Newbie - Graves' Disease and now what???

[ImmortalOne]

Hello, I came across this site while trying to interpret what my latest labs meant from my most recent doctor (a new family doctor).

A bit of history about me... in 2003 I was diagnosed with Graves' Disease. I battled the Graves' on and off for 4 years (beta blockers, medications, testing after testing). I went for periods that I did what I was supposed to do and others which I just totally blew it all off (luckily not damaging my heart). During this time I refused to have RAI done or my thyroid removed, mostly impart because I felt that was treating the symptom not the cause (since Graves' is Auto Immune).

[During this time frame my 14 year old brother (now 17) was diagnosed with Graves' Disease as well. My parents both have problems with their thyroid, and my other brother who is 25 currently is believed to have Hashi's]

In December 2006 I got pregnant by some miracle, I was told I probably couldn't keep the baby, that my Graves' would harm the baby, etc, etc. It was also found that I had an ovarian tumor that continued to grow during my pregnancy (and was removed along with that ovary at 13 weeks). Oddly enough, from that point on all my TSH levels started to go into a normal range. My Free T4 and T3's all fell back in line into a normal range. It was as though that tumor must have been doing something all that time.

Now 8 months postpartum, they are revisiting my Graves' disease. I have also recently been diagnosed with Fibromyalgia now. However after looking over all the symptoms the only real issue I have that is remotely relative to that is the all over incredible muscle pain and fatigue. Anyway... so here at the most recent blood tests (I have a new Endo that I am going to on the 19th of this month as well).

TSH-------- 0.50 (Normal: 0.47 - 4.53)
Free T4---- 1.21 (Normal: 0.84 - 2.26)
T3--------- 111 (Normal: 65 - 170 )
TSI-------- 91 (Normal: 0-129)

So at first glance those look "okay". That's the best numbers I've had in 5 years! Yet... then I get these ones...

Thyroglobulin Ab ------ 7.00 (Normal: 0.0 - 0.9)
Microsomal (TPO) Ab -- 4.63 (Normal: 0.0 - 0.9)

Obviously something isn't right... now I'm trying to figure out if the Graves' has turned into something else. Kinda confused on everything at this point, especially since my husband and I want another baby but have been told we will be lucky because of these numbers... *sigh* Hoping to find someone out there that maybe can relate... everything I have looked at (checklists, etc) seems to point that I have Hashi's now, not Graves'... Is this a normal shift? What to expect? I need to do something soon, tired of feeling horrible.

[NastyHashi]

I can relate. We have essentially the same labs, or at least I used to have the same labs...my numbers recently have been all over the place too. I too have "normal" T3 and T4 but my TSH this last time went from 4.9 (high normal) to 19.8 (full blown hypo) and my antibodies are all high.

You too seem to have the trifecta - TSI, TPO and TG antibodies as do I. Its these stupid antibodies that make us feel the way we feel. I call it the Hashi Graves' Combo....some days we drag ass like hypos and others we are ramped up like hypers....Im still searching myself for an answer.

My endo just gave me a barage of tests I still need to take including the RAI uptake scan, an MRI of my brain, a sono and more blood tests.....it looks like unless they find a tumor on my pituitary, RAI is going to be the only way for me to ever get normal.

[GD Women]

I assume you are not on nor have been on thyroid medication or supplements.

It is not unusual for hypos or hypers to go back to normal levels.

Are you correct with the antibody ranges. Normally Thyroglobulin Ab
0 to 40 IU/mL and TPO Ab 0 to 50 IU/mL and of course there might be a variation between Labs.
Thyroglobulin antibodies are not specific for confirming a diagnosis of autoimmune thyroid disease. Thyroglobulin may occur in organ-specific autoimmune diseases, including pernicious anemia, Addison's disease, type I diabetes mellitus , polyglandular endocrine failure syndromes etc.
Sjögren syndrome, lupus, rheumatoid arthritis, and pernicious anemia are sometimes positive. As well as in the normal population without thyroid disorders.
I wouldn't worry about the antibodies because they will or can fluctuate, wax and wan, go up and down. Sometimes hide into remission only to pop-up again in the future. They do not provide an indication of whether a person has normal or abnormal thyroid function. There is nothing that can prevent or eliminate thyroid antibodies nor are they curable or treatable.
I would keep your concerns on your thyroid levels and be tested on a regular bases with family history and being postpartum. In a few months things can change again.
I have seen others with antibodies as high a 3000/4000. Such high numbers can cause miscarriages as well as too high or too low TSH levels. TSH levels will change every trimester especially the first trimester so it is very important to have TSH levels tested (every trimester). For good healthy pregnancy TSH more in the middle or between 1 and 2. Just because you had no problems with first baby doesn't mean the same for the second baby. Graves' can cross the placenta line causing baby to be born with Graves' with complications.
However, I agree I don't see Graves, nor Hashi. But on the other hand, I'm not a doctor.

Good Luck - hope you have a healthy pregnancy and baby. And don't worry too much;)