TSH undetectable-so is my sanity. . .What is TG ABS?

[bgtown]

First of all to Jean-You were right I had became hyper! I saw an Endo for the 1st time She was puzzled by my syptoms & seemed frustrated by my treatment. She told me I had become Hyper before she even checked by previous lab work She could tell from looking at me.  She also told me that I never had a chance to see what would happen with normal tsh because I was at 1 last June 05 then they kept increasing my dose She said I was at .063 when they put me on 50 mcg of cytomel daily I was told to immediately decrease cytomel to 25 mcg daily I had more blood work $ my FNA biopsy reexamined She told me my tsh was so low it was completely undetectable & my Free T4 was 1.0 She said my antibody levels were extremly high & if she goes by my blood work thryoid medicine may help shink my goiter/nods If she goes by my FNA I should just have surgery because the biopsy does not show the hashi but the blood work antibodies extremely high She told me to cut my Cytomel to 10 mcg daily &get more blood work in 4 weeks. She sent me a test form in the mail Can you all help me understand the diagnosis she has indicated It reads GOITER, MULTINODULAR (ICC-241) THYROIDITIS NOS,+HASHI AND TG ABS (ICD-245.9) I have NO idea what TG ABS means or is. Can you pls tell me? Cytomel felt like it helped me- my menstral cycles were now bearable. She FIRMLY said I am on too much meds I think I am just done with all this, when my tsh gets normal I may go ahead w/ the Thyroid completely removed as sugg. I feel like I am getting depressed again I need to know what u all would do I just can't think clearly any more.

[bgtown]

Thank you for all of the information and caring enough to share so much helpful information.

Diana

[NURSELPN]

Sorry to be a bother but can you direct me to your original post?               Jean

[NURSELPN]

bgtown,

If you had a fine needle biopsy the Dr. would have told you if there was any possibility of cancer so don't let that frighten you. With that being said...

I'm glad your on the right path now. I've walked in your shoes...I know how you feel physically & this condition is very scarey & the symptoms you have do not help. Your whole body is affected by this disease. There is an end to this tunnel so just hang in there.

Did they test your free T-3 & free T-4? Keep copies of all your tests & lab results for yourself. The Dr. will be glad to give them to you.

Do you work outside of the home? If the symptoms of your disease is affecting you profoundly maybe it's best to take some time off. I know I worked when I had no business even driving let alone taking care of patients. I was so ewasily overwhelmed. I thought I was in control but the truth was I was struggling to even function. I had no idea what was wrong with me. But like you said...you can't even think. It's no time to push yourself right now. Stress makes this condition much worse...

While you are waiting for treatment you might ask the Dr. if some some anti-thyroid meds would help to get you get back into a lot more normal range. I'm not sure if they would prescribe them in this instance but it wouldn't hurt to ask.

----------------------------------------------------------------

Basic Thyroid info: I found this first site easier to understand but I've posted a couple so you can take your pick.
Basic info in laymen's terms.

http://www.suite101.com/course.cfm/19330/overview

http://thyroid.about.com/cs/basics_starthere/a/thyroid101.htm

http://thyroid.about.com/sitesearch.htm?terms=Hyperthyroidism,%20Nodules,%20Goiter,%20and%20Thyroid%20Cancer%20&SUName=thyroid&TopNode=3902&type=1

Maybe this site will give you some insight into (Anti-TG Ab) ...Did the endo test anymore antibodies? for Graves perhaps?...You can have both Graves & Hashimotos antibodies present at the same time. Info is posted below the site reference.

http://www.dpcweb.com/medical/thyroid/thyroid_tests_antitg.html

Antithyroglobulin Antibodies (Anti-TG Ab)
Historically, Anti-TG Ab determinations were used in tandem with antimicrosomal Ab determinations to maximize the probability of a positive result in patients with autoimmune disease. Although the prevalence of Anti-TG Abs in thyroid autoimmune disease is significant (85 percent and 30 percent in Hashimito's thyroiditis and Graves' disease, respectively), it is much lower than the prevalence of the Anti-TPO Abs. The diagnostic information provided by Anti-TPO assays is rarely improved upon by the addition of an Anti-TG determination. The growing trend is to adopt the anti-TPO Ab test as the front-line test for autoimmune disease and no longer to routinely use the anti-TG assay routinely for this purpose.

Because anti-TG Abs constitute an interference in thyroglobulin (TG) assays, another major use of the anti-TG test is to screen samples that have been submitted for thyroglobulin determinations.
----------------------------------------------------------------

This might help you understand the tests that were ordered...
http://www.endocrineweb.com/tests.html Thyroid Function Diagnostic Tests
----------------------------------------------------------------

I hope this info doesn't confuse or overwhelm you too much but knowledge is the best way to get correct treatment & reassurance. If you have anymore questions I'll check back.

                                 Best Wishes, Jean

[NURSELPN]

Oh, when I re-read you post I see they did check your free T-4. Your free T-3 may be much higher because you were taking such a large dose of Cytomel with is a synthetic T-3.

I'm sure Dr. Mark will have alot more info for you pertaining your tests.  All I know is what I've researched off the internet & being a nurse for 32 years did not benefit me until I started doing research on this disease.

You never know what a person is going through until you walk in there shoes...that's for sure.

                                I'll check back, Jean

[Mark Lupo, M.D.]

Tg Ab is another antibody used to establish the presence of auto-immune thyroid disease.  The low TSH means you were on too much cytomel (50mcg is like 200mcg of synthroid). Taking T3 (cytomel) once a day is rough sometimes as it gets out of the system quickly and am & 2-3pm dosing (ie in your case 5mcg 2x/day) may be helpful while this is sorter out.  If the FNA showed no suspicious cells and your thyroid is not enlarged to the point where you have choking, etc would hold on surgery.  Also consider combo T4/T3 rather than T3 alone.

[NURSELPN]

You should not be scratching or rubbing your thyroid gland right now because that will cause it to excrete more hormones,which will make your levels higher.
Get some hydrocortisone cream & apply it to the area that will help the hives & itching. But do not rub it too hard.
You should call your endo & let her know about your redness (might need to be treated right away)& hives & ask her if the hydrocortisone is ok. I don't want to tell you to do anything until you've checked it out with her, ok.

Tests: I'll try to make this simple .......................

Throxine, Free this is the free t-4 I was telling you about. Produced by the thyroid ...converts to free t-3 for use in your body's cells.

TSH- thyroid stimulating hormone (produced in your pituatary gland - stimulates your thyroid to produce free t-4 which converts to free t-3 for your body to utilize.

Venipuncture- when they poked you to get your blood

Microsomal ABS Each Detectable levels of Tg Abs(antibodies) and/or TPO Abs (antibodies) are mainly associated with thyroid autoimmune disorders and with thyroid cancers but low concentrations are also found in a significant percentage of the normal population. Tests for autoimmune Hashimitos disease.

Thyr Stim Imm(TSI) Tests for autoimmune Graves disease

T-3, Free-thyroid hormone that your cells utilizes.

I had a pounding racing heart too when I was hyper.
http://thyroid.about.com/cs/hyperthyrdgraves/a/panicpalps.htm I would lay in bed at night & just pray over & over again "Jesus help me" I prayed all through my waking hours. You've brought back memories....those symptoms & feelings were horrible.

Insomnia
Tiredness
Irritability
Nervousness
Unexplained weight loss (I lost 60 #'s)
Heat sensitivity
Increased perspiration
Thinning of your skin
Warm skin
Flushing
Itchy skin
Fine hair
Brittle hair
Thinning hair
Muscular weakness
Eye changes
Lighter menstrual flow
Decreased menstruation
Menstrual cessation
Rapid heart beat
Palpitations
Breathlessness
Hand tremors
Shaky hands
Eye changes
Weak leg muscles
Weight loss - especially if occurring even with increased appetite
Weight gain - hyperthyroidism can cause both weight loss and gain depending on balance of appetite changes versus metabolism changes
Stomach upset
Diarrhea
Bowel frequency
Goitre
Protruding eyes
Lung in front of neck
Tiredness
http://thyroid.about.com/cs/hyperthyrdgraves/a/panicpalps.htm for more about palpitations

See also symptoms of Graves disease - the most common type of hyperthyroidism
Symptoms of Hyperthyroidism: This is a condition that occurs from overproduction of thyroid hormones. These symptoms include insomnia, irritability, weight loss without dieting, heat sensitivity, increased perspiration, thinning of your skin, fine or brittle hair, muscular weakness, eye changes, lighter menstrual flow, rapid heart beat and hand tremors.

Symptoms may include nervousness, irritability, shaky hands, increased perspiration, warm skin, thinning hair, weight loss, decreased menstruation, eye changes, and weak leg muscles. Grave's disease is the most common form of hyperthyroidism. It is an autoimmune condition in which the body produces antibodies that overstimulate the thyroid gland, so that it produces too much thyroid hormone.


You also absolutely need to read this... http://thyroid.about.com/od/hyperthyroidismgraves/a/thyroidstorm.htm
Ok that's enough of a lesson for you tonight.

[bgtown]

I am taking 100 mcg of synthroid in addition to the cytomel.  So does that mean it was like I was taking 300 MCG of synthroid?

[bgtown]

Thank you for your responses.  
Jean-The orig. post was "Please help me what do I do now" "any advice or suggestions would be appreciated" I guess I better not post any more I think I read the limit was 2.
You know I sound crazy from my posts, Honest! I am sane, I am just so very stressed and it seems like I am constantly confused.  That is why I need my lab results all the time.  I did not realize my TSH was lower than what I had previously posted until I saw the endo.
I will ask for a copy of my lab results at my next appt. She just told my over the phone what I listed. I did however get the bill from the lab today, it lists the tests that were ordered.
  Throxine, Free
  TSH
  Venipuncture
  Microsomal ABS Each
  Thyr Stim Imm(TSI)
  T-3, Free
It also lists ICD-9 Codes 241.1 and 780.71
I will look check out the links you provided for more info. Thank you for that.  I have not heard of some of these tests that were ordered either.
You know it is funny you mention taking it easy at work.  I received  a long awaited promotion about 6 weeks ago.  It is a perfect job - If I didn't feel awful.  We are starting a new location and if I can survive getting it going I might be ok. I have been working approx 50-55 hours per week.  This thursday, I will have to work 8:30am -5:00pm then go back in at 12:00am and work until 5:00pm It would not be so bad if I could go home and go to bed before I go in at 12:00am but that is not possible my husband works nights one of my kids has baseball practice and it is my daughters 16th birthday(Thurs).  I am not sure how I am going to do this but I know I have to. I am managing this location and people had made previous prior arrangments to be off a long time ago so I have to cover these hours. I have to laugh out loud at this happening for me at this time, it just figures!!  This will slow down after a couple of months and I really want this and I love my new boss.  But I am losing it.  It is so bad that today when the alarm went off I woke up realizing I had been dreaming about work.  I get hives easily esp. on my thyroid part of my neck. My neck was all red I had hives so bad I must have my scratching at my neck in my sleep.  I do know that stress agravates it. But my family cannot make it without my income, we were needing money badly and I got a good raise with this promotion. Its easy to say money isn't everything, but we have to have my income we would lose house and all- plus, I can bardly afford my meds now + I have other monthly meds for one of my kids.  
Sometimes I will just go in the bathroom at work and shut the door and pray that God will get me through the day and that I will be able to keep it together to pull this off.
When you read about my heart racing- I know that your thyroid can contribute to this. But I believe this is one thing I have inherited from my Grandfather, he had this same issue.  When I race I can feel my hearts electrical system sort of misfire it feels like getting a mild shock straight to our heart.  Then I start to race. Another great Problem! LOL (I have to try to laugh at myself so I dont cry - the problem is my laughter is becoming almost too much hysterical)
I am go check out those sites!
Thank you very much, Diana

[snake lady]

I did a little research on your TG ABS and found a site that discribed it.  The whole thing was pretty complicated but I believe it is in relation to a possibility of tendencies toward cancer.   All I did was place the TG ABS in the search line of google and the site came up along with others.  Entrez PubMed is how they bookmarked it.  I really don`t understand it at all. Take care. Dee