# TSI?



## Rach33 (Jun 24, 2014)

I had my labs drawn 7 weeks ago. My doctor at the time said there was nothing to worry about when it came to my TSI. I had one person tell me I was borderline Graves. What does the TSI mean?
TSI: 93 (<123)


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## joplin1975 (Jul 21, 2011)

Generally the <123 range is applied to diagnose Grave's. But a healthy person should not have any TSI in their blood.

TSI, if you ask me, is the nastiest of the antibodies and can really throw your body for a loop. It can mimic TSH, making your thyroid overproduce hormones. You often will find it with advanced cases of Hashi's and/or hashitoxicsis.

It can made stabilizing on medication difficult because you will see very rapid changes from hypo to hyper.


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## Rach33 (Jun 24, 2014)

I had not clue TSI was an antibody, I figured it was just another test on your thyroid function. I'm being treated for hypothyroidism for the last 8 months, it wasn't until last week that my current doctor brought up Hashi. Only symptoms I can think of is this hot flashes and freezing roller coaster ride I will sometimes go through for a couple hours at a time. I had one occasion a couple months ago where my heart just started beating rapidly for no reason. My pulse dropped from 80 bpm to 60 bpm a year ago so I figured it was back at 80 bpm and I wasn't used to that speed anymore. When I checked it it was at 90+ bpm. I didn't wake my husband cause I knew he'd freak out and I'd be on my way to the ER so just tried to ignore it and fall back to sleep. I woke up later to my heart rate back down to 60. 
Then there's the swollen tongue with scalloped edges that I'm not sure if it's due to hypothyroidism or Hashi.


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## joplin1975 (Jul 21, 2011)

Rapid heart beat, random sweats, sudden flushed and/or feverish feeling, anxiety or unexplained jittery-type feelings, random bouts of diarrhea...all those things are often found when TSI is found in blood work (obviously, there are other causes for everything as well, but...if you have TSI, there's a good chance that nasty stuff is to blame).

Think of it as your body's reaction to the destruction of your thryoid. TPO attacks your thyroid, the gland slows down the production of thyroid hormone, so your body reacts by releasing TSI to speed things back up again. Hence the ups and downs of autoimmune disease.


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## Rach33 (Jun 24, 2014)

Oh wow, I have had random bouts of diarrhea but figured it was something I ate even though my diet hadn't changed, never thought it may be linked to my thyroid or TSI.
Is there anything to do to reverse it TSI? I had watched a video last night that suggested changing your diet can reverse it but I wasn't sure about it.


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## bigfoot (May 13, 2011)

Finding a doc to properly interpret a TSI test, amongst other tests, can be an exercise in frustration. Like you, my TSI was 93 last time it was drawn. I have some great doctors, but I don't think they even understand the implications. I know I sure don't! All of the signs & symptoms described above sound very familiar, including the rapid fluctuations up/down like a roller coaster.

I think that short of ablation or surgical removal of the thyroid, there isn't a foolproof way to stop the various antibody attacks. The problem is that, with folks like us, our labs look pretty decent on paper. So no doctor is going to even think about removing or destroying the offending gland. If you get "lucky" and a test result or imaging data happens to show something really wacky, then maybe it is considered.

Next best approach is to quiet the antibodies down as much as possible. This involves reducing inflammation from any other causes, whether illness-related, nutrition-related, allergy-related, etc. The less inflammation you have going on, the better. Also, suppressing the thyroid, keeping the TSH low and thus in a roundabout way, lowering the antibody attacks.

Lastly, there are immune-suppressing drugs and steroids out there, but they come with a laundry list of side-effects and their own issues. I can tell you that I have had to take powerful immune-suppressing drugs for other conditions and for a brief while, felt really good, almost "normal". (Similarly, with steroids.) Unfortunately, that was all short-lived because treatment can't go on forever.

If you're interested, you might check into something called Low Dose Naltrexone. It is a compounded medication in small doses (up to 4.5mg) that is frequently used for MS patients, chronic fatigue sufferers, etc. It is also apparently used for Hashi's. There isn't a ton of press about this drug because it is old, cheap, and reliable. I am currently taking this in addition to thyroid hormones and I have to say, it has definitely helped. Whether it has actually lowered my various antibodies or not, including TSI, remains to be seen.


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## Melissa_Welsh (Jul 25, 2014)

i have had borderline TSI for years (<120%)... I would be 75... and the doctors have all said it was normal. I also have had TPO-ab not enough to be considered positive. I have thyroid nodules (not large enough to biopsy) and entire thyroid is heterogenous. My TSH has been normal... as are Free T3 and Free t4. I feel horrible... anxious all the time, but can't lose weight. I have palpitations... followed by slow heart rate. I told my doctor to test for the antibodies... and told him that NORMAL PEOPLE DO NOT HAVE TSI AND TPO-AB - he essentially looked at me like I was a nut. I saw an endocrinologist in the past who ONLY relied on TSH.

Both my grandmothers (paternal and maternal) had Graves disease. Both had TED and exopthalmos. One had a huge goiter. When I told my doctor about the family history, he said that Graves disease is not genetic.

I have been dealing with this since 1998. I am unsure what kind of doctor I should see... or if I should just continue to feel this way and forget about it.

Melissa


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