Graves' antibodies + symptoms, but dismissed as healthy?

[cbdbmbtbbb]

I am a 27 year old female, experiencing debilitating anxiety, fatigue, and rapid heart beat, for about the past year.  I have extreme sensitivity to caffeine which was not an issue until these symptoms all began to appear about a year ago.  I have a younger sister with Graves' disease and noticed I am having the same symptoms she was before diagnosis.  My primary physician says I am "normal".  The endocrinologist dismissed me as "crazy".  It is important to note that both of these doctors confirmed I have a goiter, but continue to say I am normal despite the thyroid enlargement.  Is there anything in the following results to indicate Graves' disease (aside from the antibodies) or is it all in my head?

T4,Free(Direct) - 1.35   (reference range: 0.82-1.77)
TSH - 0.830   (reference range: 0.450-4.500)
Thyroglobulin, Antibody - <1   (reference range: 0.0-0.9)
Reverse T3, Serum - 15.0  (reference range: 9.2-24.1)
Thyroid Stim Immunoglobulin - 34 (reference range 0-139)
Thyroid Peroxidase (TPO) Ab - <6  (reference range: 0-34)
Triiodothyronine (T3) Free,Serum - 3.6  (reference range 2.0-4.4)

[Barb135]

Typically, a dx of Graves is 120% of the TSI scale, not 2%.

Sometimes, we have symptoms of a certain thyroid condition and our labs don't bear that out; we have to exhaust other possibilities before doctors are willing to come back and take another look.  Many of us have gone through years of symptoms prior to dx...

I had Pernicious Anemia (autoimmune B-12 deficiency) for more than 20 yrs before I was finally diagnosed.  My complaint was always "I'm so tired"... my doctors kept telling me I was depressed and I kept telling them "I'm only depressed because I'm so tired"... They didn't get it... Finally, I started having numbness/tingling in my feet/hands and and was eventually diagnosed with Pernicious Anemia.  I take weekly B-12 injections to keep my levels up, but I also take serious meds to counter the effects of the permanent neuropathy (nerve damage) caused from the years of not having a proper diagnosis...

It was a year after my PA dx and monthly B-12 shots,  that I was diagnosed hypo... so we can have more than one thing wrong... Don't set your sites on just one thing.

I had anxiety, rapid heart rate and fatigue when I was very hypo... these symptoms "cross over" and can apply to either, though your labs don't indicate either right now.  

AND  autoimmune diseases tend to run in families but not every member of he family will get the same disease... For instance; I have Pernicious Anemia and Hashimoto's, my son has Type I Diabetes and my daughter has Lupus... These are all autoimmune diseases and there are more that present similar symptoms.

Don't accept "there's nothing wrong" or "you're crazy"... find a doctor that will figure out what's wrong...

Keep digging...

[cbdbmbtbbb]

Thank you for the speedy reply!

I am just very confused over these results because I had read elsewhere that anything above 2% on the TSI antibody scale was technically positive for Graves' disease, yet all of my other results were in range, although TSH seemed on the lower end of that standard range.  I thought maybe I was just one of the unlucky ones who had hyper symptoms while still in range.

I suppose I will look into some of the additional tests you mentioned and see if they rule anything out.

Thanks again!

[Barb135]

There's nothing in your labs to indicate Graves Disease, including the antibodies.  The reference range is 0-139 and your result is 34, which is well below the upper limit of 139 and is considered to be negative.  

All of that said, I have no doubt that your symptoms are very real and since you have a goiter, future thyroid issues are a future concern, though not a present one.  There are other things that can cause your symptoms and we'd be more than happy to try to help figure out what the problem(s) might be.

Anxiety is a condition of its own and can cause the symptoms you mention or there are conditions that can cause anxiety.  

Caffeine can cause a lot of different symptoms... I never used to have issues with it, either, but I suddenly had to start drinking the decaff, as it caused rapid heart rate, and similar symptoms as yours - this was long before I even had a thyroid issue.  I was eventually able to go to the "half caff" versions, so I'm not completely without my caffeine.

Adrenal issues can cause some of those symptoms, however, many doctors don't test for them and.  You can try getting cortisol levels tested, but the test you need is a 24 hr saliva test and most doctors don't do that.

Next, there are some vitamin/mineral deficiencies that can cause fatigue and other thyroid-like symptoms... Vitamin B-12 deficiency can cause the most debilitating fatigue I've ever known and when we're that fatigued, anxiety is always only a step away - rapid heart rate often goes with anxiety.  Getting B-12 levels tested would be my first recommendation.