Could it be Graves?

[ms_sally1974]

Ok, I'm waiting to see an integrative medicine doctor.  I'm not getting anywhere with the Endo that I have now (this being the second one)  I may have more than one thing going on....

I've been reading alot and there are several sites that say any # on TSI above 2 is positive.... so my # is 42 (0-130)...I've also read the same about TPOab  anything is positive... my # is 15 (0-34)  so could this mean that I have or can expect to get both graves and hashi's?

Also, can a TSI level at 42 cause severe irritability?  Meaning everyone around me is irritating me and I'm almost at the point of tears daily because I just can't deal with these irritating people....I just want to lock myself in a room where there's nobody to pester me,  I'm so scared I'm gonna go off on someone.... :(

Anyway, I know my thyroid labs look fine and the only thing that looks weird or bad is b-12 and vit D.  Can't really find out if either of these things cause the irritability.  As I keep researching I have symptoms of both hyper and hypo, although most of my symptoms are hypo.  

Anyway, the main reason I'm going to the integrative doctor is that if it isn't my thyroid, what is it...Then Endo only wants to look at my labs and "oh it's not thyroid"....and not give me any other explanation of my symptoms....
9/2015
TSH 1.32 (.45-4.5)
FT4 1.24 (.82-1.77)
FT3 3.4 (2.0-4.4)

10/2015
RT3 22.5 (9.2-24.1)
FT3 3.6 (2.2-4.4)
Ratio 16
TPO 15 (0-34)
Thyrogolbulin antibodies < 1 (0-.9)
TSI 42 (0-139)
B-12 267 (211-946)
D 37.4 (30-100)

2013
tsh 0.634 (.450-4.5)
FT3 3.8 (2.0-4.4)
FT4 1.25  (0.82-1.77)

[ms_sally1974]

Thanks everyone. I'm hoping that he new doctor will at least give me a plan other than "just go get some pills and take them".... The current doctor actually looked over both the D and B12 at first....till I called her back about it. I still have no idea how much I should be taking, and when to follow-up.

[Red_Star]

I had SEVERE irritability due to vitamin B12 malabsorption (autoimmune pernicious anaemia).  My nose itched it was that bad!  I take 2000 mcg daily of sublingual B12 spray which works great for me.

[vino14]

Hi, just wanted to  ask if you had a female hormone panel done. A hormone imbalance can cause  the irritating feeling you have, it sounds very familiar. I'm a year younger than you and  had started perimenopause at 33.5 didn't know what hit me. I not quite at menopause but getting close. I had suffered not knowing what was wrong, and no one believed me when I mentioned perimenopause because of my age. I'm also hypo.

[goolarra]

It's true that the general population has TSI of less than 2.0.  The reference range is a gray area.  As far as TPOab is concerned, it can be elevated if you have another autoimmune disease. and remember that most of us have antibody counts much, much higher than that on diagnosis. What does it mean?  Probably not a lot more than it's something to keep your eye on.

No, you don't feel TSI, or any other antibodies, directly.  You feel the resultant effect on your thyroid.  Both hypo and hyper can make you feel irritable, but according to your current labs, you are neither.  Not feeling well can make you irritable, no matter what the cause.

B-12 and D could be causing most of your symptoms.  Furthermore you could be hypo at the cellular level if there's not enough D to help metabolize hormones.  

I think you have another explanation of your symptoms...D and B-12.