GP diagnosis makes no sense, help!

[dellouise80]

My GP has diagnosed me with Graves Disease after obtaining the following lab results:

TSH <0.03 (RR 0.40 - 4.00)
Free T4 13.2 (RR 10.6 - 20.5)
Free T3 5.4 (RR 3.3 - 6.2)

Thyroglobulin Antibodies 17 (RR <150)
TPO Antibodies 399 (RR <50)

Thyroid ultrasound- "...thyroid normal in size, however diffusely inhomogeneous with increased vascularity..."

- Both antibodies tested can be present in BOTH Graves and Hashi's. I've read that Thyrotrophin Receptor antibodies are ONLY present in Graves. Are these tests available in Australia?

- With a TSH as suppressed as mine Ft3 and FT4 should be high yet my FT4 is at the low end of normal. Any suggestions?

- Are my results more indicative of Hashi's? Or, presuming I have the TSH receptor antibodies as well, could these be inhibiting TSH while the TPO antibodies are interfering with production of T3 and T4?

I have been referred to an Endo but yet to see him. Any insights would be welcomed : )

[dellouise80]

Thank you so much for your time and information! I'm a nurse and it's very frustrating not to be able to figure this whole thing out. :)

[Barb135]

Not sure if they are the same, but here's what I found on one site:  "Graves' disease can be diagnosed using Thyroid Receptor Antibodies (TRAb) / Thyroid-Stimulating Immunoglobulins (TSI). The presence of TRAb/TSI test can confirm Graves' disease, and while experts can't agree, it's thought that from 75 to 95 percent of all Graves' patients will test positive for these antibodies. Practitioners do agree, however, that the presence of TRAb/TSI is considered diagnostic for Graves' disease. (Note: some patients with Graves' disease do not test positive for these antibodies.)"

It *IS* possible to have both Graves and Hashi's -- Did you have a TRab test that was positive?  If so, you might fit the category of having both.

One of the CL's on this forum, Stella5349, has both Graves and Hashi's, she would be able to help you.  

[Nat_16]

The TSI test used to diagnose Graves is available in australia.

I dont know whether its the same as TRAb though.

[dellouise80]

I had thought that myself but do you know if that is available in Australia? A lot of the research I've read is from the US.
And is TSI the same as TRAb? And they can be stimulating, inhibiting or binding right?

[Barb135]

You need a Thyroid Stimulating Immunoglobulin (TSI) test to dx Graves.  I've never heard of TPOab being used to dx Graves.