It’s working! Thank you so much! I was on block and replace for about 6 months but had to stop because I was going hyper with 37mcg levo and 1.25mg methimazole. It looks like maybe my blocking antibodies dropped significantly. I have been taking only 1.25mg methimazole. The last 2 weeks and I am feeling very good.


My TSI is the lowest it has been since I was diagnosed 6 years ago! I know I still have a long way down for my TSI, I think I read in one of your other posts that ideally TSI gets down to 0.3 before I stop methimazole. What about Thyrotropin Receptor Ab, Serum (TRAb)? What level does it need to come down to before I am considered in remission and can stop taking methimazole?


5/18/2022 - Was taking 1.25mg for about 3 months prior to test. Started 37mcg levo and 1.25mg methimazole.
TSH 1.23 (0.45-4.5)
FT4 1.19 (0.82-1.77)
FT3 2.9 (2-4.4)
Thyroid Peroxidase (TPO) Ab 26 (0-34)
Thyrotropin Receptor Ab 2.87 (0.1.75)
TSI 2.12 (0-0.55)

8/1/2022 - Dropped my levo to 25mcg because TRAB dropped, kept 1.25mg methimazole. In september I missread my symptoms as I thought I was going hyper so I increased my methimazole to 5mg and lowered levo, clearly a bad decision.
TSH 0.365
FT4 1.47
FT3 2.7
Anti-TPO Ab (RDL) 25.4 (<9)
Thyrotropin Receptor Ab 2.41
TSI 1.42

10/3/2022 - Felt awful the entire month, low energy, TED. Realized that I was hypo, so I went back to original block and replace 37mcg levo and 1.25mg methimazole.
TSH 1.510
FT4 1.17
FT3 2.6
Thyrotropin Receptor Ab 2.89
TSI 1.47
11/28/2022
TSH 0.017 (0.45-4.5)
FT4 2.09 (0.82-1.77)
FT3 3.7 (2-4.4)
TSI 1.54 (0-0.55)

1/23/2023
TSH 0.013 (0.45-4.5)
FT4 1.52 (0.82-1.77)
FT3 3 (2-4.4)
Thyrotropin Receptor Ab 1.88 (0-1.75)
TSI 1.11 (0-0.55) Finally breaking new lows!

Hi Anthony,
You don't really need the TRAb level. In some countries TSI isn't available so they only get TRAb levels. The TRAb can be misleading since as you know it measures TSI, blocking and also binding TSH receptor antibodies. In your case most of your TRAb are TSI, and the TSI alone gauges remission.
Your labs look very good so continue what you're doing. Before you know it you'll be in remission. Remember that low vitamin D causes a rise in thyroid antibodies. Ask for a 25OH vitamin D level if you haven't had one recently. Keep up the good work. Best, Elaine