Graves or postpartum thyroiditis?

deleted due to account fraud

[Buddy195 Administrator]

Welcome to the forum Kdizzly

Graves Disease (hyperthyroidism) needs to be confirmed via positive TRab or TSI:

TRab

TSH receptor antibodies

TSI

Thyroid-Stimulating Immunoglobulin

TPO & TG antibodies may be Graves or Hashimotos.

 TPOab

Thyroid Peroxidase antibodies

TGab

Thyroglobulin antibodies

I would ask for TSI to be tested in addition to the tests you have had. Can you edit your post to include ranges, as these can vary between laboratories.

It’s useful to have key vitamin tests (ferritin, folate, vitamins D and B12) as these support thyroid health. If your GP is unable to complete, you could look to do this privately, as many forum members do.

thyroiduk.org/help-and-supp...

[SlowDragon Administrator]

You will also need to test vitamin D, folate, B12 and ferritin levels

[Hidden in reply to SlowDragon]

Thank you, the GP sent for these and all the results came back as normal. Would this indicate it’s unlikely to be Graves?

[SlowDragon Administrator in reply to Hidden]

Can you add actual results and ranges

Within range, not necessarily optimum levels

Good vitamin levels are

Vitamin D at least over 80nmol

Serum B12 over 500

Active B12 over 70

Folate at top of range

Ferritin at least over 70 minimum

[Hidden in reply to SlowDragon]

Again, thank you. I am not at your reference ranges.

What would this indicate?

How do I best achieve optimum of these scores?

Thanks, again!

[SlowDragon Administrator in reply to Hidden]

Low B12 symptoms

b12deficiency.info/signs-an...

methyl-life.com/blogs/defic...

With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a separate B12 supplement

A week later add a separate vitamin B Complex 

Then once your serum B12 is over 500 (or Active B12 level has reached 70), you may be able to reduce then stop the B12 and just carry on with the B Complex.

If Vegetarian or vegan likely to need ongoing separate B12 few times a week

Highly effective B12 drops

natureprovides.com/products...

Or

B12 sublingual lozenges

uk.iherb.com/pr/jarrow-form...

cytoplan.co.uk/shop-by-prod...

B12 range in U.K. is too wide

Interesting that in this research B12 below 400 is considered inadequate

healthunlocked.com/thyroidu...

Low folate

supplementing a good quality daily vitamin B complex, one with folate in (not folic acid)

This can help keep all B vitamins in balance and will help improve B12 levels too

Difference between folate and folic acid

healthline.com/nutrition/fo...

B vitamins best taken after breakfast

Igennus B complex popular option. Nice small tablets. Most people only find they need one per day. But a few people find it’s not high enough dose

Post discussing different B complex

healthunlocked.com/thyroidu...

Thorne Basic B recommended vitamin B complex that contains folate, but they are large capsules. (You can tip powder out if can’t swallow capsule) Thorne can be difficult to find at reasonable price, should be around £20-£25. iherb.com often have in stock. Or try ebay

IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg) and continue separate B12

Post discussing how biotin can affect test results

healthunlocked.com/thyroidu...

helvella.blogspot.com/p/hel...

Look at improving ferritin by increasing iron rich foods in your diet

Vitamin D test

Can test via NHS private testing service

vitamindtest.org.uk

[pennyannie]

Hello Kdizzly and welcome to the forum :

By most ranges your results ' look ' suspect as T4 top of range is generally around 22 with a TSH stuck down at under the range at 0.01 -

and you do have an over range TRab - which is the medical antibody evidence of Graves with also probably over range TPO antibodies - but Graves Disease treatment takes precedence.

The NHS allocate around a 15 - 18 month window with an Anti Thyroid drug which is prescribed to semi block your new daily thyroid hormone production and hopefully your T3 and T4 levels will fall back into range without the need for any drugs with your symptoms relieved.

There is an option to Carbimazole if you need to consider an alternative - Propylthiouracil - PTU for short - generally prescribed during pregnancy and after birth.

Considering you have been struggling along for around 2 years with a mountain of symptoms your body will likely be exhausted in very many ways - all of which will be compounding your health issues further.

Please arrange for your core strength vitamins and minerals to be run - as in order to recover you need a strong core strength of ferritin, folate, B12 ad vitamin D and we can advise on optimal levels as some NHS ranges are too wide to even be sensible.

Considering full blown Graves is life threatening if not medicated and considering you have not been medicated for 2 years I 'm confused and hope that this is more likely a case postpartum thyroiditis - but my knowledge limited.

[Hidden]

thank you, this is super helpful.

I had a full blood screen and the results are as follows:

Folate (within NHS range) 10.9

B12 (within NHS range) 327

Ferritin (within NHS range) 48

Some are a bit low in the range but nothing the NHS qualify as needing attention.

I want to think it’s a savage case of postpartum thyroiditis and not Graves. After less than a week, the 20g per day of carbimazole has calmed my hand shakes, but I am open minded to Graves, I just want to get to remission and for it to last.

is a score of 3 (0-3.3 range) considered to be positive for Graves or not, in your experience? NHS notes say it’s equivocal based on other results.

PS I don’t have a goiter, at least not yet!

[pennyannie in reply to Hidden]

Hey there -

You need to make sure when you reply to somebody that you reply in their message box and their name comes up as you start your reply - as then they get notified they have a message waiting for them - otherwise it's just pot luck if they come back to your question or not.

Well you give the range as 0 - 3.30 for TRab and with a reading of 3 - it reads as a negative - but I guess because of your having given birth some 2 + 1/2 years ago all your hormones may well have been all over place - and why the term ' equivocal ' is being used now and your result seen as ambiguous :

How was the birth - silly question again maybe ?

but if very stressful and not ' plain sailing ' - whatever that means - it may just have triggered Graves as this is an immune system disorder which tends to get triggered by stress and anxiety.

I aim to maintain my core strength vitamins of ferritin at around 100 - folate around 20 - active B12 75++ say around 125 - ( serum B12 - which I think your result is 500++ ) and vitamin D up at around 100.

  Hidden - I've just reread this reply of mine and I told you wrong - I'm so sorry - your antibody reading is 3 and the range is up to 3.30 - I had twisted them around in my head - so a negative for Graves but raises the question as to why they are even there and may have been higher so a question mark and why your result was marked ' equivocal ' especially since you have been suffering symptoms associated with Graves Disease.

Apologies :

[Hidden in reply to pennyannie]

Hi @pennieannie

The birth was traumatic with 2 blood transfusions, so fits the bill for Graves. TPO reads as classic postpartum thyroiditis though, along with the elevated but not extreme T4.

I have read that TRAb is indicative of seriousness of Graves, so with a borderline reading it is possible that I am only experiencing borderline symptoms?

I will invest in supplements, continue taking the meds and hope I continue to see improvement over the next month. Thank you for the recommendations,

[pennyannie in reply to Hidden]

Well Graves is Graves - I don't know any sliding scale of seriousness :

Ok - so a stressful birth may have triggered this but then I presume you would have been diagnosed way back then anyway at some 2 years ago :

Can you look back and find your thyroid results post giving birth ?

Well done for linking me in - but you need action only 1 of these 2 options -

the @ option is generally used when wanting to draw someones attention to a post but not necessarily wanting them to comment - at least that's how I use it !!

[Hidden]

thanks for the tips, have purchased some vitamins for a boost. Wish me luck.

[pennyannie in reply to Hidden]

Have you seen the message I sent you above in the reply where I wrote about your Graves antibody reading being positive - as I made a mistake there - and your current antibody reading is under the cut off number- so a negative for Graves - but as mentioned you are likely a question mark considering your symptoms these past couple of years.

Apologies :

[Hidden in reply to pennyannie]

deleted due to weird stuff on web

[pennyannie in reply to Hidden]

Ok good - yes give the Carbimazole a good couple of weeks and these symptoms should subside and you should start to feel more on an even keel.

Focus on building back up your core strength vitamins and minerals which will better able you to continue your journey back to better health and have the energy to enjoy your beautiful child.

Keep us in the loop :