. The expertise of the operator for one and a whole bunch of other stuff.

Please try to get RAIU because that would be more revealing PLUS, you do need to know your rate of uptake.

RAIU
http://www.radiologyinfo.org/en/info.cfm?pg=thyroiduptake

Also, radioactive uptake scan (RAIU); sonograms have limitations.

Ultra-sound limitations http://www.radiologyinfo.org/en/info.cfm?pg=us-thyroid


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## th66 (Mar 9, 2013)

can anyone recommend an endocrinologist in the los angeles area? I thought i was seeing some of the best, but these doctors ar waving me off saying its not the thyroid I am feeling and to go get checked for Lupus (again), or another autoimmune disease.
This has been almost 2 years of chasing my tail. Its 2013, I live in southern california, and I still can't get help?? Too weird.


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## Andros (Aug 26, 2009)

th66 said:


> can anyone recommend an endocrinologist in the los angeles area? I thought i was seeing some of the best, but these doctors ar waving me off saying its not the thyroid I am feeling and to go get checked for Lupus (again), or another autoimmune disease.
> This has been almost 2 years of chasing my tail. Its 2013, I live in southern california, and I still can't get help?? Too weird.


My dear; you have antibodies that are indigenous only to the thyroid. At least confront the doctors w/ this. I wish I was there to advocate for you!

And guess what? You do not need an endo. All you need is a good doc that understands what I just told you and he/she has a desire to make a very unwell patient well again.

Bottom line here.

Arm your self w/credible information. Go to the links I provided and by the way, here is one for TBII.

And TBII and Trab.

blocking antibodies
http://www.suite101.com/lesson.cfm/19330/2899/4

TBII (Thyrotrophin Binding Inhibiting Immunoglobulin)
http://www.ncbi.nlm.nih.gov/pubmed/1969138 (good test for TSHR)

Trab (Thyroglobulin antibody) TSH receptor antibody
http://jcem.endojournals.org/content/83/11/3781.full

"T" stands for thyroid; how could a doctor not get that?


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