Guys can have Graves with normal TSH for 5 years without symptoms but with high antibodies?

[samoozain]

Guys can have Graves with normal TSH for 5 years without symptoms but with high antibodies? Doctor suggested Hashimots last year and said i will need Levo hormone in the future but read over internet that have high antibodies are shared with Graves though, any idea?

[pennyannie]

Hello Samoozain and welcome to the forum :

Both Graves and Hashimoto's are auto immune diseases that both tend to attack the thyroid and eyes, and the issue is one of your immune system having been triggered to attack your body rather than defend it.

Quite why your immune system has been triggered to go ' on the attack ' rather than ' on the defence ' of your body is the question - and there might be a genetic predisposition but then again, there might not be, and, given some thought, you are the one who may be able to shed some light on this part of the equation.

Graves and Hashimoto's can both wax and wane throughout one's life, like any other AI disease, and they can both be positive in your thyroid antibody blood test.

If that is the case Graves Disease takes priority as it is considered life threatening if not medicated - initially with Anti Thyroid drugs, eg. Carbimazole or Propylthiouracil - ( PTU ) - while we wait for your immune system response to calm down and your T3 and T4 thyroid hormones to fall back down into the range.

Hashimoto's is not treated with AT drugs but you will eventually require thyroid hormone replacement as this AI disease systematically disables your thyroid

The unique Graves antibodies are generally expressed as either a TR ab - a thyroid receptor blocking antibody or a TSI - a thyroid stimulating antibody.

Hashimoto's antibodies are generally expressed as TPO or TgAb :

Further reading - for all things Graves Disease - elaine-moore.com

and for Hashimoto's - the research of Dr Izabella Wentz - thyroidpharmaist.com

[Buddy195 Administrator]

Welcome to the forum samoozain,

So we can offer better advice, can you tell us more about your thyroid condition, eg ongoing symptoms, plus blood test results (with ranges in brackets) for:

TSH

FT3

FT4

Plus key vitamin tests (ferritin, folate, vitamins D and B12)

Regarding antibody tests, which tests have you had?

[PurpleNails Administrator]

Which antibodies were tested? There are quite a few thyroid antibody test. 

TPOab (Thyroid Peroxidase antibodies) TGab (Thyroglobulin antibodies)   Both signify thyroid autoimmune but the thyroid levels can either be other under active or over active. 

 If hyper Graves suspected this can be confirmed by TSI - Thyroid-Stimulating Immunoglobulin (signifies hyper Graves) TRab - TSH receptor antibodies (TRAb) (signifies Graves) 

Antibodies don’t alway correlate to the autoimmune activity, it’s just that the presence of antibodies is evidence that “something” autoimmune is occurring. 

There is no treatment or management for antibodies as they are a result of the condition not the cause.  Treatment is always based on where your FT4 & FT3 are.

  Doctors simplify this by looking at TSH although the TSH is not a reliable marker & knowing your FT4 & FT3 are important.  

Antibodies can be present many years before developing treatable thyroid levels.