Help with Antibody Results

[ToniMac]

hi there

I was diagnosed in June with Graves but others suggested I might have hashimotos on my previous post. Can you advise on my antibody tests please. Thanks

[ToniMac]

These were my other results…

Other test results

[SlowDragon Administrator]

previous post here

healthunlocked.com/thyroidu...

You have a consultation today?

How much Carbimazole were you taking in run up to these test results

what vitamin supplements are you taking

[ToniMac in reply to SlowDragon]

5mg Carbimazole and no supplements

[SlowDragon Administrator in reply to ToniMac]

B12 and folate are low

Likely to benefit from improving

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...

In-depth article on different forms of B12

perniciousanemia.org/b12/fo...

B12 range in U.K. is too wide

Interesting that in this research B12 below 400 is considered inadequate

healthunlocked.com/thyroidu...

perniciousanemia.org/b12/le...

And why aiming to keep B12 over 500 recommended

perniciousanemia.org/b12/le...

Great reply by @humanbean on B12 here

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 and may need separate methyl folate couple times a week

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 5-7 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 until level has improved

Post discussing how biotin can affect test results

healthunlocked.com/thyroidu...

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

[SlowDragon Administrator]

Antibodies

You must have TSI and/or Trab antibodies tested as this is essential to confirm Graves’ disease

At moment with only high TPO and TG antibodies this looks more like Hashimoto’s

It’s possible to have both Hashimoto’s and Graves’ disease

TSH is high

What has consultant suggested

[ToniMac in reply to SlowDragon]

TRab results were 3.3 in August

[SlowDragon Administrator in reply to ToniMac]

What was range

[ToniMac in reply to SlowDragon]

I’m sorry I don’t know the range, I’d rang my Endocrinologist’s Secretary for the value but she has now stopped until 6th January

[tattybogle in reply to ToniMac]

which set of thyroid results were taken at the same time as that TRab test ? ToniMac

(we can tell which sort of TRab were dominant at that time by looking at their action on thyroid hormone levels)

copied from previous post :"TSH <0.05 T3 15.5 T4 42.3.

I had an urgent referral to Endocrinology. By mid August, I was told that I had Trab antibodies and Graves Disease. TSH 19.00 T4 8.0 "

ie . did they test your TRab at same time as that TSH 19.00 result ... or did they test it earlier with the TSH <0.05 result and endo only informed you of it in Aug ?

[ToniMac in reply to tattybogle]

The TRab was tested and scored 3.3 in August when I got the TSH 19.50 and T4 8.0 results

[tattybogle in reply to ToniMac]

oh i'm a muppet, sorry . i was forgetting you were already taking carbimazole at that point toni

(if you get someone who's got very hypo T4 /TSh results with positive TRab result at same time , it means most of the TRab ( at that time) must have been the blocking sort, not the stimulating sort ... but once someone is already taking carbimazole levels it's not possible to say what is causing what)

[SlowDragon Administrator]

vitamin D

U.K. Government recommends everyone supplement vitamin D daily as a minimum between early October and end of April

gov.uk/government/news/phe-...

Many thyroid patients find they need to supplement all year

Aiming to maintain vitamin D at least over 80nmol

[pennyannie]

Hey there again :

Well if you do have Graves you also have Hashimoto's running alongside - and since Graves is considered life threatening if not medicated - treatment for Graves takes precedence and read you are on Carbimazole an Anti Thyroid drug which is semi-blocking your own daily thyroid hormone production.

Do you have the antibody blood test results from last June showing which antibodies were over range and positive in your blood test then - and we looking for a TSH Thyroid Receptor antibody reading - or a Thyroid Stimulating - or a Thyroid Blocking ab reading and range.

Graves generally presents as a very low suppressed TSH and with high over range T3/T4 readings or with low, generally inverted T3/T4 readings.

I read you are taking Amiodarone which is known to cause thyroid issues and hyper and or hypo symptoms - so I'm not sure how 'real ' or ' drug induced ' - these blood tests are.

Those highlighted in red - are obviously the ones out of range -

and you are now showing both sets of antibodies over range and dealing with Hashimoto's -

Your TSH is showing high and over range signalling you need more thyroid hormones -

with your T3 at around 54% and your T4 at around 27% through the ranges -

and showing as inverted - as generally the T3 reading tracks behind the T4 reading -

How are you feeling - I imagine with some internal pressure - and feeling you have no surplus energy ?

Maybe your dose of the AT drug needs reducing - as this would then release a little more T4 into your blood stream and hopefully re-balance these two vital hormones.

Most important to maintain your core strength vitamins and minerals at optimal levels so to support you through this phase of ill health -

i now aim to maintain my ferritin at around 100 - folate around 20 - active B12 @ 125 ( serum B12 500++ ) and vitamin D up at around 125.

[ToniMac in reply to pennyannie]

I only had amiodarone intravenously once in Nov 23 whilst in hospital just after my open heart surgery.

TRab was 3.3 in August when tested

[pennyannie in reply to ToniMac]

Do you have the range please ?

[pennyannie in reply to pennyannie]

Just searched Amiodarone on Elaine Moore's website and there are 3 papers there you might like to dip into - elaine-moore.com

[ToniMac in reply to pennyannie]

I have no idea of the range, I was just told 3.3 by my Endocrinologist’s Secretary

[pennyannie in reply to ToniMac]

Ok - no worries :

I think it's likely a positive and over range.

[TiggerMe Ambassador]

They don't seem to vary greatly...

TRab range

[TiggerMe Ambassador in reply to TiggerMe]

Or this from Leeds Teaching Hospital...

Ref. Range Notes

TRAB > 1.8 IU/L us regarded as positive.

TRAB 1.0 to 1.8 IU/L is regarded as equivocal.

TRAB < 1.0 IU/L is regarded as negative.