TSI antibodies disappear? Confused

[Gin52]

Hi, I'm totally confused about this.
I tested positive for TSI antibiodies several times in 2012/2013. Now it's showing negative. What happened? Does anyone know.  I am also positive for the Hashi's antibodies and they're dropping too but still above normal.
Still feel like crap though.
Reference is <=110
5/12   103
10/9    166
12/18   147
2/26/13  156

Different lab Reference range is  <=1.3
2/26/14   <1.0

Thanks

[goolarra]

No, you're not nuts.  You don't feel the antibodies, per se.  You feel the result of the damage they've done to your thyroid.  When I was first diagnosed hypo, I didn't know I had Hashi's.  That diagnosis came about a year later.  I felt my worst when my thyroid hormones were too low.  By the time I found out about my antibodies (TPOab 900+, TGab 3,000+), I was feeling really good because I'd been on meds for about a year already.  I'd say your NP "doesn't get it".  How you feel depends on the cumulative damage the antibodies have done to your thyroid, not on the antibody level today.  The damage done is not undone when antibody counts go down.

I'm not sure you are hyper symptom-wise.  Most of the symptoms you list are pretty classic hypo symptoms.  Even some of the ones that sound hyper (tremors, heat intolerance, e.g.) can "cross over" and be symptoms of both hypo and hyper.

Good on the mag.  You want to avoid mag oxide as that's really nothing but a mild laxative.  

B-12 was pretty low.  In some countries, lower end of reference range for B-12 starts at 500.  So, in another part of the world, you would have been considered deficient.  You want to follow up on B-12 to make sure that your oral supplement is raising your levels.  Pernicious anemia, the inability to absorb B-12 through the gut, is another autoimmune disease, and once we have one AI, a second is more probably.  If you have PA, oral supplements will not work.

Your D was dismal.  Most people have to be well up into the range on D to feel well, and yours is considerably below.  Check with your doctor on this.  Many doctors will put patients with a severe D deficiency on 50,000 IU per week to start until levels start to rise.  That's then scaled back until you're ready for a maintenance dose.  14,000 IU may not be enough.  Follow up testing on this is important, too.

  

[Gin52]

Hi,
So I''m not nuts that I should be feeling better because the TOPab are lower but I'm not. My NP seems to think so. I had a hard time convincing her to accept the TSH value as a 3 instead of the lab value. Her as well as my previous dr (she moved to MI) don't want to start me on any meds because they're worried that it will make me hyper! I already am, symptom wise. Plus
I so far have called as has been recommended here, 5 endos in my insurance plan so far. One refused to answer any question but the other 4 did say that they wouldn't give me any meds until my actual thyroid numbers are out of range. I'll keep calling from my list. New insurance,  high deductible, co-pays and I don"t want to waste money or time.
Yes, I did have those tested on 12/23/13
Vit b12  417 (211-911)
Magnesium  1.6  (1.8-2.4)
Vit D   20.5        (30-100)

I take Magnesium Glycinate 400 mg  Once a day
Vit D3  2000 iu    Once a day
Super B Complex  which has 6 mcg of B12 Once a day
It also has 400mcg of folic acid which she recommended due to a slightly high MCV. My folate was tested on 12/23 at 10.4 (5.4-24.0)
Thanks for any advise.

[goolarra]

Your FT4 in your February labs is very low.  It's 18% of range, and many of us find FT4 has to be about 50% of range to relieve symptoms.  FT3 is at 37% of range, and the guideline there is 50+%.  So, it's no wonder you're not feeling well.

Thyroglobulin (Tg) is the protein precursor of the thyroid hormones.  The thyroid synthesizes T4 by attaching iodine to Tg.  Why they tested yours, I haven't a clue.  It's not a part of routine thyroid testing.

Nothing jumps out at me in your TPOab history.  Some people with low levels of TPOab feel worse than others with very high levels.  Antibody load often doesn't correlate with symptoms or labs.  

In the early stages of Hashi's, labs and symptoms often do bounce around.  As the thyroid is "dying", it doesn't do so on a nice, gradual slope.  Instead, it sputters and coughs, sometimes putting out too much hormone, sometimes too little.  As thyroid cells die, they can "dump" hormone into the blood.  

Were mag, D and B-12 tested before you started supplementing?  If so, what were the results?  How much are you supplementing of each?  What kind of magnesium do you take (oxide, citrate, glycinate)?    

[Gin52]

Hi,
I have most of my other test results listed in another post. This one was mainly the TSI question but now the TPO is puzzling too.
First my last 2 thyroid panels
12/23/13
TSH  2.86 (0.55-4.70)
Total T4 9.00 (4.5-12.0)
FT3      3.3   (2.3-4.2)
Reverse T3  18 (8-25)
TPOab   237 (<35)

2/26/2014
TSH  2.57  (0.55-4.70)
FT4   1.05  (.89-1.76)
FT3   3.0    (2.3-4.2)
Thyroglobulin 31.7 (<55) Don't know what this is)
TPOab  228  (<35)

Symptoms are hard to explain. They are all over the place. They seem to come and go.

dry skin
increased bad headaches
no outer eyebrow and dry brittle, breaking hair
brittle spilting nails
hot/cold intolerance no matter the temperature
Increased pulse rate
trembling (at times)
increases aniexty (sometimes unbearable)
Trouble sleeping. But tired. Never refreshed.
Energy now it's gone again.
Moody and cranky
Brain fog is back.
Don't feel like doing anything is back
Weak tingling legs when I do things are back. Normal activity.
Balance issues and dizziness are back.
Some of these were not present a few months ago, now they've come back over the last month or so.

My TPOab history  (<35 for all of them)
2/2012  483  (TSH 3.23  FT4 1.13  FT3 2.8) Highest TPO
4/2012  420
8/2012   471  
10/2012  318
12/2012   441
2/2013     390
12/2013    237
2/2014     228 (TSH 2.57  FT4 1.05  FT3  3.0) Lowest TPO
My Tgab has always been <20 (<or=40)

So i'm lost. They're lower but I feel worse again lately. They don't seem to have  affect on the thyroid numbers. Those bounced around too no matter what the TPO is.
I have been taking mag, Vitamin D and B12 for at least 2 months now. Doesn't seem to be helping anything so far.
Thank you so much for your time.

PS I take Metoprolol 25 mg. at night because it makes me sleepy.
And Xanax 1mg up to 4 x's a day as needed. Somedays I take the 4, others I don't.
No thyroid meds.

[goolarra]

Your TSI was positive, which indicates Graves'.  It is possible to have both Graves' and Hashi's, and it looks to me (not a doctor) like you do have both.

Please post your thyroid test numbers with reference ranges.  It often takes more than just being "in range" for us to feel well.

TPOab numbers can vary wildly, even intraday.  I have no idea why, but Hashi's seldom goes into remission like Graves' does.  Once we have Hashi's, we have antibodies until the thyroid is destroyed, then they sometimes go down, which can take a while.  If you want to post your TPOab history, I can look at that, too.

Please list you symptoms.

[Gin52]

I've never been told I have Graves. The TSI results just got a "hmm" Officially my dr said I have Hashimotos Thyroditis.
The last time my results were even close to hyper was in 11/06-1/07. Which was 0.018 (.35-5.5). TSH only. Put on Methimazole 5 mg one daily. By 4/07-Tsh was 15.33. Stopped the meds and it came down on it's own. The only symptom I had at the time was a large weight loss that I needed anyway. Felt fine otherwise.
Fast forward to June 2011 when many symptoms began. Mostly on the hypo side. But I do bounce between hyper & hypo symptoms even both at the same type.  I have another thread relating to that. Still stuffering despite  supplementing as recommended. My dr nor any endos I contacted so far will give me meds because my other numbers are "within range"
Also my TPO numbers are going down, does that mean the Hashi's is going into remission, too?

[goolarra]

The TSI test is tricky to interpret.  Your 2/26/14 result isn't really "negative".  People who don't have Graves' have TSI less than .02 (reference range <1.0) or 2 (reference range <110).  The upper limit of each of your ranges represents where most people start having symptoms.  So, there is a huge "gray area" in the TSI test.  "Normal" people do not have TSI.  

Your TSI is dropping, which could mean that you're going into remission.  This happens quite frequently with Graves'.

Are you taking thyroid meds at the moment?

Please list you symptoms.