# Latest labs - Antibody question



## Rain (Jun 19, 2012)

Morning all,

Previous thread here.

Finally got my last results, which this new "specialist" surgeon man ordered. I have read on labtestsonline what the antibody tests are, but I'm still confused as to what they mean. All the new doc said was they indicate Graves, and I'm slightly hypo.

He got me to stop medication for 5 days, then start on 1 x 5mg per day (started yesterday). I'm to get another thyroid panel done in one month.
I also noticed my total bilirubin was high. Could this be because of the whole thyroid/metabolic thing, or because I've had my gallbladder out? Or something else? Doc didn't mention it.

I still feel very tired and out of it, weak/sore muscles, headaches, minor heart pounding/palps, sometimes some slight blurry sight, period changes, dry skin.

Test Performed 18/10/12

TSH...... 8.64 (0.50 - 4.00)
FT3....... 4.3 (3.5 - 6.5)
FT4....... 12.6 (10.0 - 19.0)

Anti-thyroid Peroxidase...... > 1300 kIU/L (< 60)
Anti-Thyroglobulin........... 70 kIU/L (< 60)

Antinuclear Antibodies (Serum):
Nuclei (HEp-2000 Cells) : Negative

Total Bilirubin...... 29 (< 15) [ALT, AST and ALP were in range]
B12................. 213 (150 - 700)
Sodium........... 138 (136 - 146)
Cortisol........... 492 (119 - 618)

Everything else was in range.


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## Lovlkn (Dec 20, 2009)

> I still feel very tired and out of it, weak/sore muscles, headaches, minor heart pounding/palps, sometimes some slight blurry sight, period changes, dry skin.


How long have you been taking your anti thyroid medication?

I had bad muscle pain when taking it and struggled to stabilize.

Have you been able to get into mid range on your FT-3 and FT-4and remain stable for any period of time yet?


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## Rain (Jun 19, 2012)

Lovlkn said:


> How long have you been taking your anti thyroid medication?
> 
> I had bad muscle pain when taking it and struggled to stabilize.
> 
> Have you been able to get into mid range on your FT-3 and FT-4and remain stable for any period of time yet?


Late June this year.
I haven't been stable at all. Started off very hyper and have dropped to what I am now, there was no in between for any length of time.


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## Rain (Jun 19, 2012)

Bump

Sorry to be impatient..


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## Octavia (Aug 1, 2011)

Rain...I see a question about bilirubin, but do you also have other questions? (I'm assuming by your "bump" that you do...they're just not clear.) Are you wondering about antibodies and Graves?


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## webster2 (May 19, 2011)

I never stabilized on ATD's. Perhaps I didn't stay on them long enough. I have felt so much better since my remaining thyroid was evicted. I did have to have my gall bladder removed a few months after that. I don't really have an answer for you but if you are not feeling well, hang in there....sometimes it takes a lot of being pushy, persistant.


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## Lovlkn (Dec 20, 2009)

High Bilirubin might be from being on anti thyroid meds? I really cannot say for sure.

Your FT ranges are very strange and different from what i have seen, are you sure those are actually FT tests?

I never stabilized on anti thyroid meds - your levels look better than how you describe you feel.

Have you had your Ferritin and Vit D levels checked? Being low in those can mimic low thyroid levels and most of what you describe as symptoms are low thyroid symptoms.


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## Rain (Jun 19, 2012)

Sorry, I was wondering what exactly those antibody tests mean, and if it's normal for the first one to be so damn high.

I haven't seen any other results on here that were that high. I suppose I was also wondering why, if those two are positive, why my TSI was negative. Is this definitely Graves?

My FT ranges are exactly what's on the paper from the docs. Maybe it's because I'm in Australia they're a bit different?

My ferritin and D levels were checked a few months ago, I'll have them done again.

Thank you all.
I just don't know what to do about this is all, I'm sick of not having a clear answer to anything (had enough of that through the stomach/gallbladder issues), it's so difficult not having the money to go and see a proper endo who deals with this kind of thing every day.


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## jenny v (May 6, 2012)

Rain, you still have your thyroid, right? If so, is it possible to talk to your doctors about just removing it or ablating it? It sounds like you are struggling to stabilize and you just don't feel good and Graves is not something to play around with.


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## Andros (Aug 26, 2009)

Rain said:


> Morning all,
> 
> Previous thread here.
> 
> ...


Why did you have to stop the anti-thyroid med for 5 days?

And, are you seeing an Ophthalmologist, I hope?

Increased bilirubin could mean liver due to anti-thryoid med. Perhaps that is why he stopped you for 5 days?

http://labtestsonline.org/understanding/analytes/bilirubin/tab/test


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## Rain (Jun 19, 2012)

I still have my thyroid.
I've thought about getting rid of it, the only thing stopping me is the worry of making any eye conditions worse with RAI.
Surgery isn't an option at the moment, because I can't afford to go to a capital city to find someone who does more than one a year.

I'm not sure why he got me to stop meds for 5 days. When I called to get the results, he didn't call me back for a week so it couldn't have been too important.

I did see an ophthal., He said my eyes were perfect, and he didn't think I had anything to worry about in regards to TED.

Looking at that labtestsonline, it says thyroglobulin antis are present in Hashis and cancer. Is it common for it to show up in Graves patients?


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## Rain (Jun 19, 2012)

Can anyone give me some advice on these antibody tests?

I'm confused by them. And I really don't know what to do here.
Any advice would be highly appreciated


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## Rain (Jun 19, 2012)

No help?

Well for my own sake, my latest labs, taken 22/11:

TSH....... 3.31 mIU/L [ 0.50 - 4.00 ]
FT4....... 15.3 pmol/L [ 10.0 - 19.0 ]
FT3....... 4.7 pmol/L [ 3.5 - 6.5 ]

LFTs all fine but total bilirubin still high at 23 umol/L [ <15 ]

Still getting strange feelings in the chest (heart palps or gastro?), chest pain, tired, brain fog, headaches, some eye strain.
Doc said to continue on 1 x 5mg carbimazole per day, re-test in two weeks before appointment with him.


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## StormFinch (Nov 16, 2012)

Rain, here is the site I use when I get confuzzled on all the different tests: http://thyroid.about.com/od/gettestedanddiagnosed/a/bloodtests.htm.

According to what I've learned, and of course I'm not a doctor nor even as good as some at judging what's going on via the tests, Thyroglobulin can indeed show up in Graves. Antithyroid Peroxidase on the other hand causes problems with the conversion of T4 to T3. Since your T3 always seems to run slightly low that might be why you were still feeling bad. I think optimum should be in the mid range. You're TSH looks better in your newest posting, though you're still a bit hypo. How are you feeling since it dropped back down? Is your Doc still keeping an eye on your bilirubin? Have you asked for an ultrasound to check for nodules?

Ultimately if you get a positive ultrasound, and with an all clear from you optha, I'd say RAI could be done if you want to kill your thyroid without having to wait to see a practiced surgeon. Just have your Doc prescribe a round of steroids for before and after the procedure to guard against GED.


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## Rain (Jun 19, 2012)

I have read that site, thank you.
I suppose I'm just having a hard time correlating my lack of clinical symptoms with my test results and Graves diagnosis. Not having an endo where I live isn't helping- I did wonder if I should travel and see one before making the final decision for ablation.
I'm also a little sceptic that the ophthal took two minutes to say my eyes were fine, but I can't afford to go back, or see another one, just for the same diagnosis.

I feel pretty much the same, always a strange mix of hypo and hyper symptoms. Being so tired exacerbates it I think. Bilirubin is being tested every time I get the thyroid panel done. Ultrasound was clear.

Thank you for the advice, I really appreciate it.


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