Urgent advice needed!

[Paolatello]

Can someone help me with TRAb antibody reference range please?

My result came back as 3.0 but the doctors info doesn’t give a reference range.

I’m currently hyperthyroid by bloods but also have elevated TPO.

Does this mean Graves??

[Paolatello]

Just found out the reference range is maximum 2.9 so I’m 0.1 over. Is that significant?

[PurpleNails Administrator in reply to Paolatello]

It means you are weakly positive for trab. Antibodies do fluctuate and there is some over lap with antibodies being present in both autoimmune thyroiditis (Hashimotos) and Graves.

Do you have a suppressed TSH eg <0.01 and very high FT4 & FT3 eg over double the range. As Graves causes very high continuous levels.

[Paolatello in reply to PurpleNails]

My current levels are:

TSH 0.03 (0.35 - 3.5)

Free T4 17 (10-20)

Free T3 5.5 (3.5-6.5)

TPO 128 (range less than 35)

[PurpleNails Administrator in reply to Paolatello]

You have had high TPO antibodies for a long time? Your thyroid levels are within range.

You’ve never had replacement levo or anti thyroid medication?

Did you have a scan of thyroid or a radio iodine uptake scan to see how thyroid functioning?

[Paolatello in reply to PurpleNails]

My TPO has been up and down for over a decade. My TSH is currently out of range at 0.03. I have a large non-cancerous nodule found by ultrasound, a very swollen neck, constant bloodshot eyes and am having a thyroid uptake scan in April.

[PurpleNails Administrator in reply to Paolatello]

Do you have a record of how your levels have changed?

The uptake scan will show if the nodule is hyper functioning. Often the TSH lowers first and the high levels very (very) slowly creep up (often leading with FT3).

I have a solitary hyper nodule & my FT3 took about 4 years to go from just above range to almost double.

It might be that originally your thyroid was trending to be under active (with high TPO) but the nodule is hyper functioning & making up for the failing thyroid.

If you have eye issues & a positive Trab it is very important to have your eyes assessed for thyroid eye disease. The condition is treated separately to Graves as the conditions do not always occur at the same time. I would ask for referral to ophthalmology.

I also have eye issues & asked for a referral but endocrinologist states as my TSI is negative, I do not have autoimmune cause and refused me.

[Paolatello in reply to PurpleNails]

Thank you. I will definitely do that.

[PurpleNails Administrator in reply to Paolatello]

Also, you are not currently hyperthyroid. If your doctor suggest you are, they are diagnosing by TSH alone. Should they suggest an anti thyroid medication to bring your TSH up into range this would lower your FT4 & FT3 levels.

Is your doctor going to keep monitoring your TSH FT4 & FT3? How frequently?

[Paolatello in reply to PurpleNails]

I don’t know this yet. I am having the scan done on the 22nd April which has been requested by the endocrinologist and then I have a follow up appointment with him after the scan has been done.

[Simplyred57 in reply to Paolatello]

Did you find out what was causing your rash ? I have one and feel like my thyroid area is hot 🤷🏼‍♀️

[Paolatello in reply to Simplyred57]

Mine is down to inflammation in my thyroid. It happens when I’m having a flare up.

[Simplyred57 in reply to Paolatello]

Thank you I will mention it to my endocrinologist when I speak to him in a few weeks.