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  • Criteria for Graves' Remission? What to make of my antibody levels...

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    Old 09-14-2012, 07:54 PM   #1
    pazoodle
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    Criteria for Graves' Remission? What to make of my antibody levels...

    Hello,

    As discussed in a couple of other posts I wrote on here, I have gotten confusing information and mixed signals from endos and docs since being diagnosed with Graves' in March of '12 after exhibiting a goiter and elevated T3 and T4. My current doc, who is just a GP and not an endo, has recently declared that I have reached remission based on my significantly elevated TSH level + low/low normal T3 and T4 levels. She has therefore told me to stop all Tapazole, and I did, about two weeks ago.

    I asked for the antibody test and she denied me saying it wasn't necessary and couldn't conclusively diagnose Graves' anyway and blah blah...that is the same answer I got when I asked my endo if I could have the tests when I was being diagnosed with Graves'. Anyway, I went ahead and ordered some antibody tests myself via a self-pay online lab. Here are the results...but I could really use some insight on interpreting them:

    Thyroid Stim Immunoglobulin
    Result Ref Range
    87 0-139

    Thyroid Peroxidase (TPO) Ab
    Result Ref Range
    HIGH 190 0-34 IU/mL

    Antithyroglobulin Ab
    Result Ref Range
    35 0-40 IU/mL


    Does this confirm my Graves' and/or my remission from it? Thanks for any information you might share with me as I am a bit lost here.

     
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    Old 09-15-2012, 10:22 AM   #2
    midwest1
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    Re: Criteria for Graves' Remission? What to make of my antibody levels...

    I don't have Graves' and only know what I've learned by hanging around here for years. I hope that will help you at least a little.

    Your TSI titer is technically negative, but based on how high it is, it's a sure thing you have Graves'. Healthy people have no TSI.

    This part I'm not 100% sure about, but... Your high TPO may mean that you also have Hashimoto's thyroiditis, which will cause your thyroid gland to stop working at some time in the future. Then you will be permanently hypOthyroid. As I say... I'm not 100% certain of this, but I think it's true.

    I'm uncertain at all about what constitutes remission. You certainly would want your free T4/3 to be well within lab range bounds and to be symptom free. TSH will probably remain low for a long time once the FTs are in control; the Graves' antibodies do that to TSH. Do not let any MD rely solely on TSH to determine your thyroid status from here on out. It's totally unreliable at this point.

    You may find some benefit from the book, Graves' Disease: A Practical Guide. If I had Graves', I know it has the information I'd want to rely upon for making good treatment decisions.
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    Old 09-15-2012, 10:26 AM   #3
    pazoodle
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    Re: Criteria for Graves' Remission? What to make of my antibody levels...

    Thanks so much. My TSH is currently elevated so I am not sure what to make of your comment on that.

     
    Old 09-15-2012, 10:58 AM   #4
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    Re: Criteria for Graves' Remission? What to make of my antibody levels...

    I haven't been on here in awhile and am still not able to post regularly. I just took a peek now.

    Your TSI level indicates that you have Graves'.

    Just so you know, most people achieve remission within 2-4 years of starting anti-thyroid drugs.

    Stopping meds before the body indicates that remission is imminent sets the patient up for relapse.

    Remission is considered imminent when ALL of the following criteria are met:

    TSI is 40 or lower

    FreeT4 level is in the upper third of the range

    TSH is at least .3


    Your high TSH and low/normal T4/T3 levels show you to be hypothyroid and not in remission - sorry.

    Unfortunately, many doctors have no clue how to treat Graves' and yours sounds like one of them.

    The right way to be medicated for Graves' is to take the lowest possible dose that will maintain the FreeT4 level in the upper third of the range (or higher), regardless of TSH.

    Most people are taking 1.25mg every third day before stopping meds.

    TPOab's are markers of thyroid inflammation and levels such as yours are seen in Graves' and usually higher in Hashi's.

    The fact that you have measurable anti-TGab's *could* mean that you'll develop Hashi's along the way.

    Being hypo increases antibody production....antibody production is what got us sick in the first place.

    I suggest that you get thyroid function labs done every 2-3 wks. so you can "catch" your FreeT4 level before it goes over-range again. Without a doubt, I also suggest that you find a more thyroid-savvy doctor.

    Your doctor has obviously overmedicated you and it will be anyone's best guess as to what Tap dose you should be taking..

    So sorry to hear of yet clueless doctor - I saw 4 of them.
    __________________
    Graves' 2007...remission 2009....hypo 2010

     
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