High T4, T3 and Anti-Thyroglobulin. Graves Disease?

[Edwina29]

Hi all,

I have just recieved my blood test results, but haven’t seen the doctor yet. My results are as follows:

Free T4 - 44.3 pmol/L - ref range (10.0 - 23.0)

TSH - <0.03 mIU/L - ref range ( 0.05 - 4.00)

Free T3 - 18.1 pmol/L ref range ( 3.5 - 6.5)

Anti- Thyriod Peroxidase - 42 IU/mL - Ref Range (< 60)

Anti - Thyroglobulin- 82 IU/mL - Ref Ranfe (< 6O)

Would this indicate Graves Disease?

Thanks

[SeasideSusie Remembering]

Edwina29

To diagnose Graves disease the following antibody tests are needed:

TSI - Thyroid Stimulating Immunoglobulin) antibodies

TRAb - TSH receptor antibodies

You can't diagnose Graves from TPO and Tg antibodies (the ones you have had done).

[Edwina29 in reply to SeasideSusie]

Thanks. What is the Doctor checking for with my test?

[greygoose in reply to Edwina29]

Hashimoto's Thyroiditis - aka Autoimmune thyroiditis. And, it's positive.

Hash's - as we patients know it - often starts with a hyper phase, but it's not true hyper, as in Grave's, because the thyroid isn't over-producing. It's just that the dying thyroid cells - dying because your immune system is slowly destroying it - are dumping all their stock of hormone into the blood, causing FT4/3 levels to rise and the TSH to therefore drop.

Your doctor will probably want to put you on carbimazole, but that is not the right treatment for Hashi's. The high levels will go down by themselves, and you will become hypo. If you take the anti-thyroid drug Carbimazole, your levels will drop even faster. And, the problem is that once a doctor has you on carbi, he's very reluctant to take you off it!

Also, your FT4 and FT3 are not high enough for it to be Grave's. Those are Hashi's results.

[Edwina29 in reply to greygoose]

Thanks

[Valarian in reply to greygoose]

'Also, your FT4 and FT3 are not high enough for it to be Grave's. Those are Hashi's results.' ....

where are you getting this information from greygoose ? I definitely have Graves', my initial results were similar, and the endo thought FT3 was pretty high. Others with a diagnosis of Graves' from TRAb have reported similar results.

I agree Edwina29 needs antibody tests for a proper diagnosis, but from my personal experience, I don't believe the thyroid levels are too low for Graves'.

[Lora7again in reply to Valarian]

I agree mine were similar.

[greygoose in reply to Valarian]

OK

[pennyannie]

Hello Edwina and welcome to the forum ;

If there isn't any obvious sign of a swelling in the neck area or discomfort when you swallow the cause may well be an autoimmune thyroid disease of which there are two, Graves and Hashimoto's and they both start the same way, with the same symptoms.

With Graves the " hyper phase " is constant and needs to be controlled with anti thyroid drugs like Carbimazole which block your own thyroid production whilst with Hashimoto's this " hyper phase " is transient and your levels will come back down naturally.

The only way to know if you have Graves is to have a blood test run for the antibody unique to Graves commonly referred to as a TSI ( roughly translated in laymans terms as stimulating ) and or a TR ab ( roughly translated as blocking ) .

This is the medical evidence that either rules Graves in or out of the equation. If the blood test comes back positive with over range antibody numbers, this is the medical evidence you need and the diagnosis of what you are dealing with and decides the treatment.

[Edwina29 in reply to pennyannie]

Thanks.

[SlowDragon Administrator in reply to Edwina29]

Ask GP to also test vitamin D, folate, ferritin, B12 and cholesterol

High cholesterol suggests Hashimoto’s

Low vitamin levels are extremely common with both Hashimoto’s and Graves’ disease

Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins

List of private testing options

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus vitamins including folate (private blood draw required)

medichecks.com/products/thy...

Thriva Thyroid plus antibodies and vitamins By DIY fingerpick test

thriva.co/tests/thyroid-test

Thriva also offer just vitamin testing

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test

bluehorizonbloodtests.co.uk...

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/thyr...

Graves Disease antibodies test

medichecks.com/products/tsh...

Link about thyroid blood tests

thyroiduk.org/getting-a-dia...

Hashimoto’s frequently starts with transient hyperthyroid results and symptoms and is frequently misdiagnosed as Graves’ disease

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Link about Graves’ disease

thyroiduk.org/hyperthyroid-...

[Edwina29 in reply to SlowDragon]

Thanks. The GP has already tested cholesterol and it was very low, I also have critically low Vitamin D so have started supplements. I am in Australia and think that further tests will be covered via are our Medicare system.

[SlowDragon Administrator in reply to Edwina29]

Please add country you reside in to your profile

Getting b12, folate and ferritin tested too

[Edwina29 in reply to SlowDragon]

Thanks. And have updated profile.

[Valarian]

As others have said, you need to have TRAb/TSI tested to be sure.

Your FT3 is high and you could be feeling pretty uncomfortable - are you experiencing any symptoms ?

[Edwina29 in reply to Valarian]

Yes. I have a rapid heart rate, for which the doctor has put me on a beta blocker, while they determine what is causing the issue etc. I also get hot really quickly, have lost weigh, trouble sleeping etc

[Valarian]

All typical symptoms associated with being hyper, The beta blockers will hopefully take the edge off the symptoms, but you won't really feel much better (and could get worse) until you get treatment , or the thyroid levels fall of their own accord.