Can you have Hashimoto's with just raised Thyroglobulin antibodies?

[ShonaGreen]

Hi,

I posted yesterday with blood results checking for thyroid antibodies.

Thyroglobulin TgAb - 277 (range <115)

TPO - 17 (range <34)

At first I thought that this could be an indication of Hashimoto's, but from the info I've read today, it seems that diagnosis usually made if have raised TgAb and TPO.

I'd appreciate it if anyone could let me know if they've got Hashimoto's based on raised TgAb only? Or is it likely that something else causing increased TgAb?

Thanks for your help!

[SlowDragon Administrator]

NHS are reluctant to diagnose Hashimoto's on just high TG antibodies

Others in similar situation of only high TG antibodies struggle to get autoimmune thyroid diagnosis.

But many medics ignore/don't understand the significance of thyroid antibodies anyway

High TG antibodies can be due to other illnesses or no obvious reason too

healthline.com/health/antit...

[ShonaGreen in reply to SlowDragon]

Hi SlowDragon, thanks for your response and the helpful info. As my results weren't too high either I guess that makes it more difficult to tell if it's Hashimoto's or maybe nothing at all. I also tested positive for an ANA test recently but can see now that could be due to a number of different autoimmune conditions and may not find out which one easily. But on a positive note I've started to feel a lot better recently so think I must be responding well to the Levothyroxine, long may it last!

[SilverAvocado]

Shonagreen, I'd always thought that TgAb was just as diagnostic for Hashimoto's as TPO, but sounds like I may be wrong.

I looked back at your previous results and was a bit confused, I think the ones you shared were medicated results? So you did have low freeT4 and/or freeT3 when before you started thyroid hormone replacement?

Having the antibodies plus underactive thyroid is fairly conclusive that its Hashimoto's. Almost all underactive thyroid is caused by Hashimoto's, unless you've had a thyroidectomy or anything else that damaged your thyroid.

[ShonaGreen in reply to SilverAvocado]

Hi SilverAvocado, thanks for your message. I thought the same as you but the more I read the more it seems that testing positive for TPO (as well as TgAb) is more conclusive of Hashimoto's than just having a positive TgAb.

My first tests for thyroid levels on 29 March showed quite low levels (see below) and I initially saw a new GP that was very understanding and prescribed 50mg Levothyroxine (which I've been taking for 3 weeks now).

TSH - 1.92 (0.35 - 4.50)

Free T4 - 11.8 (11.0 - 26.0)

Free T3 - 2.8 (3.9 - 6.8)

I've had a few blood tests since then testing for other things, and the most recent ones I shared were done on 29 April checking for the thyroid antibodies. I did a medichecks test as although my GP asked for antibodies to be included in last test, the lab didn't do it and then another GP said that wasn't that important anyway as would still be treated in the same way. But I was interested to know about the thyroid antibodies, as after positive ANA test I'd like to try to find out if/what autoimmune conditions I may have. I'm seeing the new GP again next week so will discuss the antibodies results and see what he thinks.

[SilverAvocado in reply to ShonaGreen]

With Hashimotos you can also get false negatives, so it can be worth retesting. Some people are hypothyroid for years and never see a positive antibody test.

That thyroid panel makes me suspicious you may have Central Hypothyroid. Your freeT3 is extremely low (often it doesn't get to the bottom of the range, and some people will be diagnosed without dropping at all).

But your TSH hasn't really raised at all. Most people would have it sky high with freeT4 and freeT3 like that, which makes me think your TSH response is not working.

This is more of a pituitary disorder, as it's the pituitary that produces TSH. Ideally you want that checked out, as other hormones may be affected.

It's theoretically possible to have both central and auto immune hypothyroid, very unlikely, but I don't see any reason why it couldn't happen to the one very unlikely person

[ShonaGreen in reply to SilverAvocado]

Hi SilverAvocado, thanks for your message. When I posted my first blood results a few people mentioned central hypothyroidism too, so I did some research and mentioned it to my GP. He agreed to test some things to see if my pituitary is functioning well (FSH, LH, prolactin, oestradial). They all came back normal so I guess that means that pituitary is OK? I'm not sure if some other tests need to be done too? I'm seeing the GP again next week so can ask him then. I'll do some more research to see what else I can have done. I'm also going to ask for a referral to see an endocrinologist so we'll see how that goes. I've heard of a local one mentioned on here that other people have seen and got on well with so fingers crossed!

[SilverAvocado in reply to ShonaGreen]

I don't know much about the non-thyroid elements of central hypo. Doctors can often be really awful, too, but it sounds like you've got quite a good one!

There is a forum regular who has central, she has a pituitary tumour. She had to self diagnose, and read up in endocrinology textboks to find out what tests she needed. I believe Prolactin is the big one she had out of range. It's also possible to have a scan, I believe an MRI scan. Unfortunately I don't know anything beyond that.

Definitely make sure you keep copies of the prolactin and other results and put them somewhere safe. You will probably slowly find out more and more about the illness over the years, and get better at interpreting these results. A number doesn't have to be out of range to be an issue, although I think Badhare's prolactin was several times larger than the top of the range.

[SlowDragon Administrator]

Yes...i think it's Japan....I read that too somewhere

[ShonaGreen]

Hi JaneyJaney, thanks for sharing your experience with me, I hope you're feeling better now? I laughed when you said that you felt hungover everyday as that's exactly what I say too! It really helps to hear how other people are getting on and have learned so much from this forum already! I think it makes sense to see an endocrinologist next and get a thyroid ultrasound, will go private if need to. Will also try going gluten-free, I've already cut out a few things that I know don't agree with me so will see if this makes a difference too!

[ShonaGreen]

It would be great if you could share the article if possible, thanks!

[ShonaGreen]

Thanks again for this JaneyJaney!