The Wellness Q&A with Elaine Moore

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APRIL 2020


Very High TgAb and TPO
Last Post 04 Jun 2019 12:59 PM by Elaine Moore. 1 Replies.
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DMMUser is Offline New Member New Member Posts:
28 May 2019 05:57 PM
    Nov. 2015 (5 mg Methimazole daily for 10 years)
    TSH 0.35 (0.36-3.74)
    Free T4 1.16 (0.76-1.46)
    Free T3 2.71 (2.18-3.98)
    TPO 202 (0.0-9.0)
    TgAb 28.7 (0.0-4.0)
    TSI 183 (0-139)

    August 2016 (1.5 years off methimazole)
    TSH 0.10 (0.36-3.74)
    Free T4 1.27 (0.76-1.46)
    FreeT3 2.90 (2.18-3.98)
    TPO 242.6 (0.0-9.0)
    TgAb 53.6 (0.0-4.0)

    March 2017 *NOTE the range changes due to a change in testing lab
    TSH 0.365 (0.450-4.500)
    Thyroxine (T4) 9.4 (4.5-12.0)
    T3 uptake 21 (24-39)
    Free Thyroxine Index 2.0 (1.2-4.9)
    Triiodothyronine, Free, Serum 2.7 (2.0-4.4)

    October 2017
    TSH 0.175 (0.450-4.500)
    Thyroxine (T4) 9.4 (4.5-12.0)
    T3 uptake 26 (24-39)
    Free Thyroxine Index 2.4 (1.2-4.9)
    Free T4 1.56 (0.82-1.77)

    March 2019
    TSH .01 (0.40-4.50)
    Free T3 4.1 (2.3-4.2)
    Free T4 1.7 (0.8-1.8)
    TgAb 183 (< or equal to 1.0)
    PTH 30 (14-64)

    May 2019 (Now Post menopausal, No medications for 4 years)
    TSH .84 (0.40-4.50)
    Free T3 2.7 (2.3-4.2)
    Free T4 1.2 (0.8-1.8)
    TgAb 219 (< or equal to 1.0)
    TPO 578 (0.0-9.0)

    Hi Elaine, I hope this finds you well and smiling. I have Graves Disease. I am NOT currently on any medication and have not been for 4 years. Previously I took methimzole in ranges from 2.5 mg to 10 mg for 10 years. Last time I wrote for your opinion regarding the March 2019 test results you said I was mild subclinical hyperthyroidism, and my doctor & I agreed so thank you. I just had my new May tests & I am in all the normal ranges, however, the TSH is higher than it has been in years, & the Free T's went down to the lower end of the ranges. My doctor wanted your opinion on those changes, as well as the elevated TgAb and TPO. If you look back you can see past TgAb and TPO test to see the changes over time. I just had a neck ultrasound that came out clear for nodules. I made many life style changes the past year & I feel great. Also, what other tests might I need to figure out why the TgAb and TPO are still so elevated?

    Thank you in advance, my sincere gratitude.

    Elaine MooreUser is Offline Veteran Member Veteran Member Posts:3413
    04 Jun 2019 12:59 PM
    Most people with Graves' disease will continue to have elevated levels of thyroglobulin and TPO antibodies. Although they're elevated, they're not nearly as high as the levels seen in Hashimoto's thyroiditis. Both of these antibody levels also rise with age. TPO antibodies are markers of inflammation and thyroglobulin antibodies can destroy thyroid cells, which isn't as bad as it sounds as we're also making new cells.
    I think your levels look good but you may be one of the 20% of Graves' patients who spontaneously move into mild hypothyroidism. This is caused as the immune system begins producing more blocking than stimulating (TSI) TSH receptor antibodies. Since you feel great, you just need to continue having annual thyroid function tests although if any symptoms change you'd want to have them more often. Your thyroiid hormone levels may stabilize now but if they continue to fall you may want to ask your doctor about thyroid replacement hormone. Best to you, Elaine
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