Need help with labs! Elaine? Jody? Others?

[Guest guest]

I have had Graves since Dec. 1999 and had RAI in Feb. 2000. I've had

TED since June of 2001. I've had several decompression surgeries due

to compression of the optic nerve, have had double vision for a year,

and now hope to have strabismus surgery in January, followed by

eyelid surgery.

I just got back my lab report and I need help in interpreting it,

particularly in light of my TED. Here are the results:

Free T4 .83 Normal Range: .71-1.85

Total T4 .5.2 Normal Range: 4.5-12.0

TSH .32 Normal Range: .32-5.00

T-Uptake .49.2 Normal Range: .30.0-45.0

Free T4 index(Calc) 2.6 Normal Range: .1.2-4.4

Thyroid peroxidase

AAB, Serum .493 Normal Range: less than 40

Free T3 .3.30 Normal Range: 2.3-4.2

Total T3 .134 Normal Range: 80-180

As you can imagine, I am particularly alarmed by the TPO antibody

test!! I am quite concerned that my eyes are still in quite an

active phase of the TED. Any interpretations would be helpful!

I am currently taking 1 grain of Nature-throid (like Armour) a day

and I am not sure if I should increase that a bit, given the fact

that my T3 and T4 levels are only at the mid-range of normal. Any

thoughts on this would also be greatly appreciated.

Thanks so much to anyone who is able to help me with this!

Northstar

[Guest guest]

Hi Northstar,

The uptake test indicates that you have a high level of binding proteins;

these will make your T4 and sometimes also your FT4 falsely elevated. You'd

likely feel better and so would your eyes with a higher FT4; since your TSH

is on the low side, your doc might not want to produce more thyroid hormone,

but TSH is often misleading after RAI. TSH receptor antibodies, the ones that

cause GD and GO, may interfere with the TSH test causing it to be falsely

decreased.

Tests for both stimulating and blocking TSH receptor antibodies are the ones

you need. These are the ones associated with GO. Recent studies show that

people with GO are most likely to have high titers of TSH receptor antibodies

and No TPO antibodies. I've also seen studies saying that TPO antibodies are

linked to GO, but the ones that actually cause GO are the TSH receptor

antibodies. Take care, Elaine

[Guest guest]

Thanks so much, Elaine. I hope to learn more about all of this soon

so that I will have a better idea of what is going on.

I guess my main concern from these labs was the thyroid peroxidase

antibody test, which was 493 (!), ten times the normal range, which

is less than 40. What does this test measure and what does it

show? What can I do to reduce this number?

I really appreciate your help and do plan to slowly see if an

increase in my Nature-throid would be helpful. I also plan to get

the stimulating and blocking TSH receptor antibody tests.

Northstar

---

In graves_support , daisyelaine@a... wrote:

> Hi Northstar,

> The uptake test indicates that you have a high level of binding

proteins;

> these will make your T4 and sometimes also your FT4 falsely

elevated. You'd

> likely feel better and so would your eyes with a higher FT4; since

your TSH

> is on the low side, your doc might not want to produce more thyroid

hormone,

> but TSH is often misleading after RAI. TSH receptor antibodies, the

ones that

> cause GD and GO, may interfere with the TSH test causing it to be

falsely

> decreased.

>

> Tests for both stimulating and blocking TSH receptor antibodies are

the ones

> you need. These are the ones associated with GO. Recent studies

show that

> people with GO are most likely to have high titers of TSH receptor

antibodies

> and No TPO antibodies. I've also seen studies saying that TPO

antibodies are

> linked to GO, but the ones that actually cause GO are the TSH

receptor

> antibodies. Take care, Elaine

>

>

>

[Guest guest]

Hi Northstar,

Thyroid peroxidase antibodies are directed against the enzyme thyroid

peroxidase, which is needed for proper thyroid hormone production and

metabolism. It's instrumental in destroying thyroid cells, which in GD, can

boost the activity of other cells. You do want to keep your immune system

functioning properly so it stops producing any thyroid antibodies. In

autoimmune disorders, the immune system is essentially weak, which makes it

function ineffectively, over-reacting to normal bodily protein antigens. You

want to strengthen, but not stimulate it. Take care, Elaine

[Guest guest]

Hi Northstar,

Thyroid peroxidase antibodies are directed against the enzyme thyroid

peroxidase, which is needed for proper thyroid hormone production and

metabolism. It's instrumental in destroying thyroid cells, which in GD, can

boost the activity of other cells. You do want to keep your immune system

functioning properly so it stops producing any thyroid antibodies. In

autoimmune disorders, the immune system is essentially weak, which makes it

function ineffectively, over-reacting to normal bodily protein antigens. You

want to strengthen, but not stimulate it. Take care, Elaine