[gravessufferer]

#1059090

Hi Everyone,

Haven’t been here for a while but would really appreciate any advice. To cut a really long story short, I was diagnosed with Graves Disease in October 2008 (T4 45.8 / T3 46 / TSH <0.01) had medication for a year, went into remission and have been up until now.

I am originally from the UK but am now living in Spain. I had a blood test the other day to check everything was going alright and got these results. The doctor was meant to test T4 but didn’t even though I asked.

So my TSH was 4.69 (normal range here in Spain 0.34 – 5.60 ) this is normal so wasn’t too worried but it had risen a lot since last test.

The worrying part was they tested for:

Anti thyroid peroxidase antibodies TPO – results were 973.0 (normal range here in Spain 0.0 – 20.00)

Anti throglobulin antibodies TGA- results were 48.6 (normal range here in Spain 0.0 – 5.0)

The doctor said it wasn’t normal but she didn’t seem too concerned, problem is she doesn’t know my history or that I am supposed to be in remission and I can’t properly communicate with her so she may have thought I was still ill now so to speak.

Can anyone advise on these results, should I get more tests, from what I have found on the web results like this are definitely something to worry about and could indicate hashimoto disease, and or relapse?

I appreciate any advice… thank you and you have always been such a great support for me here!

Abigail

[Bobbi]

#1172065

Hi, Abigail.

Remission for us is defined as being able to go off the meds for a year or more while maintaining normal levels of thyroid hormone. The definition has nothing to do with the antibody levels — only with the thyroid hormone levels. And if you thyroid levels are normal — as the TSH suggests — then treatments are not warranted. There are no treatments for the antibodies.

I suppose you don’t have a history of antibody levels to refer to? Because while antibody levels rise and fall for no well-understood reason, your own levels might be high over time. Putting on my Pollyanna hat for a moment, I will speculate that perhaps your antibodies are within this range normally, and that they are simply balancing one another out? (I have no medical training whatsoever, so take that comment with a grain of salt. But it strikes me as a possibility nonetheless.) In other words, you might watch for signs of hypo, but worrying about it might be a waste of time.

[gravessufferer]

#1172066

Hi Bobbi,

Thanks for the fast response. Unfortunately I don’t have any previous antibodies results to refer to.

I think if I had the T4 and T3 to look at then I might be able to get a better picture so maybe I should get them checked? My current TSH level would be classed as high in the UK as the upper limit there is 4.50.

I am trying to get hold of my old endo as he is amazing and I think he will be able to let me know if anything to worry about. I didn’t really want to just leave it and wait to get ill again if these were signs if the illness creeping back or going hypo.

I wondered if high levels of antibodies like this were normal in patients in Graves remission.

Thanks
Abigail

[snelsen]

#1172067

Hi Abigal,
I think the main thing is-how do you feel? If you are feeling fine, you probably are fine. Antibodies can be elevated for ayears and years. I suggest that you reflect on Bobbi’s post, follow your plan and enjoy Spain and your new life there. To address your concern about communication with the doc in Spain I suggest you write a short summary of your Graves’ history so she can read it at her own rate.
Be aware the there is always a chance of a change in your remission status,so it is wise to be followed by a doc over time.
Shirley

[Kimberly]

#1172068

Hello – I don’t have any knowledge of TSH ranges in Europe, but there is some controversy in the U.S. over whether the upper end of “normal” should be reduced. There is some more info in this thread:

(Note on links: if you click directly on the following links, you will need to use your browser’s “back” button to return to the boards after viewing. As an alternative, you can right-click the link and open it in a new tab or new window).

http://gdatf.org/forum/topic/42581/?page=2

If you are having symptoms of hypO, it would be worth pressing the doctor to check your T4/T3 levels.

Take care!

[Author]

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