What tests are available?

[Lisa629]

I've heard that the normal initial test a doctor can do to check your thyroid sometimes will not acurately tell if you have issues.  What is the name of the second (more conclusive) test that a doctor can do?  I'm really wondering if I have issues - I've gained over 40 pounds in less that 2 years.

[kitty9309]

Hi and welcome.

Ask for TSH, free t3, free t4 and thyroid antibodies. Sometimes they will wait to do the antibodies depending on the results of the others. Do you have other symptoms or family history?

Good luck with the tests.

Kitty

[Nyxie63]

Most docs will test the TSH, total T4 and sometimes T3 uptake.  The last 2 are pretty much useless and the TSH is not the gold standard many docs believe it to be.  TSH can be affected by physical illness, medications, time of day the test was taken, and even the time in your menstrual cycle.

A more "telling" panel would be TSH, Free T4, Free T3, as well as TPO and Tg antibodies.  The FreeTs show just exactly what thyroid hormones are available (unbound) for use by your body.

It might also not be your thyroid.  There are a lot of things that can cause weight gain, even if we're watching our diets and exercising.  Are you having other symptoms besides the weight gain?  Have you had your glucose/insulin tested?  How are your adrenals?  Do you have food intolerances?

[GravesLady]

TPO and Tg antibodies are not good indicators as to autoimmune thyroid.

Some patients with Hashimoto's disease may have negative levels of circulating antibodies, and conversely, patients with positive levels of thyroid antibodies may never develop thyroid disease during their lifetime.  Also,  the antibodies are seen in Hashi/ chronic thyroiditis, Graves' disease, other autoimmune disorders such as Sjögren syndrome, lupus, rheumatoid arthritis, and pernicious anemia  and in people with no evidence of thyroid disease, and therefore do not provide an indication of whether the person has normal or abnormal thyroid function

Along with  thyroid levels, which are the prevailing diagnose, there are specific antibodies to Hashi and/or Graves' that are more deffinite to diagnosing and confirming autoimmune. But they are just to confirm what all there thyroid test relates.  In other words antibodies must correspond with all three levels to be autoimmune. Having antibodies with normal thyroid levels means that the autoimmune condition is not in the active phase yet. Antibodies are not curable nor treatable, nothing can be done about them, so its the damage to the  thyroid that is treated, and all three thyroid abnormal levels can only prevail this.

TSH tells whether a person is hypo or hyper and along with both FTs which tells the thyroid status, such as autoimmune thyroid and non-thyroid conditions such as adrenal, allergies, etc.
All can be effected by certain and different conditions. That is why it is suggested to get a second test 6 weeks after the first test to verify any abnormal levels and errors or flukes.

Happy New Year - Good Luck and Best Wishes for 2008.

[kitty9309]

Antibody Testing is useful in conjunction with the other thyroid tests. It may not be your thyroid, but it is good to check it out.

Hope this information has helped.

Kitty

[GravesLady]

The correct antibodies have to be done for them to be useful to autoimmune thyroid.  That is, for them to confirm what the TSH and both FTs relate. In conjunction with TPO and Tg antibodies (which to me are a waist of money and time for autoimmune thyroid), there is a specific antibodies to Hashi (and specific antibodies to Graves'), that are more DEFINITE diagnose to autoimmune thyroid! than TPO and Tg antibodies.

[ki_chris]

What is autoimmune thyroid?  is that different than hyper or hypo?  The first doc I ever saw about thyroid stuff told me I had some antibodies present that suggest I'd develope a problem.  

[GravesLady]

Autoimmune thyroid is either Hashimoso's or Graves' Disease which are some what different than Hypo and hyper-thyroidism.  A person can be hyperthyroid without having Graves' Disease but can not have Gravers' Disease without having hyperthyroid,  it's called  Hyper/Graves'.  Likewise, a person can be hypothyroid without having Hashimoto's but can't be Hashimoto's without having hypothyroid, it's called Hypo/Hashi.

Graves' Disease is a type of autoimmune disease in which the immune system over stimulates the thyroid gland, causing hyperthyroidism. Over-activity of the thyroid gland is also sometimes called "diffuse toxic goiter." The thyroid gland helps set the rate of metabolism (the rate at which the body uses energy), and when it is over-stimulated, it produces more thyroid hormones than the body needs. High levels of thyroid hormones can cause difficult side effects. This is an extremely rare disease that tends to affect women over the age of 20 although it does effect children. The incidence is about 5 in 10,000 people.

Hashimoto's Thyroiditis is actually a systemic disease where the thyroid is major target organ and is a type of autoimmune thyroid disease in which the immune system attacks. It is a progressive disease of the thyroid that will  eventually destroys the thyroid gland causing a lack of thyroid hormone (hypothyroidism).
Once it is present it doesn't seem to go away, although the disease usually waxes and wanes and some patients never have further trouble.
The anti-bodies, however, usually stay positive and are of little help in assessing the activity of the disease, merely the diagnosis.

An autoimmune disease occurs when the body's immune system becomes misdirected and attacks the very organs, cells, or tissues that it was designed to protect. About 75% of autoimmune diseases occur in women.
Autoimmune thyroid disorders are known to have a genetic predisposition  in most cases. There is some evidence that Hashimoto’s Thyroiditis and Graves' Disease can have a hereditary link. If autoimmune diseases run in ones family, there is a higher risk of developing one yourself.

Hashimoto's was discovered by and named after, Hakaru Hashimoto who was born in 1881 to a family of medical practitioners in the village of Midau, Japan.  At the age of 22 he entered the new medical school at Kyushu University and was one of its first graduates in 1907.

Graves disease is named after Robert J. Graves, MD, circa 1830s

Happy New Year - Good Luck and Best Wishes for 2008.

[AR-10]

What anti-body tests are more definitive for Hashimoto's or Grave's?

Why don't Endocrinologists run those more definitive tests?

I've had two PCPs and three Endo's and they didn't run these other tests you speak of, as far as I know.

[kitty9309]

bump