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Thyroid Disorders Message Board

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    Old 10-24-2007, 05:41 PM   #1
    amanda26
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    I took your advice and made an appt w/ my GP again to ask him to run antibodies test. They have a cancellation at 11:00 in the morning. What specifically should I ask for and how do I convince him if its a hard sell? Also, if I go at 11:00 I will probably get to the lab around 12:00. Is that a good time or should I wait until early morning next day to test? One more thing for when I get the results, what should I look for w/ those? Thank you for your support. Now hopefully these test results will be back before endo appt in 2 weeks and if I do need to see endo I have already waited most of the 2 month wait. Thanks again.

    Last edited by amanda26; 10-24-2007 at 06:06 PM. Reason: grammar

     
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    Old 10-24-2007, 07:03 PM   #2
    mkgb
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    Re: ********

    The antibodies you need to run for the hypothyroid AI Hashimoto's are TPOAb and TGAb. If I remember correctly you are having mor hypo than hyper symptoms. So Hashi's is the most likely culprit.

    Taking blood work in the morning is mainly important with the TSH and T4 and T3 blood concentrations. As the day goes by the levels are depleted. The antibodies will either be there or not time of day is not that relevent. .

    The standard tests you need to get a full picture are
    TSH - optimal is about 1. Normal range since 2002 is 0.3 - 3.0.

    FT3 and FT4 - optimal is in the 50-80% of the laboratory normal range.. some feel hypo at 50%.

    T3 Uptake - If you are low.. you are not converting enough T4 to T3 and can feel hypo as a result. High you can be over converting and too low in your T4.

    RT3 - will determine if you are converting to the inert form of T3 versus the active form of T3.

    There are four main antibody tests:
    TPOAb - 90-95% confirmation of Hashimoto's. So this means 10% will have a false negative.
    TGAb - 75 % confirmation of Hashimoto's
    TSI - 80% confirmation of Graves
    TRAb - 60% confirmation of Graves

    Note that the antibodies have room for negative results.. so you can still have Hashimoto's but not have a positive antibody test. In these cases a biopsy of a groiter or growth will show a positive result in some those that do not test positive for the antibodies. I am not saying go for a biopsy.. that is for an Endo to decide.. or thyroid savy IM/ENT.

    Argue your symptoms. Plead for thoroughness of care and peace of mind. Talk with your relatives and get a thorough thyroid history. These tests will not hurt you only help you. If nothing comes off odd.. then the MD can get on his high horse..and check you ferritin, vit D, vit B12, and Carnitine levels which when low can man ifest hypothyroid symptoms. There are many reasons for the symptons.. try and get him on board to help you find the problem. Be nice.. but firm.. take a self addressed envelope for them to mail a copy of your results to you in. Also start a log of your symptoms with morning and evening Bp and temperature readings. ALl this shows you are thorough and serious. Do not budge.. it is your insurance and your money.. and your body and health.. you deserve the best care.

    Hope this covers all your questions.
    MG
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    Old 10-24-2007, 07:46 PM   #3
    mkgb
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    Re: ********

    I went back and looked over your symptom list again.. get it all run antibody wise.. it is possible that you have both Hashi's and Graves.. which is a real fun body thryoid war. My mother was Hashitoxicosis as was her next sister in line.. then we have the Hashi's middle child, hypo refuse to be tested second youngest, and the youngest of my mother's sisters Graves all the way.

    I am the newest generation of AI's from the oldest of five thyroid rich sisters. So it is genetically dominant.. studies show and eighty percent dominance in females with thyroid history parents.. fight for adequate care.. use the old words of wisdom.. WHEN IN DOUBT CHECK IT OUT? The refusal to test really make me want to break things.. here comes another mood swing.

    MG
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    Old 10-25-2007, 06:50 AM   #4
    mkgb
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    Re: ********

    Hoping for your best on getting those tests run today. Make sure you get a copy of the results and tell us how it goes. Often being fore armed and educated on the the details can get you better care.

    Sincerely,
    MG
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    Old 10-25-2007, 03:22 PM   #5
    amanda26
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    Re: ********

    Thank you for your advice. I went and the nurse asked if I might want to see the nurse practitioner since she is a woman (sometimes they understand better) and she may have different opinions on things, so I said sure. This was the first time I have seen her but I gave her the rundown on my symptoms, family hx and she seemed very open to all of it and agreed to do antibody testing. The first thing she said as she shook my hand was "oh my gosh your hand is freezing!" I said "It always is." So from there I went over to the lab. So, are the antibodies test an all or none thing. Like if you have them you have a problem, and if you don't then you don't. Thanks for your advice. I really appreciate it.

     
    Old 10-25-2007, 05:08 PM   #6
    mkgb
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    Re: ********

    I am glad you got your testing and found someone that will listen and test you when you have a concern.

    As to the antibodies. You do not get false positives. If you are abnormal in the TPOAb or TGAb you have Hashimoto's disease. If you are abnormal in the TSI or TRAb you have Graves Disease.

    In the case of Hashimotos.. the TPO Ab test has a 95% accuracy rate.. so five percent of those tested that have Hashi's will not test positive on it. The cross check TGAb has a 20% false negative chance.. but if you are positive abnormal in both TPOAb and TGAb there is no doubt you have Hashimoto's.

    In the case of Graves Disease the tests are not as accurate. The TSI test will catch 80% of those with Graves disease.. and the cross check TRAb will catch 60% of Graves cases. An uptake scan is the main method of confirmation in Graves. But if you do come up positive in either or both TRAb/TSI you have Graves disease.

    If you test positive for Hashimoto's and Graves disease you have a condition known as Hashitoxicosis. In the end Hashimoto's will kill off the thyroid and thus cure Graves so to speak, but the journey to hypothyroid is a real pain in the neck.

    Sincerely,
    MG
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