TGab 263, TPO 600, TSH<0.005, HELP!!!

[balalaika]

I was tested with low TSH after 6 months delivery of my first baby, so I got another test on Thyroid level. TGab 264, T4 1.43, TSH600, Triiodothyronine 4. The doctor doesn't want to start medication right now. Is there any chance my system will go back to normal naturally? The doctor said if the medication start, it will last for 2 years. I want to another child in about a year, will the treatment affect the pregrenacy?

[goolarra]

What are the reference ranges on your FT4 and FT3 (triiodothyronine)?  They'll be on your lab report, or you can call your doctor or your lab to get them.  Also, I believe you left out a decimal point in your TSH.  Is it 6.0 or 60.0?  Did they test TPOab?

[goolarra]

Sorry, I was reading the text and not your title line, and I just realized that they tested both TPOab and TGab.  Since TPOab and TGab are both elevated, it indicates that you have an autoimmune thyroid disease.  Your immune system sees your thyroid as a "foreign substance" and is attacking it.  You will not get over an autoimmune disease naturally.  It has to be treated.  Your FT3 of 4 (I'd still like to see your range) is quite high, and your TSH of 0.005 is extremely low.  Both of these indicate hyperthyroidism.  Once you test positive for antibodies (TPOab and TGab), you have them for life unless your thyroid is removed.  

Do you have symptoms?

I think you should see another doctor who understands thyroid better.  If your condition is not treated and it doesn't improve or worsens, it will most likely be difficult to conceive.  The best thing you can do is get your thyroid under control.

[balalaika]

I don't feel abnormal at all, good sleeping and good appetite, even slight weight gain. I also have a thyroid ultrasound, which turn out normal.

Here is my detailed lab result;
TGab                                        263 High   (0-40)
Thyroxine T4 Free                      1.43         (0.93-1.71)
TSH                                         <0.005       (0.45-4.5)
Thyroid Stimulating Immunoglob  91     (0-129)
Testosterone, Serum                  37     (14-76)
Thyrotropin Receptor AB           600    (0-34)
Triiodothyronine free                   4        (2-4.4)

The Tgab, TSH, and TOPab are not normal, all others seem in the range. I really don't know what does this means. Should I do something to treat it? Is it a lifetime problem? Hope it won't make difficulty on the pregnancy.

[goolarra]

All of your antibody tests are elevated (TPOab, TGab and TRab). Would you check your TPOab and TRab again?  Are they really both 600?  This definitely indicates an autoimmune disease, most likely Grave's.  Your FT4 still looks good, but your FT3 is definitely getting very high in the range, which indicates that you might start having hyper symptoms before too long.  Your TSH is also very low, which also indicates hyper.  

It's good that you don't have any symptoms yet.  However, the antibodies are going to continue destroying your thyroid function, and before too long your FT3 and/or FT4 will be effected enough that you will become symptomatic.

I'm hypo, so hyper is not my specialty.  I really don't know when it's appropriate to start treatment.  Would you post another question asking when treatment should be started for hyperthyroidism and posting your labs again?  Also give your symptoms (or lack thereof).  That way it will get noticed by people who know a whole lot more about hyper than I do.  Be sure to get "hyper" into the title line so our hypers will notice!

Best of luck in sorting this all out!