# Can you have low antibodies and still have Hashi's?



## chickp (Sep 29, 2010)

I have symptoms of Hashi's and a nodule that came back after a FNA with Hurtle cells that are indeterminate. My endo said that I don't have Hashimoto's because my antibodies were at 9. Just wondering if anybody else has had this situation. Thanks!


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## Andros (Aug 26, 2009)

chickp said:


> I have symptoms of Hashi's and a nodule that came back after a FNA with Hurtle cells that are indeterminate. My endo said that I don't have Hashimoto's because my antibodies were at 9. Just wondering if anybody else has had this situation. Thanks!


All I know is that there are more than one kind of Hurthle Cells. One is for Hashimoto's and the other for cancer. So, I do urge you to seek a second opinion.

Also, TPO is only "suggestive" of Hashimoto's. TPO is also suggestive of a lot of things including cancer.

Read this........

What does the test result mean?

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's thyroiditis and Graves' disease.

Pay attention to wording such as "frequently indicate." This is in no way definitive. Only suggestive.

http://www.labtestsonline.org/understanding/analytes/thyroid_antibodies/test.html

Not sure I am impressed with the endo. You can have Hashi's and no TPO.

Once again, I urge you to get a second opinion on that FNA.


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## greatdanes (Sep 25, 2010)

chickp said:


> I have symptoms of Hashi's and a nodule that came back after a FNA with Hurtle cells that are indeterminate. My endo said that I don't have Hashimoto's because my antibodies were at 9. Just wondering if anybody else has had this situation. Thanks!


What test did he run for the antibody, was it the Antithyroglubin? Has he run the Anti-microsomal test( I think they call it the Atab or something)Anyway I would like to see what your anti-tPO was. A high elevation could point to hashi too. Don't get too freaked out, there could be more reasons other than cancer, and the majority of time it's not. Your number is really low and not alarming at all, considering healthy ppl can test positive for antibodies.


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## chickp (Sep 29, 2010)

I am going to see a specialist on Thursday for a 2nd opinion. I was not impressed with the endo either. He just told me I needed my whole thyroid out and that I should just go see a general surgeon, and come back in 4 weeks. Yeah....not working for me, especially the part where my thyroid comes out and I'm not on meds for 4 weeks! Also that Hurthle cells can be indicative of several things, and I want someone reading my biopsy who knows what the heck is going on.

Anyway I am just trying to figure out all the questions I want to ask. This doc is an ENT and has a really good reputation, and does a lot of thyroid surgery and consultations. I was just curious. It was the TPO test as far as I know.

Oh and I know that it's possible cancer and I am trying not to freak out. I know thyroid cancer is fairly manageable (you know, for cancer!). Thanks for your responses.


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## upstate87 (Sep 24, 2010)

I'm pretty sure that my anti-bodies were low also, but after they removed my nodule, the biopsy determined that there were lymphocytes present. Don't think it showed up in the FNA either. The first time the word "lymphocytic" came up was after my surgery once they'd done the pathology.

Before surgery: ANTI-TPO AB, IGG 3.0 (<20= neg, 20-30=equivocal, 30+ = pos)
After: Thyroperox - 1.2 (<9.0)


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## Andros (Aug 26, 2009)

upstate87 said:


> I'm pretty sure that my anti-bodies were low also, but after they removed my nodule, the biopsy determined that there were lymphocytes present. Don't think it showed up in the FNA either. The first time the word "lymphocytic" came up was after my surgery once they'd done the pathology.
> 
> Before surgery: ANTI-TPO AB, IGG 3.0 (<20= neg, 20-30=equivocal, 30+ = pos)
> After: Thyroperox - 1.2 (<9.0)


Welcome upstate87 and thank you so much for sharing your experiences.


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## CA-Lynn (Apr 29, 2010)

My antibodies were high when they were run a few years back. The same tests were repeated a couple months ago and the antibodies were minimal. But I certainly do have Hashimoto's.

Another tip-off is if you have other autoimmune disorders. If you have one, too often other autoimmune diseases are lurking in the shadows.


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## chickp (Sep 29, 2010)

I don't really have anything, so that's why I'm sort of baffled. nothing autoimmune, no bad symptoms. All tests normal as can be.

Upstate87, did you have Hurthle cells also? Does lymphocytic mean cancer? My FNA only said that Hurthle cells were present and it was indeterminate which kind they were.

I have a surgery scheduled to remove half of my thyroid on December 6, and I guess I'm wondering what my next testing steps should be. A blood test pre-surgery? Post? The ENT was really helpful and well-rated as a thyroid surgeon, but I won't be going to him for followup, he'll kick me back to the endo who I'm not sure about.


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## Andros (Aug 26, 2009)

chickp said:


> I don't really have anything, so that's why I'm sort of baffled. nothing autoimmune, no bad symptoms. All tests normal as can be.
> 
> Upstate87, did you have Hurthle cells also? Does lymphocytic mean cancer? My FNA only said that Hurthle cells were present and it was indeterminate which kind they were.
> 
> I have a surgery scheduled to remove half of my thyroid on December 6, and I guess I'm wondering what my next testing steps should be. A blood test pre-surgery? Post? The ENT was really helpful and well-rated as a thyroid surgeon, but I won't be going to him for followup, he'll kick me back to the endo who I'm not sure about.


Did you have all these antibodies' tests run?

TSI (thyroid stimulating immunoglobulin),TPO (antimicrosomal antibodies) TBII (thyrotropin-binding inhibitory immunoglobulin), Thyroglobulin Ab, ANA (antinuclear antibodies), (thyroid hormone panel) TSH, Free T3, Free T4.

You said your antibodies were @ 9. You also have Hurthle cells (which ones we won't know until surgery in Dec.) so you do have "something!"

Keep us in the loop here.


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## chickp (Sep 29, 2010)

I did not have all those tests run...I had TPO and TSH. I need to look back at my paperwork to make sure though, because the endo ran two panels, one more in-depth. And my TPO was actually <9, so I don't know if there actually were ANY antibodies there.

I know it's not nothing, because there was a nodule, and I will look into the other tests and see what I can see. Thanks for your responses, I really appreciate it!  My surgery is not til December 6 so I have some time pre-surgery to figure this out.


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## Andros (Aug 26, 2009)

chickp said:


> I did not have all those tests run...I had TPO and TSH. I need to look back at my paperwork to make sure though, because the endo ran two panels, one more in-depth. And my TPO was actually <9, so I don't know if there actually were ANY antibodies there.
> 
> I know it's not nothing, because there was a nodule, and I will look into the other tests and see what I can see. Thanks for your responses, I really appreciate it! My surgery is not til December 6 so I have some time pre-surgery to figure this out.


You are very welcome. I just hope that myself and others are providing the assistance that you need.

<9 means that there are a "smattering" of antibodies. The thing about antibodies is that they do wax and wane and for the most part are accountable for the way you feel. It is very tricky to catch them at their worst behaviour but you can be clinically symptomatic. Learn to listen to your body.

Some of us old-timers just automatically know when the antibodies are flaring. You might say, "We can feel it!"


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## sjde (May 6, 2010)

My sister was diagnosed with Hashimoto's 11 years ago so I asked my doctor if I could be tested. The antibodies were sky high--so high that they repeated the test. (Thyroglobulin was 88 and normal range is 0-40. Peroxidase was 1384 and normal is 0-34. ) But my TSH was fine. 
I was told that I had hashi's and it was only a matter of time before my TSH would go high and I'd need meds, but not until then because too much thyroid hormone can weaken bones and I had osteopenia. My thyroid was enlarged too, another symtom of hashi's.

The doctor explained that if my antibodies were to be tested later they would be normal--that it's only at a certain point in the course of the disease that they are high. In the beginning. When alot of people aren't even tested because they aren't having symptoms. (Two years later I was tested and the thyroglobulin was normal--<2--but the peroxidase was still high at 1062.) 
My TSH didn't reach 5 or 6 for over 10 years; usually that only takes about a year the endo told me.

Did you end up having all or half of your thyroid removed?

Sue


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## daisydaisy (May 12, 2010)

in my personal opinion i don't believe hashi's every goes away. Its not curable. There is not cure for it. Basically its just how well we can manage it. Some of us are more sensitive to what goes on in our body than others. I avoid caffeine for instance and notice i feel more bleh and jittery when i get sick/colds than i ever was before the hashi's. Its just an extra stress our body has to deal with. I don't think it ever goes away and they don't even do long term studies on this yet...at least the doc's aren't well versed on it from what i know.


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## CA-Lynn (Apr 29, 2010)

It's a forever deal. My antibodies tests currently look close to normal. LOL, but it wasn't always that way.


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## chickp (Sep 29, 2010)

Thanks for your responses....I'm still confused though, and not sure what to do next.

My antibodies were <9, and I did have the free t3 and free t4 run and everything was well within okay range, like, smack in the middle. I had my nodule with non-malignant Hurthle cells out a few weeks ago (whew!), and my TSH was mid-range yet again.

I feel pretty good. I am cold all the time (but it's super cold here for Georgia) and my skin is really dry, but that's really the only typical hypo symptom I'm having. I did cut out wheat a few months ago as sort of an experiment, and even if I don't have Hashi's I'll probably keep that up because I feel so much better.

So....would you go ahead with a battery of blood tests, or just let it go until a flare up? I don't want to look for something that's not going to show up anywhere, but neither do I want to be miserable and have a good idea what's going on. Thanks in advance for anything you can offer!


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## Andros (Aug 26, 2009)

chickp said:


> Thanks for your responses....I'm still confused though, and not sure what to do next.
> 
> My antibodies were <9, and I did have the free t3 and free t4 run and everything was well within okay range, like, smack in the middle. I had my nodule with non-malignant Hurthle cells out a few weeks ago (whew!), and my TSH was mid-range yet again.
> 
> ...


It takes a while for the TSH to get the message and I might add that it is most desirable to get the FT3 up about 1/2 way between the mid-range of the given range and the top of the range.

What thyroxine replacement are you on and how much.

The organ that the antibodies have been attacking has been removed so you should see them go into remission. <9 is very good. The caveat though is you will always considered a patient that has autoimmune thyroid disease as well you should be. Regular check-ups will be a necessity. As you know.

Crikies!! It has been very very cold here in Ga.. Hubby and I live in Henry Co. south of the perimeter.

I am so glad to hear that you have gone gluten free. Don't you feel grand? I have been gluten free for so many years that I cannot remember how long it has been.

Good for you!!!


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## chickp (Sep 29, 2010)

I only had half of my thyroid removed, so I am not on any sort of replacement. That's why I am wondering about waiting til I'm symptomatic....that maybe that half will do okay for a while. I know that it probably will have some problems eventually though, and I don't want to get another nodule and have to go through all that stuff again.

It IS cold here! We live way up in North Fulton Co almost to Forsyth.  I am so thankful to live in Atlanta since the gluten free resources here are amazing. I just went to Natural Foods Warehouse and it is gluten free heaven. I do feel SO much better, it is amazing.


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## Andros (Aug 26, 2009)

chickp said:


> I only had half of my thyroid removed, so I am not on any sort of replacement. That's why I am wondering about waiting til I'm symptomatic....that maybe that half will do okay for a while. I know that it probably will have some problems eventually though, and I don't want to get another nodule and have to go through all that stuff again.
> 
> It IS cold here! We live way up in North Fulton Co almost to Forsyth.  I am so thankful to live in Atlanta since the gluten free resources here are amazing. I just went to Natural Foods Warehouse and it is gluten free heaven. I do feel SO much better, it is amazing.


Well then; I would suggest antibodies' tests on a regular basis (every 6 months or so>) because they still have an organ to attack. Sad, but true. Dang!!

Even our local Ingles has just tons of gluten free foods. And yes, you are way up there and it is about 10 degrees colder (always) than it is on my side of town.

Stay on track w/your gluten free. You will never regret it.


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