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Elevated THYROGLOBULIN AB - recovering from Subacute Thyroiditis
Hi,
I was diagnosed with Subacute Thyroiditis in March 0f 2013. Have been through the course of this disease without medication, but seeing endocrinologist and having blood work for monitoring. My endo says I have been progressing through the disease as expected and hopefully all will return to "normal" when it is over. It has been a difficult year, and at times I felt very ill. But at last endo check up in June of 2013, I did feel better and was hoping the light was at the end of the tunnel. However, over last two months I have been feeling much worse again, very tired, have weight gain of about 10 lbs (very unusual for me), much hair loss, (which is perhaps the most unsettling) and just feeling very anxious and miserable overall.
I just had more blood work done in preparation for endo visit next week. All appears normal, except the elevated THYROGLOBULIN AB at 361; range is listed as 0-115. I listed the test results below. I was wondering if anyone could give me some feedback on this....could this be a signal of Hashimoto's?
Thank you in advance for any info!
T4,FREE - Range: 0.93-1.70
02/06/14 1.28
06/21/13 1.17
THYROXINE (T4) - Range: 4.5-11.7
02/06/14 9.6
06/21/13 7.6
T3 UPTAKE,SERUM - Range: 22-35
02/06/14 28
06/21/13 30
THYROID STIMULATING HORMONE - Range: 0.270-4.200
02/06/14 2.110
06/21/13 1.540
THYROGLOBULIN AB - Range: 0-115
02/06/14 361 H
THYROID PEROXIDASE AB - Range: 0-34
02/06/14 9
I was diagnosed with Subacute Thyroiditis in March 0f 2013. Have been through the course of this disease without medication, but seeing endocrinologist and having blood work for monitoring. My endo says I have been progressing through the disease as expected and hopefully all will return to "normal" when it is over. It has been a difficult year, and at times I felt very ill. But at last endo check up in June of 2013, I did feel better and was hoping the light was at the end of the tunnel. However, over last two months I have been feeling much worse again, very tired, have weight gain of about 10 lbs (very unusual for me), much hair loss, (which is perhaps the most unsettling) and just feeling very anxious and miserable overall.
I just had more blood work done in preparation for endo visit next week. All appears normal, except the elevated THYROGLOBULIN AB at 361; range is listed as 0-115. I listed the test results below. I was wondering if anyone could give me some feedback on this....could this be a signal of Hashimoto's?
Thank you in advance for any info!
T4,FREE - Range: 0.93-1.70
02/06/14 1.28
06/21/13 1.17
THYROXINE (T4) - Range: 4.5-11.7
02/06/14 9.6
06/21/13 7.6
T3 UPTAKE,SERUM - Range: 22-35
02/06/14 28
06/21/13 30
THYROID STIMULATING HORMONE - Range: 0.270-4.200
02/06/14 2.110
06/21/13 1.540
THYROGLOBULIN AB - Range: 0-115
02/06/14 361 H
THYROID PEROXIDASE AB - Range: 0-34
02/06/14 9
Hi, and thank you very much for this information! I was diagnosed with subacute thyroiditis not quite a year ago, so it appears I am actually moving through this disease as expected... "resolution of all thyroidal abnormalities after 12-18 months is seen in most patients (~95%)".
Hopefully, at the end of it, all will remain normal, with no hypothyroidism. I am puzzled though, as I still feel "not well" and have so much hair loss. But perhaps this is the normal course. I do plan to ask for the Free T3 & Free T4 when I see the endo Friday and we'll see what, if anything that shows...if he agrees to do the test.
Thank you again for your reply and information! ;-)
Hopefully, at the end of it, all will remain normal, with no hypothyroidism. I am puzzled though, as I still feel "not well" and have so much hair loss. But perhaps this is the normal course. I do plan to ask for the Free T3 & Free T4 when I see the endo Friday and we'll see what, if anything that shows...if he agrees to do the test.
Thank you again for your reply and information! ;-)
Still in error geez. lol "Thus, the transitory immunologic markers that are observed during the course of subacute thyroiditis appear to occur in response to the release of antigenic material from the thyroid." 3rd time the charm. :)
That was my typo error...Oops. Sorry Werner & Ingbar lol.
"Thus, the transitory immunologic markers that are observed during the course of subacute thyroiditis occur in response to the release of antigenic material from the thyroid."
"Thus, the transitory immunologic markers that are observed during the course of subacute thyroiditis occur in response to the release of antigenic material from the thyroid."
Excerpts from Werner & Ingbar's The Thyroid: A Fundamental and Clinical Text...
"There is no clear association between subacute thyroiditis and autoimmune thyroid disease. Serum thyroid peroxidase and thyroglobulin levels are usually normal. When described, the levels of thyroid peroxidase and thyroglobulin antibodies correlated with the phase of transient hypothyroidism. Antibodies to an unpurified thyroid preparation can be detected for up to four years after a bout of subacute thyroiditis.
Several reports have suggested that subacute may trigger the development of TSH receptor antibodies (63), contributing to a prolonged hypothyroid phase (64) and occasionally leading to Graves disease (65), although this was not observed in the most recent epidemiologic study (37)."
"Following recovery from the inflammatory process of subacute thyroiditis, all immunologic phenomena disappear (66). Thus, the transitory immunologic markers that are observed during the course of appear to occur in response to the release of antigenic material from the thyroid."
***
Excerpt from The American Thyroid Association - What is Thyroiditis...
"Subacute thyroiditis follows the same clinical course as painless and post-partum thyroiditis, but is often accompanied by thyroidal pain. The thyroidal pain in patients with subacute thyroiditis usually follows the same time-frame of the thyrotoxic phase (1-3 months). However, not all patients with thyroidal pain necessarily have thyrotoxicosis. As noted with painless and post-partum thyroiditis, resolution of all thyroidal abnormalities after 12-18 months is seen in most patients (~95%). Recurrence of subacute thyroiditis is rare."
"There is no clear association between subacute thyroiditis and autoimmune thyroid disease. Serum thyroid peroxidase and thyroglobulin levels are usually normal. When described, the levels of thyroid peroxidase and thyroglobulin antibodies correlated with the phase of transient hypothyroidism. Antibodies to an unpurified thyroid preparation can be detected for up to four years after a bout of subacute thyroiditis.
Several reports have suggested that subacute may trigger the development of TSH receptor antibodies (63), contributing to a prolonged hypothyroid phase (64) and occasionally leading to Graves disease (65), although this was not observed in the most recent epidemiologic study (37)."
"Following recovery from the inflammatory process of subacute thyroiditis, all immunologic phenomena disappear (66). Thus, the transitory immunologic markers that are observed during the course of appear to occur in response to the release of antigenic material from the thyroid."
***
Excerpt from The American Thyroid Association - What is Thyroiditis...
"Subacute thyroiditis follows the same clinical course as painless and post-partum thyroiditis, but is often accompanied by thyroidal pain. The thyroidal pain in patients with subacute thyroiditis usually follows the same time-frame of the thyrotoxic phase (1-3 months). However, not all patients with thyroidal pain necessarily have thyrotoxicosis. As noted with painless and post-partum thyroiditis, resolution of all thyroidal abnormalities after 12-18 months is seen in most patients (~95%). Recurrence of subacute thyroiditis is rare."
Ok, thank you...I think I understand now. Very discouraged, though as I was hoping a med would be the solution and I would start to feel better soon. Will try to get the Free T3 and Free T4 done and see what they show. Thank you again for your help!
COMMUNITY LEADER
Meds won't help your antibody count and because your TSH and FT4 are good, it's unlikely that your endo will put you on med, at this point. It's more likely that he will try to attribute the symptoms to "something" else. Be persistent.
Ok, thank you so much for your quick replies and all the information; I really appreciate it! I will try for the FT3, but endo does tend to kind dismiss symptoms, so not sure if he will agree. I am really losing my hair and just feel so awful in general...I just think it's time I took something in the way of meds to "fix" this.
COMMUNITY LEADER
"Is it correct that an elevation to one or the other- THYROGLOBULIN AB or THYROID PEROXIDASE AB - but not necessarily both, could point to Hashimoto's?" Yes, that's what I was saying above. Not everyone has both antibodies. Some of us have TPOab, some have TGab and still others have both.
If you can you can get the FT3, that would be great, though some doctors will brush it off as unnecessary and refuse to order it.
If you can you can get the FT3, that would be great, though some doctors will brush it off as unnecessary and refuse to order it.
Thank you so much for your reply and the info! I will definitely ask for the Free T3 test, along with Free T4 when i see edno next week.
Is it correct that an elevation to one or the other- THYROGLOBULIN AB or THYROID PEROXIDASE AB - but not necessarily both, could point to Hashimoto's?
Is it correct that an elevation to one or the other- THYROGLOBULIN AB or THYROID PEROXIDASE AB - but not necessarily both, could point to Hashimoto's?
COMMUNITY LEADER
The elevated TGab would grounds for a diagnosis of Hashimoto's. Both TPOab and TGab are markers for Hashi's and a person can have either one, or both.
While subacute thyroiditis, typically, resolves on its own, it often develops into Hashimoto's.
Unfortunately, T3 uptake and Thyroxine are obsolete tests. Your doctor should be testing Free T3, along with the Free T4. Free T3 is the hormone that's actually used by individual cells and correlates best with symptoms.
Can you ask for the Free T3 test, along with Free T4?
While subacute thyroiditis, typically, resolves on its own, it often develops into Hashimoto's.
Unfortunately, T3 uptake and Thyroxine are obsolete tests. Your doctor should be testing Free T3, along with the Free T4. Free T3 is the hormone that's actually used by individual cells and correlates best with symptoms.
Can you ask for the Free T3 test, along with Free T4?
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