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mimi1999 11-11-2008 05:05 PM

Confused about anti-bodies and Graves' vs. Hashimoto!

I found out that I have twice the normal range of TSH Receptor Antibodies (TSH-rec AB). I think this is sometimes referred to as TSI?

From my online readings, this seems to indicate Gaves' disease. However, the doctor I was referred to (an internist) says it is no big deal and that it is the beginning of Hashimoto. He says I just need to monitor my TSH levels (which are currently normal).

Does this make sense, or should I ask for a second opinion? Should I see an endocrinologist?

The thing is, I DO have the symptoms of Graves.

Many thanks for any advice!

mkgb 11-11-2008 06:10 PM

Re: Confused about anti-bodies and Graves' vs. Hashimoto!
Actually you had a TRAb test. it is a Graves identifier test.

The Hashimoto's tests are TPOAb and TGAb.. TRAb are not a precursor to Hashimoto's unless you have the TPOAb and TGAb as well. But then you cna have Graves and Hashimoto's at the same time.

You need a DIFFERENT MD that will run some added tests to confirm Graves for sure. You need a TSI run and get the TPOAb and TGAb run. If the TSI is positive and the TPOAb and TGAb negative you have clear cut Graves. You also should request and iodine uptake scan. This will clearly denote Graves versus Hashimoto's thyroid uptake behavior. I really question the Internist ability to manage your care with that slip up.


GravesGirl73 11-12-2008 06:01 PM

Re: Confused about anti-bodies and Graves' vs. Hashimoto!
Yes find out something Mimi cause I am confused too as I have been treated for Graves for 2 years with meds. I have abnormal anti tpo's anti thyroglobulin,tsi and TRab. I was never told Hashi's....but I had Graves symptoms like you but labs to match, how about you?Your FT3 and 4,tsh? I thought I knew a lot about Graves till I found out I may have Hashi's too thanks to MG, not a doctor or endo! LOL!!

mimi1999 11-16-2008 01:41 PM

Re: Confused about anti-bodies and Graves' vs. Hashimoto!
Hi GravesGirl73,

Yes, I think we are our own best advocates when it comes to health concerns. I am very grateful for those more experienced then me who share their knowledge!

To answer your questions my TSH, FT3 and 4, are all normal. I have an apointment with an endocrinologist in 2 months to find out more!

What symptoms do you have? Do you still have them with treatment?

mkgb 11-18-2008 08:00 AM

Re: Confused about anti-bodies and Graves' vs. Hashimoto!
Hummm.. the DREADED NORMAL. You can be in NORMAL range and not OPTIMAL for you. What were your actual TSH, FT3, and FT4 values and ranges? If you share thosee we can advise on medication options and may be able to advise on additional testing to help narrow down and refine your treatment.


mkgb 11-19-2008 07:45 AM

Re: Confused about anti-bodies and Graves' vs. Hashimoto!

THANKS! *SNIFF* I am so touched. The teacher in me is HAPPY! I am glad that I can serve as a communication bridge to slog through the techno jargon and put it into layman's terms. I can put M.D. with Medically Down with thyroid dysfunction in parentheses. :D

I do not think MDs are necessarily bad or dumb. HECK they made it through medical school. However I do think that they often try and take short cuts and do not take the time to see the whole picture. They are just to busy and overworked to have the time or concern to treat each patient as an individual. It is no longer a practice in the art of medicine, instead MDs are in the medical industry. This brings images of assembly lines and sterile factories.

That is not sufficient for thorough medical care in my engineering/scientific view point. I see each patient as an individual experiment. ODD, I know.. but you just have to step in my head to understand. You have to evaluate each experimental problem efficiently.. this requires lists: knowns, unknowns, constants, equations.. in people that are ill you have knowns (symptoms) and hard facts/constants (supporting blood work). The unknown is the source of the illness and the equation/solution is medication that DIRECTLY applies to the source NOT the symptom. TOO many things can cause the same symptom set... SO you need to be willing to take the shotgun approach to testing your system.

You also have to understand where NORMAL comes from... I found it fascinating that MALES from 25-45 that were fit and healthy with no history of thyroid dysfunction were used as the basis normal determinant for thyroid function tests. This determine 95% of these 17000 males had TSH levels from 0.89-1.1 and Ft levels were in the 50-80% of NORMAL range. OKAY... well given the hormonal fluxing of women and the fact that effects things.. on top of us BEING female.. why not get a female range to.. broken down to correspond to hormonal cycle and phase of life? Hummm? Well the literature states females were not used because they couldn't find a large enough set to study that was free of familial thyroid dysfunction. It has got to get you thinking, How many of those men were clueless? Also how can an MD ignore symptoms and cling to a range based on MEN given a women presenting symptoms with a FAMILY history of thyroid function?

IMPO It comes down to willingness to listen, believe, and desire to heal the patient. Most MDs are double/triple booked and prefer to brand the cattle and send it down the shoot with out a second glance. You have to look out for yourself and learn to understand your body and your blood work.


GravesGirl73 11-19-2008 05:09 PM

Re: Confused about anti-bodies and Graves' vs. Hashimoto!
yes MG you are so right! Think of all the people though in my Mom's 70 plus, they think doctors are Gods and would never go look for another doctor or question them. They never took their illnesses in their own hands, heck they don't even know the names of the pills they're on!!
I thought the reason the tsh range was so high (0.35-5.5) was that a lot of the people they tested HAD thyroid disease and didn't know it! Makes sense! I think you have to look long and hard for a compassionate doctor these days....I heard they call middle age women with thyroid problems goiter girls! They don't take us seriously and think it's all in our heads most of the time. I knew I probably had Graves when I first went to the endo.It was HIM that didn't believe it...I didn't have bugged out eyes so I couldn't have it, I guess! He felt my throat and it wasn't enlarged...but when he put that paper over my hands and they were shaking like a 2 dollar horse, I was like....okay, do you believe it NOW??

lynnybug55 11-20-2008 10:17 AM

Re: Confused about anti-bodies and Graves' vs. Hashimoto!
GravesGirl, You are so right about older women. I recently found out my mom is on synthroid, but she didn't even know what it's for. (MY dad did, though). She's 88 and is entitled to some lapse of memory, but she's getting worse. Of course, her doc doesn't even know about this! I guess it's up to us to try to get the best care possible for our parents!

GravesGirl73 11-20-2008 04:57 PM

Re: Confused about anti-bodies and Graves' vs. Hashimoto!
I found out my dad's sis took Synthroid, I asked my other aunt about it and she didn't know why my other aunt took it????She's really with it too at 85. The other one who took it died at 93 a few years ago so I can't ask her.. I had a cousin that had a nodule and didn't know if she was hyper or hypo?She doesn't take anything now as far as thyroid meds.I was curious about thyroid disease in my family but no one has a clue really....just that it seems to be on my dad's side.I ask family at wakes and funerals and they don't seem to know what the hell I'm talking about! LOL!Maybe they ALL have brain fog!!!

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