[jeff92]

#1060744

My wife recent had her T3, T4, and TSI levels checked. She is currently on very low dose anti-thyroid meds (2.5 mg dose/daily). The T3 and T4 indicated she is a bit hypo; however, the TSI levels were elevated to ~three times higher than normal. Her TSI levels just a month ago were normal. She has already had radiotherapy of the eye orbits and the eyes seem to be staying the same. She has TED with one eye worse than the other, protrusion and diplopia, etc.

Does anyone know why the TSI level can change so much within 30 days?

Thank you everyone – this group is truly generous.

[Kimberly]

#1184464

Hello – It’s not well understood why antibody levels can fluctuate, with a few exceptions. Antibody levels can spike significantly after RAI treatment for hyperthyroidism. The can also decline during pregnancy and increase during the postpartum period.

I’ve also read that perhaps the stabilization of thyroid levels in itself can reduce antibodies – so perhaps it’s the fact that your wife went slightly hypo that had an impact.

http://www.ncbi.nlm.nih.gov/pubmed/17132745

Some eye docs will use TSI to determine when a patient is a candidate for surgery, but others don’t use TSI at all – they will instead rely more on documentation of whether signs/symptoms are changing over time, or whether they are stable.

[jeff92]

#1184465

Thanks, as always, Kimberly! Do you know How often do drs should check these levels? I know it is not helpful to worry but I’ve also read that high TSI levels can lead to worsening TED. And Ive read that sometimes it doesn’t.

[Kimberly]

#1184466

Hello – The antibodies have a fairly long “shelf life”, so my own doc only checks them every few months. Those who are waiting to get cleared for eye surgery, though, might go through more frequent testing.

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