Thyroglobulin antibody and TSH 0.55, Low c4 low c3 - can this be graves?

[Pyr2]

Hi everyone, Im having a lot of restlessness, palpable anxiety, dizziness, rocking sensation, eye pain/burning and nerve pain all over my body including twitches.  

I just tested positive for this antibody.  In the past it was normal.

I know my TSH is not abnormal, but it is borderline low.  Can this still be Graves?

[Barb135]

Let me clarify... Decreased complement activity (such as yours) is seen with lupus, RA, hepatitis and microbial infections, along with other conditions...

Increased complement activity is seen with thyroiditis, cancer and other conditions...

[Barb135]

Thyroid conditions are pretty straight forward, so we go by actual thyroid hormone levels, which are Free T3 and Free T4.  

As I noted, low levels of TgAb are often present in other autoimmune conditions, including lupus (SLE), Rheumatoid Arthritis, etc.  

The complement tests are, typically, used for other conditions that are a bit more complicated, though they are, rarely used to determine thyroiditis.  Low levels of C3 and/or C4 can be seen in conditions such as lupus and RA, microbial infections, some cancers, hepatitis and others.  The tests themselves won't tell the doctor what the condition is, it will only tell the doctor that the immune system may be involved.

If you have symptoms of hyperthyroidism, you need to be tested for Free T3 and Free T4, which are the actual thyroid hormones.  With hyperthyroidism, Free T3 and Free T4 will be high and TSH will be very low (often lower than yours, but not always).  

To determine if you have Graves Disease, which often causes hyperthyroidism, you need to have a Thyroid Stimulating Immunoglobulin test, as that's the definitive test for Graves... Without that, you can't have a positive test for Graves.

Since you have a slightly elevated TgAb, I'd suggest that you get tested for Thyroid Peroxidase Antibodies (TPOab), which are the other test to determine if you have Hashimoto's... While Hashimoto's is, typically, associated with hypothyroidism, it's often characterized by periods of hyperthyroidism in the beginning, which can swing from hyper to hypo or normal, before eventually settling into permanent hypo.

Have you been tested for the actual Free T3 and Free T4 thyroid hormones?  If so, please post the results and reference ranges, since ranges vary lab to lab and have to come from your own report.

[Pyr2]

Barb
Thanks.  Here are the results:
Thryoglobulin AB -  2 (High)  Range -  over <1 IU/ML
TSH   0.55   Range  0.4 - 4.5 miU/L
Free T4 - 1.28  Range 0.75- 1.54
Normal TPO AB
-So basically the only test that is out of range is the first AB, although my TSH is not that high.    WHen I refer to c3 and c4, I am actually referring to my complement levels.

Thanks!
L

[Barb135]

When you say low "c3" and low "c4", do you mean T3 and T4?  Can you give us actual results and reference ranges for the labs you're referring to, please?  

Thyroglobulin antibodies are used to diagnose Hashimoto's, so you're positive for that you've most likely got Hashi's, but low levels can also be present in other autoimmune conditions.  

Typically, low TSH with low thyroid hormones, T4 and T3 would indicate central hypothyroidism, in which the thyroid works fine, but there's a malfunction with the pituitary/hypothalamus axis.  The exception would be if you're already on a thyroid hormone medication, then you could have low TSH with low thyroid hormones.