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Thyroid (Expert Forum)
Grave's Disease with Normal Thyroid Test Results
Answered by
Mark Lupo, M.D. - Thyroid Nodules, Thyroid Cancer, hyperthyroidism, hypothyroidism, Thyroid Ultrasound
Thyroid & Endocrine Center of Florida
Sarasota - FL
Questions in the Thyroid forum are answered by Dr. Mark Lupo. Topics covered include goiter, graves disease, Hashimoto's thyroiditis, hyperthyroid, hypothyroid, thyroid cancers, thyroiditis, and thyroid stimulating hormone (TSH).
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Grave's Disease with Normal Thyroid Test Results
by Eby, Jul 20, 2007 12:00AM
I've been diagnosed with Grave's Disease with hyperthyroid in April 2007. My results were:
TSH = 0.01
FT4 = 20
FT3 = 7.2
After I got my results I was a bit worried because the Endocrinologist said if I wanted to conceive I would have to make sure my thyroid is normal or else there is a high possibility that my future baby will get hyperthyroid as well. For this reason, I changed my diet and ate healthier.
I had my blood tested again in July 2007 and the results for my thyroid is normal (without any medication). The results were the following:
TSH = 0.96
FT4 = 16
FT3 = 4.6
Yet the Endocrinologist says I still have Grave's Disease? Is that possible? The test that shows this was my TSH Receptor Ab (TBII) which was 4.3. What exactly does it mean?
My husband and I are planning to concieve in the near future. With my current test results, will it pose any problems? Is Grave's Disease hereditary? Will Grave's also increase my chances of infertility and/or chances of miscarriage?
TSH = 0.01
FT4 = 20
FT3 = 7.2
After I got my results I was a bit worried because the Endocrinologist said if I wanted to conceive I would have to make sure my thyroid is normal or else there is a high possibility that my future baby will get hyperthyroid as well. For this reason, I changed my diet and ate healthier.
I had my blood tested again in July 2007 and the results for my thyroid is normal (without any medication). The results were the following:
TSH = 0.96
FT4 = 16
FT3 = 4.6
Yet the Endocrinologist says I still have Grave's Disease? Is that possible? The test that shows this was my TSH Receptor Ab (TBII) which was 4.3. What exactly does it mean?
My husband and I are planning to concieve in the near future. With my current test results, will it pose any problems? Is Grave's Disease hereditary? Will Grave's also increase my chances of infertility and/or chances of miscarriage?
Doctor's Answer
by Mark Lupo, M.D., Jul 21, 2007 12:00AM
, Jul 21, 2007 12:00AM
Sounds more like a transient (silent) thyroiditis with the recovery of the TSH. I would need a referenc range for the TSH-R-Ab but that may be a bit high for most commercial labs --- this suggest Graves and sometimes the Graves will improve on its own like this, but the risk of relapse is present. Regarding pregnancy, we try to avoid treatment unless the T4/T3 are high (ie, don't treat a low TSH with normal t4 and t3 unless there are significant symptoms). It is potentially hereditary and can complicate pregnancy. Would also test the TPO/Tg antibodies.
Dr Lupo will be answering you soon. But I had Graves with normal TSH and Free T's, my diagnosis was made by running antibody tests, and my symptoms. Many in our other forum had normal TSH, diagnosis was made by running antibody testing and Uptake scans.
Hope that helps till Dr Lupo can answer you.
Thyroglobulin AB = 447
Thyroid Peroxidase AB = 550
Looks like it's significantly higher than the normal range.
Should I still try to concieve or not? Are there any risks involved?
Thyroglobulin (TG = <1 (significantly lower then normal)
Anti-Thyroglobulin AB = 1200 (significantly higher than normal)
My naturopath friend suggested that I take Thyroidium, has anyone heard of it? Does it work if I have the tendency to become hyperthyroid easily?
The positive antibodies confirm the immune system is attacking. Would keep a close eye on the TSH while TTC and during pregnancy -- as I would not be surprised if you develop a little hypothyroidism -- and if that is the case treatment w/ levothyroxine and close monitoring may decrease the miscarriage rate that is associated with antibodies (even in women with normal thyroid function tests).
The key in this case is close monitoring -- you may have a tendency to between hyper and hypo with all the antibodies (some call this hashitoxicosis).