# Antibodies "in thyroid only"?



## nilsby (Aug 14, 2011)

My endocrinologist diagnosed me with Hashimoto's this morning, despite being negative for antibodies. He said that it's because the antibodies are in my thyroid only, and not circulating in my blood. I can't find any research to corroborate that idea --- has anyone here ever heard of such a thing?


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## Andros (Aug 26, 2009)

nilsby said:


> My endocrinologist diagnosed me with Hashimoto's this morning, despite being negative for antibodies. He said that it's because the antibodies are in my thyroid only, and not circulating in my blood. I can't find any research to corroborate that idea --- has anyone here ever heard of such a thing?


Oh, Lord! Well, welcome to the board.

You cannot find anything to corroborate that idea because I don't think that it exists.

This a just a sampling of BLOOD tests that are indigenous to the thyroid.........

TSI (thyroid stimulating immunoglobulin),TPO{Thyroid Peroxidase Ab}, (antimicrosomal antibodies, http://www.nlm.nih.gov/medlineplus/ency/article/003556.htm) TBII (thyrotropin-binding inhibitory immunoglobulin), Thyroglobulin Ab, ANA (antinuclear antibodies), (thyroid hormone panel) TSH, Free T3, Free T4.

You can look this stuff up here and more.........
http://www.labtestsonline.org/

Perhaps you would like to explain what took you to the doc in the first place, what tests you did have and let us have a peek at the results and the ranges! We must have the ranges as different labs use different ranges.

Also, if you are symptomatic, list the symptoms please.

You may wish to peruse this link.
http://labtestsonline.org/understanding/analytes/thyroid-antibodies/tab/test

I will say this; a person could have thyroid disease that is NOT autoimmune.

Hashimoto's is autoimmune. It is often called Thyroiditis as well.
http://www.thyroidmanager.org/Chapter8/8-frame.htm

3.Subacute thyroiditis, also called De Quervain's Thyroiditis: this will involve inflammation and pain of the gland and a quick release of excess thyroid in your blood, but antibodies are not found. It's rare. Taking aspirin to reduce inflammation, plus bed rest, is recommended by doctors. Patients can recover from this.
http://www.stopthethyroidmadness.com/thyroiditis/#


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## nilsby (Aug 14, 2011)

Yeah, he's not inspiring confidence. I have a background in molecular biology and a passing familiarity with human physiology, and it just doesn't make sense to me.

Just for amusement value, here's the latest ultrasound:
Right lobe 1.7 x 2.3 x 4.5 cm (moderate enlargement)
Complex mass, 1.7 x 1.7 x 2.9 cm
Left lobe 1.2 x 1.5 x 3.9 cm (mild enlargement)
Scattered tiny nodules suggestive of small adenomas

The latest RAIU:
normal at 6 & 24 hours
cold nodule on right lobe

The labs:
T3 134	60 - 181
Thyroid peroxidase	<10	<35
Thyroglobulin <20	<20
TSH 0.46	0.34 - 4.82

I've had intermittent bouts of hyperthyroid symptoms (confirmed by labs at another clinic) interspersed with moderate fatigue for about 18 months now. I can't even walk up a flight of stairs without feeling exhausted, and I used to run 10 miles a week. The dominant nodule aches off and on.

Unfortunately this endocrinologist was not at all concerned with the discomfort or the fatigue. He told me today that I should "look in the mirror and be glad you don't have something worse wrong with you". He didn't so much as look at my neck, and wasn't aware that I'd already had a FNA (benign in December, no cytology available). I think it's time to try somewhere new.


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## Andros (Aug 26, 2009)

nilsby said:


> Yeah, he's not inspiring confidence. I have a background in molecular biology and a passing familiarity with human physiology, and it just doesn't make sense to me.
> 
> Just for amusement value, here's the latest ultrasound:
> Right lobe 1.7 x 2.3 x 4.5 cm (moderate enlargement)
> ...


Oh, man!!! Your ultra-sound is scary! Are you saying this guy is not concerned?

Could you do me and yourself a huge favor and take that ultra-sound finding to an ENT?

Cold nodules, complex mass, nodules suggestive of adenomas? This guy is truly looney tunes.

I was that way with hyper/Graves'. Absolutely could not take the stairs and worse.

Here is more info:

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

This lab test would be good also:

Thyroglobulin Ab and cancer
http://qjmed.oxfordjournals.org/content/59/2/429.full.pdf

Thyroid cancer, cold nodules, men, uptake etc.
http://www.aafp.org/afp/2003/0201/p559.html

Sometimes it matters what I think based on gender so are you male or female?

More:

Nodules http://www.aafp.org/afp/2003/0201/p559.html

Nodules http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1665239/

Truly you have a situation and I personally will remain very concerned.

I am presuming and one should not do that but the TPO and the Thyroglobulin are just that? Not the antibodies? It makes a difference because ...............

TPO Ab should be negative, 0
http://www.medlabs.com.jo/docs/Leaflet-17.pdf
(The normal thyroid has TPO but should not have antibodies to TPO)

And the same is true of Thyroglobulin; you should have a "bit" of it.


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