Grave's Disease with Normal Thyroid Test Results

[Eby]

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?

[turtlekeeper]

Hi, Grave's disease in itself is not hereditary.  A tendency towards autoimmune conditions is.  Even if you treat all the symptoms of Graves, you will always have it.  My endocrinologist suggests to go ahead and conceive but once you are pregnant, close monitoring via blood tests is important.  Cannot pass it onto your child but CAN make conception more difficult.  Good luck :)

[Eby]

I forgot to mention results from tumour markers in April 2007.

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?

[Eby]

So I'm looking back at my test results from April 2007.  I found a few more readings, not sure if this will provide further insight into this:

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?

[hashisgirl]

Hi,
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.

[Eby]

Sorry...I meant...my Naturopath friend recommended Thyroidinum.  Anyone used this?

[drmark]

would not try a supplement with trying to conceive -- we have no idea (despite any claims by the manufacturer) what the safety of this would be.

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).

[Mark Lupo, M.D.]

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.