Confused by blood results TG/TPO and Graves disease

[Nik07]

I received my blood results from Genova today:

Total T4 117 (58-154 nmol/L)

TSH 0.004 (0.4-4.0 mIU/L)

Free T4 16.6 (10-22 pmol/L)

Free T3 (FT3) 6.59 (2.8 - 6.5 pmol/L)

FT4:FT3 Ratio 2.5 (2.0-4.5)

Reverse T3 0.32 (0.14 -0.54) pmol/mL

Thyroglobulin (TG) 39.7 (0-40 IU/mL)

Peroxidase (TPO) 78.8 (0-35 IU/mL)

I am pleased with my T3, T4 and reverse T3 results though free T3 slightly on the high side - does this matter?

I am on Nature Throid and take three quarters of a grain a day which would suppress my TSH. Genova have said this is indicative of Graves. I am correct to think this is because I have a suppressed TSH and high antibodies. I am confused as I am of the understanding I have Hashimoto's but this is the first time I have had my TG antibodies measured. Help???

I also get palpations from time to time, particularly at night after I have taken my Nature Throid. Is this normal, last nights went on for ages and kept me awake?

Thank you

[Clutter]

Nik, TgAb is another test for Hashimoto's. Some people are positive for TPO, which you are, others are only positive for TgAb (you aren't) and some are positive for both.

Suppressed TSH and elevated FT3 are indicative of Graves if the patient isn't on thyroid replacement. In your case, it is due to either taking your NDT before your blood test (did you leave 24 hours?) or being slightly overmedicated.

It is normal for heart rate/pulse to rise after taking NDT because of the T3 in it but it should drop back to normal within an hour or two. If palpitations continued all night I think it may be due to overmedication and you could cut back to 1/2 grain to see whether palpitations stop.

[Nik07 in reply to Clutter]

Hello Clutter, thank you for your response. I usually take my NDT at 10pm. I did not take the previous evening before my test. My test was at 7am. When I previously went down to half a grain I felt undermedicated. Do you think I should alternate perhaps, one day half a grain another three quarters?

[Clutter in reply to Nik07]

Nik, I think it may be worth trying that unless you have a quarter grain which you can halve and take with 1/2 grain so the dosing is more even.

[Nik07 in reply to Clutter]

By the way, palpations lasted for a couple of hours, certainly not all night