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1520550 tn?1291062449

Antithyroglobulin AB Level of 19070??

Hi, I am new to MedHelp and I signed up because I feel really worried about the lab results I received today. I am a 20 year old female, and I got my lab results at my endocronologist appt today. It says that my:

TSH is .212 and low (range of .450-4.5),
TPO Ab is 248 and high (range of 0-34),
Thyroglobulin, Qn is <0.5 and low
Antithyroglobulin Ab is 19070 and high (range of 0-40) Verified by repeat analysis

My dr. told me that the high number of antithyroglobulin ab was from my antibodies attacking my thyroid gland. I already have been diagnosed with hypothyroidism due to cysts on my thyroid gland and am on synthroid 150.

But my mom has an autoimmune disease, doctors think maybe lupus and definitely mixed connective tissue disorder, so she has Hashimoto's as a result. Could this be what I have as well? Or what else can cause these levels on the tests be indicators of? I'm really worried that these could prevent me from being able to have children in the near future because the sites I look at say infertility could occur. Please give any insight you can, I would truly appreciate it. :(
19 Responses
Avatar universal
Your antibodies that high definitely mean Hoshimotos. I have it. Usually it comes and goes, mine does not. I really need the higher dose and have trouble getting the Dr. to give it to me. You definetly  need to get that under control before you have children. I did not watch it and my 3rd child was born with a hairlip. I was told that probably did it. It is hard to control.
Avatar universal
I agree that your elevated antibodies indicate that you have Hashi's.

Is your doctor testing free T3 and free T4 as well as TSH?  It's the FT3 and FT4 levels that must be used to regulate your dose, not TSH alone.

There is no reason why you can't have a successful pregnancy with Hashi's.  However, it's extremely important to get your meds stabilized before you conceive.  Pregnancy and childbirth can wreak havoc with healthy thyroids, so you want to address your condition ahead of time to minimize discomfort to you and possible negative impact on your baby.  After that, you'll be good to go.

If you have FT3 and FT4, please post with ranges.  How do you feel?  Do you have either hypo or hyper symptoms?

  
1520550 tn?1291062449
Hi, thanks for the response, I believe she did test for free T3 and free T4, if triiodothyronine (?) is free T3

Triiodothyronine, Free, Serum 2.8 (range 2.0-4.4)
T4, Free(Direct) 1.20 range (0.82-1.77)

So neither of those are out of range, is that why she didn't raise my synthroid level? And I definitely have or have had the symptoms of hypothyroidism, weight gain, fatigue, cold all the time, etc. My vitamin D was also low at 8.8, the normal range being 32-100, if thats important at all.
Avatar universal
I'm glad to hear your doctor is testing FT3 and FT4 as well.  Your FT4 is a bit low...it's at 40% of range, and 50% is the rule of thumb for FT4.  FT3 is also low.  It's at 33%, and the target for FT3 is the upper half to upper third of the range.  However, as you noted, your TSH is also a bit on the low side.  

Whether or not you need an increase really depends on how you feel on your current dose.  If yous still have nagging symptoms, you might need just a very slight bit more.

Definitely work on your vitamin D.  Low D often seems to go along with Hashi's, and many find that that has to be higher in the range, also, before they feel well.  Has your doctor suggested supplementing?
1520550 tn?1291062449
Yes, she actually gave me a prescription for a vitamin D supplement, I don't recall exactly what it was but she's having me get another thyroid ultrasound and start on the vitamin D and come back in March with new lab results. Hopefully, I will start to feel some improvement, I'm not sure if I feel bad primarily because of my excessive weight for my height (211 lbs at almost 5'2") or if its the thyroid problems...

But I have to say I really appreciate your quick and extremely informative responses, you've really made me feel relieved that this won't affect me to the point of infertility. Thanks so much :)
1520550 tn?1291062449
And thanks to you as well, being the first responder :). I can't imagine a healthcare professional blaming the mother to her face for her child having cleft lip! Regardless of whether her conditions caused it or not, that's just cruel IMO
Avatar universal
Good on the D.  You need to get your D levels higher as the symptoms of D deficiency can also mimic hypo.  

What are your symptoms?  If you're not feeling all that well, there's certainly room in your labs for either a slight increase in T4 meds, adding some T3 in, or both.  
Avatar universal
I will say, the Dr. did not tell me. For 50 yrs. we had no idea why it happened. I read it in a paper that was done for a Dr's conference on the Mayo Web. I also read in a Dr.'s manual that when you have Hoshi's, your body only uses 60% of your production of T3. I have found Endo's that will let the THS be low to give you enough juice to live with. T3 is the one that give you energy to operate. I finally had to switch to natural Armour. A lot of Dr.'s will not give it to you. I sure changed my Endro's mine when it worked great for me. I still have very sporatic energy. They are testing my iron. The reason you are so heavy, is the thyroid. I add weight every time it is out of balance. My diet is fine and I square dance every time I have the energy to do it. I still need to come down 25 lbs. Keep pushing your Dr. until you get results. They will probably keep chasing you from one Dr. to another. I have seen 15 in two years. I am back to my Endro. She can't pass me off anymore.
1520550 tn?1291062449
My symptoms are primarily the lack of energy/fatigue, sensitivity to cold, and weight gain. After missing my synthroid for a week or two, I gained almost 10 more pounds in a matter of days. It seems nearly impossible for me to lose weight and so easy to gain. I also have an appointment with my primary doctor in a couple weeks to discuss more lab results (pretty much the same tests as the endo) and I'm curious as to whether he will to try to raise the level of my meds or not. But based on what you're saying he probably won't, and it's probably not a good idea for him to anyway. But we'll see :)
Avatar universal
When taking thyroid meds patients frequently report having their TSH level suppressed to the low end and below.  This does not mean that you are automatically hyper.  You are hyper only when having hyper symptoms caused by excessive levels of FT3 and FT4, which you do not have.   For example, my TSH has been around .05 for over 25 years, without having hyper symptoms.  In fact I continued to have lingering hypo symptoms, somewhat like you describe, until I learned about the importance of FT3 here on the Forum and got my doctor to change my meds to include a source of T3 as well as T4, and raise my FT3 from the lower end of the range to the upper part of the range.  

This is a good link to read about all this.  It was written by a doctor.

http://www.hormonerestoration.com/Thyroid.html

In my opinion the best way to treat a thyroid patient is to test and adjust levels of the actual, biologically active thyroid hormones, free T3 and free T4, with whatever type medication is required to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important, not TSH levels.  If your doctor is not aware of this and is unwilling to treat you clinically (for symptoms) in the manner I just described then you are going to have to find a good thyroid doctor that will do so.
Avatar universal
I did not mean to imply that I didn't think an increase in T4 meds or adding T3 to your meds was not a good ideal.  I agree with gimel...symptom relief is all important.  Your labs have plenty of room in them for an increase and/or adding T3.  I think either or both of those would be a good idea, and I'd press my PCP for that when I saw him if I were you. Your FT4 is a bit low, and your FT3 is quite low.  You need to increase both to feel well.
Avatar universal
I have had a terrible time adjusting my meds. I keep telling my Endro I need more. She put me on Armour( another Dr. told me that is the only one that has both T4andT3) It worked great until she started lowering the dosage. I read last night in Merck's Dr manual, that the TSH doesn't not count if the pitutary gland is not functoning correctly. My TSH was 0 , plenty of T4 and no T3. Nothing worked until the Armour. She finally got the TSH at .05 and now will not increase the dose. I am still putting on weight , cold all the time with difficulty breathing. I may have to find another Dr. that will check my P gland. You will not loose weight until thre thyroid is balanced. I have tried all the diets and none worked.
Avatar universal
I read in a Dr.s report somewhere that if you have active Hoshi's, you only use 60% of the meds you are taking and that is why Synthroid 150 is the lowest you should go. Has anyone read that?
Avatar universal
It is not unusual at all, when taking meds with T3 in them, to have TSH suppressed very low.  Your doctor should be basing your dose on FT3, FT4 and symptoms, not TSH.  Can you post your FT3 and FT4 levels with ranges?

In addition to Armour, you can take synthetic T3 (Cytomel).  The advantage to the synthetics is that T3 and T4 can be manipulated separately for a "custom" dose.  

It sounds like you might need a new endo.

"I read in a Dr.s report somewhere that if you have active Hoshi's, you only use 60% of the meds you are taking and that is why Synthroid 150 is the lowest you should go. Has anyone read that?"  No, I've never read that.  I have read that absorption of T4 meds can be as low as 60-80%.  However, this holds true no matter the cause of your hypo (Hashi's or otherwise).  There is no "lowest" you should go with Synthroid.  We're all different and have different requirements.  Some of us with Hashi's would be raging hypER on 150 mcg, others still hypO.  In addition, many factors such as general health, gut health, lifestyle, etc. can influence absorption.  I'm on 75 mcg, and both my endo and I think my thyroid is functionally "dead".  150 mcg would probably send me to the moon.
Avatar universal
My last test was as close as I will ever get to normal but I still have terrible weakness, cold all the time, short of breath, breaking nails, ect.  My TSH was 0 for years, the T4 very high and T3 below the scale for several years. I spent most of it in bed after breakfast. I had been very active. Square dancing about 4 nights a week, working in a kitchen, and up and down 26 steps moving. Now I have trouble walking 250 ft. to my mailbox. I sometimes cheat and take 30 more on the Armour when I have a big day. This weekend I have to sing 2 concerts so I will take more Armour or I will not be able to stand up long enough. The extra does help. She had me try Cytomel and it did absolutely nothing. She suggested I might need iron. The feritin was 10 so I had an infusion(4hrs) That brought it up to 20. She is happy with that. I felt better for 1 week. Now it is back to what it was. I am not sure the Ferrous Sulphate i am taking is doing any good.
Avatar universal
Why is it "as close as you will ever get to normal"?  We so often hear doctors saying "your labs are normal...there's nothing wrong with you" when, in fact, testing is inadequate or the reference ranges they're using are obsolete.  It sounds like you are stil very hypo.

Please post any recent thyroid labwork with ranges.  What is your dose of Armour?  

Your doctor is not treating you properly and is keeping you sick.

You CAN feel much better.  
Avatar universal
My TSH was .02 and the T3 was just inside of too low but she called me on the phone and I do not have the paperwork. When she started me out on the Armour at 320, I felt great, started to loose weight and had a lot of energy. Then the cutting back started. We are now at 90. I have trouble climbing stairs and have a lot of shortness of breath. I keep telling her I need more and she says the THS can't be that low because she is legally responsible. I said I'll sign a paper! My feritin is in the 20's and I think I could use more Iron. Thanks
Avatar universal
If all she's worried about is her legal responsibility, then you need a new doctor.

When you are taking any meds with T3 in them, like Armour, TSH is often suppressed and becomes a completely unreliable indicator of your thyroid status.  Many of our members that take T3 have TSH almost undetectible before their symptoms are relieved.  You have to test both FT3 and FT4 and go by those.

It sounds like your FT3 was just above the bottom of the range.  That's way too low.  Many of us find that FT3 has to be in the upper half to upper third of the range to feel good.  

The goal is feeling good, and you don't.  Is it possible for you to find another doctor?  I hate to think of you feeling so bad when I know how much better you'd feel if you had a doctor who understood thyroid better.  Don't let this one keep you sick...
Avatar universal
I find that a couple of your statements raise questions.  Since antibodies are produced by the immune system for specific tasks, how is it that thyroid antibodies TPO ab and TG ab are able to also attack the other organs you mentioned?  Also, since the need for thyroid meds is determined by the patients symptoms and levels of the biologically active thyroid meds FT3 and FT4, how does possibly reducing the levels of thyroid antibodies have any effect on reducing thyroid meds.  As long as there are thyroid antibodies, the destruction of the thyroid glands will continue, although perhaps at a slower pace.  But reduced antibodies wouldn't change the amount of medication necessary to offset the prior loss of natural thyroid production.  

Perhaps at this point, it would be appropriate to ask about your credentials and experience.  Or was your post just to promote the book?  If so, be aware that a number of members have already read the book and have serious, unanswered questions about many of the underlying assumptions, testing and treatment protocol.  
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