help with results

[Kari55]

hi, my husband has Graves and has been in remission since 2019. He checks his thyroid via Medichecks every few months. His thyroid results are good but in January his thyroglobulin antibodies crept up. He repeated it in March and the results were:

Thyroglobulin antibodies- 116 (0-115)

TSH 1.89 (0.27-4.2)

T3 4.4 (3.1-6.8

T4 17.4 (12-22)

TPO 12.1 (0-34)

He went to Endo and have following tests done end of April:

TSH 1.02 (0.465-4.68)

T3 5.4 (4.3- 8.1)

T4 13.9 (10-28.2)

TRab 1.02 negative (borderline 1.51-3)

CRP 17.4 <5

Thyroglobulin antibodies 148 (0-115)

TPO 17.8 (0-34)

he had a thyroid scan but our endo is scatty so we are still waiting for his advice in terms of next steps. Any insights ? What is going on?

[Jaydee1507 Administrator]

The 2 blood results have different ranges, so the numbers aren't comparable.

On the second results his levels have dropped somewhat to:

Free T4 (fT4) 13.9 pmol/L (10 - 28.2) 21.4%

Free T3 (fT3) 5.4 pmol/L (4.3 - 8.1) 28.9%

His TSH is similar on both tests and looks good although his free hormones on the second test are on the low side.

What time of day were these tests taken?

I wouldn't be too concerned about 1 point over range for Tg antibodies although worth keeping an eye on.

How does he feel?

Is he also monitoring vitamin levels ferritin, folate, B12 & D3?

[Kari55 in reply to Jaydee1507]

Thank you, yes the first thyroid panel was done through medichecs and the second in the hospital. He feels ok but often tired, goes for a wee at night, struggles to sleep sometimes. Both tests were taken in the morning and he hasn’t had his vitamins checked. He was really slack taking vitamin D in the winter so is now taking 4000ui. His crp is high, we aren’t sure why.

[pennyannie]

Hey there again :

I looked here first and thought this doesn't look like Graves Disease - and with no TRab antibody reading dismissed the thought.

But there is inflammation and thinking it likely Hashimito's Auto Immune disease which can present with transient hyper type swings in symptoms and often confused with Graves which is permanent hyper with thyroid hormones rising higher and higher and with a TSH stuck down under the range.

At least your husband has been given a scan - so hopefully your scatty endo will get his act together before the weekend and give you both some peace of mind.

[Kari55 in reply to pennyannie]

He had 2 Graves episodes in the past. 2007 and 2018, Graves antibodies were high then. I really hope our Endo gets a grip and tells him what the plan is.

[pennyannie in reply to Kari55]

Yes I know I read back to the previous posts -

but we are looking at an Auto Immune disease that can wax and wane throughout ones life - though for some Graves burns itself out given enough time.

Something has triggered the immune system to turn and attack the body rather than defend it - some people run with both Graves and Hashimotos - and active Graves treatment will take precedence -

but with no TRab reading and a TSH up in the range, with T3 and T4 in the range -

I doubt we are currently looking at Graves Disease - but there is something going on as there is high inflammation and a scan has been actioned - so that should give us a clue and hopefully some peace of mind.

I think I've sent these before but there they come again;

pubmed.ncbi.nlm.nih.gov/338...

ncbi.nlm.nih.gov/pubmed/306...

All things Graves - elaine-moore.com

All things Hashimoto's - Dr Izabella Wentz who writes and researches as thyroidpharmacist.com

[Kari55 in reply to pennyannie]

Thank you , I have messaged Elaine to see what she thinks

[pennyannie in reply to Kari55]

Ok then :

[Kari55 in reply to pennyannie]

He has just spoken to the doctor. His CRP from last week has gone right down and is no longer a concern. It was probably after his eye laser surgery. His thyroid scan came back clear. He will repeat tests in August to see if anything changes.