# antibodies present? I don't understand results. Can anyone help?



## David.B (Jun 26, 2013)

Lab #1 May

```
<br />
Triiodothyronine (T-3), Serum		93			ng/dL<br />
Free T-3		3.4			pg/mL<br />
Tsh-Icma		1.3			uU/mL<br />
Free T4 By Dialysis/Mass Spec		1.7			ng/dL<br />
```
Lab #2 June

```
<br />
Test	                       #	Reference Range	Units<br />
Cortisol - Am		16.4		6.2-19.4	ug/dL<br />
Tsh-Icma		1.6			uU/mL<br />
Triiodothyronine (T-3), Serum		89			ng/dL<br />
Free T-3		3.5			pg/mL<br />
Free T4 By Dialysis/Mass Spec		1.6			ng/dL<br />
Thyroid Peroxidase (Tpo) Ab		6		0-34	IU/mL<br />
 <br />
 <br />
Acth, Plasma<br />
Test	Low	Normal	High	Reference Range	Units<br />
Acth, Plasma		17.7		7.2-63.3	pg/mL<br />
 <br />
Antithyroglobulin Ab<br />
 Test	Low	Normal	High	Reference Range	Units<br />
Antithyroglobulin Ab		<20		0-40	<br />
 <br />
Thyroid Stim Immunoglobulin<br />
 Test	Low	Normal	High	Reference Range	Units<br />
Thyroid Stim Immunoglobulin		32		0-139	% <br />
```
Is presence of antibodies always not a good thing? I had a somewhat sudden onset of anxiety/panic disorder as well as fatigue and some other symptoms.

thanks for reading!


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## Lovlkn (Dec 20, 2009)

You definitely have both related to thyroid.

TPO is very low - could simply be showing inflammation. Your TSI is low as well but any TSI would be an indication that Graves is in your system.

Congratulations on finding a doctor who runs the proper tests.

What do they say about your lab tests?

Are you taking any medications yet?

I noticed the ranges for the Free's were not on what you posted - do you have them?


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## David.B (Jun 26, 2013)

Lovlkn said:


> You definitely have both related to thyroid.
> 
> TPO is very low - could simply be showing inflammation. Your TSI is low as well but any TSI would be an indication that Graves is in your system.
> 
> ...


It took 3 trips to get her to run these labs 

No, I don't have the reference ranges for the "frees" it's blank on the sheet.

Endo said labs were all OK, and I was "fine". However I don't feel that way  I made another endo appointment with a different doctor but it was 9 weeks out, I'm almost there should be in 2 weeks.

No, no meds yet. She didn't think there is anything to treat. Thanks for the response!


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## David.B (Jun 26, 2013)

Sorry, forgot to ask.

What kind of diagnosis should I expect from a doctor? What kind of meds/treatment options are there?

I'll let you know what the doctor says. Thanks again.


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## David.B (Jun 26, 2013)

I appreciate all of the input I've gotten so far.

Anyone else have comment? I can't find a doctor yet who thinks there is is an issue. Everyone so far says it looks perfect.

I'm seeing yet another doctor in a couple of weeks and the specialist from the local teaching hospital scheduled me for JANUARY!



I feel bad, yet they all keep telling me it's in my head. Why is it doctors only diagnose if your on your death bed or numbers are insanely high?


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## joplin1975 (Jul 21, 2011)

David.B said:


> I feel bad, yet they all keep telling me it's in my head. Why is it doctors only diagnose if your on your death bed or numbers are insanely high?


You've hit on a very, very common problem. The hard part is that for some people, they might feel great with your numbers...whereas others, like you, don't. I think it is counter intuitive for many physicians to move forward with treatment when the clinical results aren't awful. That is, they don't want to make you a lab rat and just start trying drugs for experimental purposes. It's tough and I'm sorry you are stuck at this point

It would be very hard for me to brain storm possible medications without seeing those reference ranges.

Has your doctor thought about an ultrasound?


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## Prudence (Oct 30, 2012)

joplin1975 said:


> You've hit on a very, very common problem. The hard part is that for some people, they might feel great with your numbers...whereas others, like you, don't. I think it is counter intuitive for many physicians to move forward with treatment when the clinical results aren't awful. That is, they don't want to make you a lab rat and just start trying drugs for experimental purposes. It's tough and I'm sorry you are stuck at this point
> 
> It would be very hard for me to brain storm possible medications without seeing those reference ranges.
> 
> Has your doctor thought about an ultrasound?


Sadly true. I was always borderline with my labs. Either a high normal, or just over the normal, yet I had severe symptoms of Graves', and was still given the brush off for a long time, just because my labs weren't high enough for them to do anything. Doctors need to really start paying attention to how a person feels, and not just what a lab tells them...everyone feels different at different ranges. I feel best when my TSH is between 3 or 4, and my FT4 is at about a 1.4-1.6. Some people feel better with a TSH at 1.


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## David.B (Jun 26, 2013)

joplin1975 said:


> You've hit on a very, very common problem. The hard part is that for some people, they might feel great with your numbers...whereas others, like you, don't. I think it is counter intuitive for many physicians to move forward with treatment when the clinical results aren't awful. That is, they don't want to make you a lab rat and just start trying drugs for experimental purposes. It's tough and I'm sorry you are stuck at this point
> 
> It would be very hard for me to brain storm possible medications without seeing those reference ranges.
> 
> Has your doctor thought about an ultrasound?


I think most of the ranges are in the charts, which ones were missing?


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## jrohrigj (Aug 30, 2012)

The ranges for the frees and tsh is missing.


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## joplin1975 (Jul 21, 2011)

Yup, no range for the frees, which would be most informative.


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## David.B (Jun 26, 2013)

joplin1975 said:


> Yup, no range for the frees, which would be most informative.


I checked the lab it doesn't have them  I think 1.7 is end of range for FT4. But that is the only one I know.

Blood work was done by labcorp if that helps.


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## StormFinch (Nov 16, 2012)

David.B said:


> I checked the lab it doesn't have them  I think 1.7 is end of range for FT4. But that is the only one I know.
> 
> Blood work was done by labcorp if that helps.


Ah, I can help with Labcorp I believe. Granted, my last doc had a Labcorp tech housed in his own practice, but all the bloodwork was sent to the main company so the ranges should be the same.

The ranges I have are listed as:

TSH - 0.450-4.500 uIU/mL
T4, Free (Direct) - 0.82-1.77 ng/dL
Triiodothyronine,Free,Serum - 2.0-4.4 pg/mL
Triiodothyronine (T3) - 71-180 ng/dL
Reverse T3, Serum - 9.2-24.1 ng/dL

I listed them all because I couldn't remember which ones you had.


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## David.B (Jun 26, 2013)

StormFinch said:


> Ah, I can help with Labcorp I believe. Granted, my last doc had a Labcorp tech housed in his own practice, but all the bloodwork was sent to the main company so the ranges should be the same.
> 
> The ranges I have are listed as:
> 
> ...


Thanks. Hopefully this will help.

Besides my antibodies the only thing I see is my tsh was low and ft4 almost out at 1.7

If anyone else has any thoughts I'd love to hear them. Good or bad 

Today I failed my asthma test. Never had asthma before. I'm also now allergic to wheat suddenly... so confused
Feel like I have fever when I don't
Achy muscles
Can't gain weight. Lost a bunch
Fatigue
Dizzy
See trails on things (even in daylight)
Night sweats
palpitations


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## Andros (Aug 26, 2009)

David.B said:


> Lab #1 May
> 
> ```
> <br />
> ...


I was leaning towards hyperthyroid when I started at the top. Then when I saw the TSI, I said....................YES!!

Hmmmmmmmmmm! Hate that for you but it can be handled.

You should not have any TSI.

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://labtestsonline.org/understanding/analytes/thyroid-antibodies/tab/test

Trab
http://www.ncbi.nlm.nih.gov/pubmed/17684583

And, getting a Trab lab test would be good as Trab blocks TSI.

Substances not found in normal serum (scroll down to autoantibodies)
http://www.thyroidmanager.org/chapter/evaluation-of-thyroid-function-in-health-and-disease/

And you do have a little Antithyroglobulin Ab. Even though it is below the range, it is making it's presence known.

When a person is hyper, the body's metabolism is racing even at rest. Thus the fatigue.

Radioactive uptake would be a good idea also (RAIU.)

Is your doctor going to do further testing on the ACTH?
http://labtestsonline.org/understanding/analytes/acth/tab/test


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## David.B (Jun 26, 2013)

Andros said:



> I was leaning towards hyperthyroid when I started at the top. Then when I saw the TSI, I said....................YES!!
> 
> Hmmmmmmmmmm! Hate that for you but it can be handled.
> 
> ...


thanks, ive been trying to get diagnosed for 5 months now. Last endo i asked "I read the presence of TSI antibodies would indicate that I have some sort of auto-immune disorder going on is this true?"

He said 'absolutely not'.... <sigh> but wouldn't explain to me why I had antibodies present.

I told him I had read a lot of articles saying this. He says they are all wrong... but of course provides no further information to back this up.

I feel like crap (listed some of my major symptoms in last post) I just want to get to feeling a little better.

I have one more doctor i'm going to try on the 16th; then I'm thinking about going to the Mayo clinic in minnesota. I'm really coming to the end of my rope...

thanks for the responses. If anyone else has any thoughts I'd love to hear them.

Yes, I have ACTH stimulation test on Monday, but to be honest I'm nervous to go take it. I did order a saliva test which I just sent in to ZRT labs on monday; not sure what their turn around time is like.


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## David.B (Jun 26, 2013)

I got my ACTH results; I posted them in a separate thread.

Sadly I'm confused again; but I'm not a doctor so par for the course I bet.

http://www.thyroidboards.com/showthread.php?t=9128&highlight=acth


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## Andros (Aug 26, 2009)

David.B said:


> thanks, ive been trying to get diagnosed for 5 months now. Last endo i asked "I read the presence of TSI antibodies would indicate that I have some sort of auto-immune disorder going on is this true?"
> 
> He said 'absolutely not'.... <sigh> but wouldn't explain to me why I had antibodies present.
> 
> ...


Let us know how the ACTH Stim Test goes. You know, if you could find a good NP or DO, your chances might be better.

Did I give you this link?

Substances not found in normal serum (scroll down to autoantibodies)
http://www.thyroidmanager.org/chapter/evaluation-of-thyroid-function-in-health-and-disease/

And meanwhile, browse through ThyroidManager. It is a highly credible site and while some things are beyond a layperson's education, you can glean enough info to advocate for yourself.


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## David.B (Jun 26, 2013)

Andros said:


> Let us know how the ACTH Stim Test goes. You know, if you could find a good NP or DO, your chances might be better.
> 
> Did I give you this link?
> 
> ...


ACTH went so-so. Felt amazing for 24-36 hours then I crashed hard been sick ever since. Called the doctor and he said the test could never cause that to happen. Now I wake up every morning with nausea which lasts til afternoon 

I posted ACTH results in another thread I linked too above.

I believe it appears I might have secondary adrenal insufficiency. My doctor thinks the test was fine though.

Basically i went from 13 baseline to 42 at 60 minutes. Seems like the baseline is low and I more than tripled. Which isn't suppose to happen I thought.


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