Swollen Lymph Nodes And Grave's? - Graves' Disease and Thyroid Discussion - Living with Graves Disease

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Swollen Lymph Nodes And Grave's?

lymphadenopathy graves lymph nodes swollen goiter

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#1 Somenume

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Posted 26 August 2021 - 10:44 AM

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Hi,

 

I was wondering if anyone else gets swollen lymph nodes with their Grave's disease.

I have a goiter + swollen lymph nodes and positive antibodies for Grave's and the lymph nodes are worrying me.

I wasn't able to find much material on swollen lymph nodes occurring with Grave's disease so I was wondering if anyone else gets these.

 

 

Thanks,




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#2 Allies

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Posted 26 August 2021 - 04:45 PM

Hi Somenume, and welcome :)

 

I can't speak for everyone, but at diagnosis (and prior to that) I had swollen nymph nodes in my armpits (and a goitre, but obviously that wasn't in my armpits :D ) At some point the lymph node swelling resolved, and as I got control of my thyroid hormones, and the TSH receptor antibodies started to fall, the goitre shrank too and my thyroid gland went back to a normal size. Neither have been an issue since then (and I'm going on three years off meds).

 

My feeling is that the lymph node swelling went down in step with a reduction in systemic inflammation, and I suspect that happened as the hyperthyroid phase of Grave's resolved, but I probably should mention that I adjusted quite a few aspects of my diet and lifestyle and this may have helped to reduce inflammation too. Lymph nodes react to all sorts of infections, which could be why I'm making the inflammation connection.

 

Allies
:D



#3 Somenume

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Posted 27 August 2021 - 11:33 AM

Hi Somenume, and welcome :)

 

I can't speak for everyone, but at diagnosis (and prior to that) I had swollen nymph nodes in my armpits (and a goitre, but obviously that wasn't in my armpits :D ) At some point the lymph node swelling resolved, and as I got control of my thyroid hormones, and the TSH receptor antibodies started to fall, the goitre shrank too and my thyroid gland went back to a normal size. Neither have been an issue since then (and I'm going on three years off meds).

 

My feeling is that the lymph node swelling went down in step with a reduction in systemic inflammation, and I suspect that happened as the hyperthyroid phase of Grave's resolved, but I probably should mention that I adjusted quite a few aspects of my diet and lifestyle and this may have helped to reduce inflammation too. Lymph nodes react to all sorts of infections, which could be why I'm making the inflammation connection.

 

Allies
:D

I have one more question, if I may ask. When the lymph nodes were swollen did you also get a lower white blood cell count?



#4 Allies

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Posted 27 August 2021 - 02:12 PM

I have one more question, if I may ask. When the lymph nodes were swollen did you also get a lower white blood cell count?

Of course you can ask :D - just remember that I'm not a doctor and that we are all rather individual in our biochemical make-up and in how our bodies react to things.

 

I've just had a look through my old blood test results starting from when I was diagnosed with Grave's disease, during that time my white blood cell count has always come back within the population reference interval, so has never been flagged as being low.

 

What did your doctor say about the low WBC? Have they ordered more tests to try and find the cause? Are they planning to re-test to see if this was a one-off result?

 

When being treated with antithyroid drugs to combat high thyroid hormone levels (FT3 and FT4), we are advised to get our white blood cell count checked if we get a sudden cold, sore throat or infection. This is because some people respond to the meds by a drastic decrease in white cells, which is called agranulocytosis - it's pretty rare, but something we need to be aware of if we are taking anti-thyroid medication since most antithyroid med side effects are at least partly related to dose - if the dose is too high we are more likely to get these side effects - although agranulocytosis can occur regardless of dose, it's just not particularly common (so don't worry too much about this, especially if your WBC is just a little low :) ).

 

Low white blood cells could mean that the immune system will struggle to fight off infections, that we bruise easily and/or are anemic. Blood tests for iron might help determine if you are anemic, I note you are in Australia (me too! :) ) and I don't think Medicare likes it much when we want blood tests :( We can get get private blood tests here (depending on whether or not you are in a locked down area), Unfortunately they are not particularly cheap, which might help explain why Medicare is not keen. Iron studies (ferritin, Serum Iron, transferrin and saturation ratio) costs around $60.00.

 

Allies
:)



#5 Somenume

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Posted 27 August 2021 - 02:57 PM

Of course you can ask :D - just remember that I'm not a doctor and that we are all rather individual in our biochemical make-up and in how our bodies react to things.

 

I've just had a look through my old blood test results starting from when I was diagnosed with Grave's disease, during that time my white blood cell count has always come back within the population reference interval, so has never been flagged as being low.

 

What did your doctor say about the low WBC? Have they ordered more tests to try and find the cause? Are they planning to re-test to see if this was a one-off result?

 

When being treated with antithyroid drugs to combat high thyroid hormone levels (FT3 and FT4), we are advised to get our white blood cell count checked if we get a sudden cold, sore throat or infection. This is because some people respond to the meds by a drastic decrease in white cells, which is called agranulocytosis - it's pretty rare, but something we need to be aware of if we are taking anti-thyroid medication since most antithyroid med side effects are at least partly related to dose - if the dose is too high we are more likely to get these side effects - although agranulocytosis can occur regardless of dose, it's just not particularly common (so don't worry too much about this, especially if your WBC is just a little low :) ).

 

Low white blood cells could mean that the immune system will struggle to fight off infections, that we bruise easily and/or are anemic. Blood tests for iron might help determine if you are anemic, I note you are in Australia (me too! :) ) and I don't think Medicare likes it much when we want blood tests :( We can get get private blood tests here (depending on whether or not you are in a locked down area), Unfortunately they are not particularly cheap, which might help explain why Medicare is not keen. Iron studies (ferritin, Serum Iron, transferrin and saturation ratio) costs around $60.00.

 

Allies
:)

My WBC has also always been in range, until today. I got partial blood results today and it came back as a low WBC. I haven't asked any doctor yet as I'm still waiting for more results but for sure it's making me stress out. I'm also not taking any meds, as I'm just TRab positive, with normal hormone levels. Or that's how I've been for several months. I don't know how the levels are going to show up for this blood test, as I had it cause I felt worse than usual...

Thanks for the answer though!



#6 Allies

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Posted 27 August 2021 - 09:31 PM

My WBC has also always been in range, until today. I got partial blood results today and it came back as a low WBC. I haven't asked any doctor yet as I'm still waiting for more results but for sure it's making me stress out. I'm also not taking any meds, as I'm just TRab positive, with normal hormone levels. Or that's how I've been for several months. I don't know how the levels are going to show up for this blood test, as I had it cause I felt worse than usual...
Thanks for the answer though!

There's a good chance it's just a temporary blip and worrying about it won't help anyway. If anything stress, anxiety and worry might make you feel worse :( ...and we are living in rather stressful times as it is!

 

If you're a chronic worrier or suffer from anxiety (I know I do) Macquarie Universiry runs various free online courses for things like anxiety (for Australian citizens), I did one earlier this year and have been finding it helpful putting some of the things suggested into practice. The one I did is specifically designed for people with chronic conditions, and autoimmune conditions fall into that category. It was 8 weeks long, and free because it's a part of ongoing trials (in exchange participants provide feedback and are followed up over 5 years)

 

Here's a link to their website in case it's something you might be interested in:
https://www.ecentreclinic.org/

 

And this is the link to their chronic conditions course (it looks like they are recruiting participants for this one at the moment)
https://www.ecentrec...org/?q=CCCourse

 

Hopefully the rest of your blood tests might give you a better idea of what is going on :)



#7 mmztcass

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Posted 28 August 2021 - 02:55 PM

Hi Somenume and welcome:

 

Could you post your lab results along with the lab reference range so we can better see and help you with any suggestions?  Such as Free T3, Free T4, and TSH?  How high is the TRAb?  I know you said normal for some, how normal? 

 

As for the lymph nodes I can't recall as it has been just about 21 years for me.  I definitely do remember the swollen thyroid.  

 

Low WBC is seen with people at the beginning of Graves' Disease.  I can see why the swollen lymph nodes as it would mean the immune system is not working as well as it should.

 

{{{hugs}}}



#8 Somenume

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Posted 30 August 2021 - 11:28 AM

Hi Somenume and welcome:

 

Could you post your lab results along with the lab reference range so we can better see and help you with any suggestions?  Such as Free T3, Free T4, and TSH?  How high is the TRAb?  I know you said normal for some, how normal? 

 

As for the lymph nodes I can't recall as it has been just about 21 years for me.  I definitely do remember the swollen thyroid.  

 

Low WBC is seen with people at the beginning of Graves' Disease.  I can see why the swollen lymph nodes as it would mean the immune system is not working as well as it should.

 

{{{hugs}}}

 

Hi!

 

FT3 2.96 pg/mL [color=#000000;](range 2.3 - 4.2 / pg/mL)[/color]

[color=#000000;]FT4 1.63 ng/dL ([color=#000000;]range 0.80 - 1.76 / ng/dL)[/color][/color]

[color=#000000;][color=#000000;]TSH 1.618 µUI/ml (range [color=#000000;]0.550 - 4.780 / µUI/ml)[/color][/color][/color]

 

I'm aware my FT4 to FT3 conversion is quite bad but as the TSH is not raised I don't think that's causing my goiter or other symptoms. Also had a B12 test which came back as 450 pg/mL (range [color=#000000;]211 - 911 / pg/mL), which is quite low, probably adds to the bad conversion rate.[/color]

[color=#000000;]Been taking a vit B complex but seems it didn't have much effect on the B12 level. Tested before trying supplements and it was higher back then actually, 480.[/color]

 

[color=#000000;]Still waiting for my TRab result this time. Back in May it was 1.85 (decision limit 1.75UI/L).[/color]

[color=#000000;]Maybe the TRab has risen however highly unlikely as it just went down by itself over the months once the vitamin D deficiency was corrected..[/color]

The lymph nodes and goiter were investigated already with an ultrasound in May, but I never got any suggestion for what can I do to get rid of this remaining problem.

 

[color=#000000;]Thanks,[/color]

 

 

 

 



#9 Allies

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Posted 30 August 2021 - 03:19 PM

Hi Somenume

 

Your FT4 to FT3 conversion does looks a bit low, at least in as far as a blood test can show - some of the deiodinase activity converting FT4 to FT3 occurs within cells so wouldn't necessarily show up on blood tests, but probably would moderate how you actually feel as cellular T3 levels effect one's energy levels (deiodinase are the enzymes that remove an iodine molecule from T4 to create T3; of course it's a bit more complicated than just that)

 

The deiodinase enzmes (there are three types) are selenoproteins, so selenium availability plays an important role here; zinc and iron also seem important. There's a growing body of research suggesting that selenium deficiency can effect how our bodies use iodine, and some doctors have speculated that either the Hashimotos or Grave's disease that occurs after iodine prophylaxis programs might be caused by a sudden increase in iodine consumption in people deficient in both selenium and iodine, and adding iodine without selenium may trigger latent thyroid autoimmunity. My doctor insisted that I address a possible selenium deficiency before adding iodine to my diet (I had stopped eating iodine fortified bread, so my iodine levels were dropping). At first I added in a supplement, but later switched to trying to get these things from my diet.

 

From your latest post it seems like your lymph nodes have been swollen since May, but your white blood cells have only fallen recently? Was anything unusual or different happening with your diet, lifestyle and general health back in May that might have caused inflammation and the lymph node swelling? Although your current concerns may or may not be directly related to Grave's, it's hard to imagine swollen lymph nodes not relating to your immune system reacting to something, and it's equally hard to imagine that the decrease in white blood cells doesn't also point to your immune system - so maybe something you changed around May that you are still doing is effecting your immune system?

 

Allies
:)



#10 mmztcass

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Posted 30 August 2021 - 03:45 PM

Somenume:

 

As Allies says. 

 

I was thinking that perhaps your labs could be trending towards Hashi's (a mostly hypO).  Though we don't look at the TSH levels as it can lag a few weeks behind the current Free Ts levels, I have always heard that any time one's TSH was over 1.5 and trending upwards, to look at hypOthyroidism.   

 

So brings to my next question if there are any TPOab and TgAb tests done to check for Hashimoto's Thyroiditis?   

 

I do not see any WBC numbers posted any where.  If you can post and the lab reference range too please.  

 

Thanks and {{{hugs}}}



#11 Somenume

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Posted 31 August 2021 - 11:00 AM

Hi Somenume

 

Your FT4 to FT3 conversion does looks a bit low, at least in as far as a blood test can show - some of the deiodinase activity converting FT4 to FT3 occurs within cells so wouldn't necessarily show up on blood tests, but probably would moderate how you actually feel as cellular T3 levels effect one's energy levels (deiodinase are the enzymes that remove an iodine molecule from T4 to create T3; of course it's a bit more complicated than just that)

 

The deiodinase enzmes (there are three types) are selenoproteins, so selenium availability plays an important role here; zinc and iron also seem important. There's a growing body of research suggesting that selenium deficiency can effect how our bodies use iodine, and some doctors have speculated that either the Hashimotos or Grave's disease that occurs after iodine prophylaxis programs might be caused by a sudden increase in iodine consumption in people deficient in both selenium and iodine, and adding iodine without selenium may trigger latent thyroid autoimmunity. My doctor insisted that I address a possible selenium deficiency before adding iodine to my diet (I had stopped eating iodine fortified bread, so my iodine levels were dropping). At first I added in a supplement, but later switched to trying to get these things from my diet.

 

From your latest post it seems like your lymph nodes have been swollen since May, but your white blood cells have only fallen recently? Was anything unusual or different happening with your diet, lifestyle and general health back in May that might have caused inflammation and the lymph node swelling? Although your current concerns may or may not be directly related to Grave's, it's hard to imagine swollen lymph nodes not relating to your immune system reacting to something, and it's equally hard to imagine that the decrease in white blood cells doesn't also point to your immune system - so maybe something you changed around May that you are still doing is effecting your immune system?

 

Allies
:)

Hi! The only thing I tried recently was going gluten free, which if anything, was supposed to reduce the inflammation. Otherwise no other illnesses that I had over the last year so the lymph nodes can't be the symptom of an actual infection. But apparently this immune system is very complicated.

Seafood contains lots of iodine. Though I think most of us don't suffer from an iodine deficiency since all salt basically has it added.

I've been taking selenium supplements on and off, but many of them contain a lot of other harmful stuff (like the "plastic" which encapsulates most of them, etc).

 

IDK, I'm still waiting for the TRab result, for some reason it takes so long.



#12 Somenume

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Posted 31 August 2021 - 11:09 AM

Somenume:

 

As Allies says. 

 

I was thinking that perhaps your labs could be trending towards Hashi's (a mostly hypO).  Though we don't look at the TSH levels as it can lag a few weeks behind the current Free Ts levels, I have always heard that any time one's TSH was over 1.5 and trending upwards, to look at hypOthyroidism.   

 

So brings to my next question if there are any TPOab and TgAb tests done to check for Hashimoto's Thyroiditis?   

 

I do not see any WBC numbers posted any where.  If you can post and the lab reference range too please.  

 

Thanks and {{{hugs}}}

Yeah, I also thought I had hypo symptoms, despite the TRab antibodies, but every time, thyroid levels come out normal, though in the lower range sometimes.

Tested both TPOab and TgAb at different times (one in June 2020 and one in December 2020) and they were both negative (thankfully!)

 

The WBC:

platelets 137 10^9/l (150 - 500 / 10^9/l)

Lymphocytes 0.98 10^9/l (1.0 - 4.0 / 10^9/l )

Monocytes 0.16 10^9/l (0.2 - 1.0 / 10^9/l )

 

thanks for reading,



#13 Allies

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Posted 31 August 2021 - 03:46 PM

Hi! The only thing I tried recently was going gluten free, which if anything, was supposed to reduce the inflammation. Otherwise no other illnesses that I had over the last year so the lymph nodes can't be the symptom of an actual infection. But apparently this immune system is very complicated.
Seafood contains lots of iodine. Though I think most of us don't suffer from an iodine deficiency since all salt basically has it added.
I've been taking selenium supplements on and off, but many of them contain a lot of other harmful stuff (like the "plastic" which encapsulates most of them, etc).
 
IDK, I'm still waiting for the TRab result, for some reason it takes so long.

TRAB results can take ages primarily because it's not a frequently run test - I don't think it's a fully automated test either. The labs run these tests in batches, so tend to wait until they have enough samples to justify running a batch of these at the same time. I've waited two weeks for results in the past!

 

Iodine is complicated :( In most parts of Australia our soils are deficient in iodine which is why mandatory iodine fortification of bread was introduced in 2009 (organic bread was exempt from this requirement) . If you have stopped eating bread, your iodine levels may have fallen a little. If salt has iodine added it is labelled as iodized salt. Sea salt may contain a little, but I don't think it's very much.

 

Removing bread from my diet and slightly later going gluten, or rather grain-free, resulted in my own iodine levels dropping into the slightly deficient range - and I've been experimenting for the past two years with how to fix this without upsetting my thyroid hormones or antibody levels (with mixed results). I've gone into my experiments with this at slighly boring lengths elsewhere :)

 

I worry a lot about the sorts of things added to supplements, so try to avoid them where possible. For selenium I add Brazil nuts, sunflower seeds and sardines to my diet on a sort of rotating basis - whilst being aware that sardines are also contribiting iodine and some of the calcium missing due to avoiding dairy products (I have a dairy intolerance)

 

On the subject of complex immune systems, I have a few observations on TRAB in particular, but will pop these into a follow-up post :)

 

Allies
:D



#14 Allies

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Posted 31 August 2021 - 04:23 PM

TRABs are not a single type of antibody, it's a family of antibodies. There are actually three sub-types of TSH receptor antibodies that have been identified.

 

The stimulating type, TSI (thyroid stimulating immunoglobulin) is the one everyone seems most concerned about, and has been definitively identified as the one that causes hyperthyroid phases of Grave's disease. When it (TSI) binds to the TSH receptor on our thyroid cells it prevents TSH from binding there and it signals the thyroid to produce more thyroid hormone. Although it's kind of doing the job of TSH, unlike TSH it's not regulated by the hypothalmus/pituitary/thyroid feedback loop and can get a bit carried away, and that's when we can end up in a hyperthyroid phase of Grave's disease.

 

The blocking type of TRAB are also now reasonably well understood (although this knowledge is slow to filter down into medical practice). When the blocking type of TRAB bind to the TSH receptors on our thyroid glands, they also prevent TSH from binding there, but their signalling to the cell is rather goitrogenic and inhibits the production of thyroid hormones. This can result in a hypothyroid phase of Grave's disease, or lowish thyroid hormone levels.

 

The third type of TRAB has been known about for a long time too, but because when it binds to the TSH receptor it doesn't prevent TSH from also binding there it has been called 'neutral' TRAB. Recent research (over the past 5 years or so) has been suggesting that it's action may involve apoptotic signalling to the cell, triggering cell death. It's possible that when studies refer to TRAB as sometimes being involved in Hashimoto's thyroiditis, that this form of TRAB is the main player- but that's speculation on my part. I haven't really found much in the freely available medical literature that expands on the rather oblique references to TRAB in Hashimoto's.

 

An individual can have a mixture of these different types of TRAB and the balance of these can shift over time, so what actually happens in, or to, the thyroid gland can be uniquely individual.

 

As an example when I was diagnosed, (with quite high FT3 and FT4) my TRAB was 10.2 (ref <1.85), later briefly rising to 15.6. I think it's fairly safe to assume that quite a bit of this was the stimulating type of TRAB. Now, even though I'm in remission from that hyperthyroid phase and have been for around 3 years, my TRAB seems to have stalled at 4.2 (<1.85) - I feel that my thyroid hormones, although within the population reference intervals, are a bit too low for anywhere near optimal bodily function and that I'm functionally a bit hypo. My TRAB is obviously not predominantly of the stimulating type at present. Because I was curious about this I paid to have TSI privately tested; it's still there, but at a threshold level of 0.36 (where <0.10 is considered negative, 0.10 - 0.55 are threshold levels an >0.55 suggest 'active' Grave's)

 

If it was possible to check for blocking and/or neutral TRAB levels outside of research circles I'd like to test those too, but as it is Medicare covers TRAB every six months or so and only the stimulating TRAB is available via private testing, so there's a bit of guesswork involved in interpreting the current make-up of my TRAB.

 

The upshot of all this is that it's entirely possible to be slightly or overtly hypothyroid with positive TRAB - it all depends on what type of TRAB is binding to the TSH receptors on our thyroid glands, what signals they are sending to the cells, and how those cells respond.

 

Shifting gears a little, I can see why you are a bit concerned about the white blood cell count :( especially in view of the lymph node swelling. It might be that your doctor checks this again in a month or so to determine whether this is a one off or the beginning of trend, these results might be considered only slightly low and nothing to worry about, I don't know enough about it to say, sorry.

 

Allies (again :) )



#15 Somenume

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Posted 01 September 2021 - 07:24 AM

:D

 

TRABs are not a single type of antibody, it's a family of antibodies. There are actually three sub-types of TSH receptor antibodies that have been identified.

The stimulating type, TSI (thyroid stimulating immunoglobulin) is the one everyone seems most concerned about, and has been definitively identified as the one that causes hyperthyroid phases of Grave's disease. When it (TSI) binds to the TSH receptor on our thyroid cells it prevents TSH from binding there and it signals the thyroid to produce more thyroid hormone. Although it's kind of doing the job of TSH, unlike TSH it's not regulated by the hypothalmus/pituitary/thyroid feedback loop and can get a bit carried away, and that's when we can end up in a hyperthyroid phase of Grave's disease.

The blocking type of TRAB are also now reasonably well understood (although this knowledge is slow to filter down into medical practice). When the blocking type of TRAB bind to the TSH receptors on our thyroid glands, they also prevent TSH from binding there, but their signalling to the cell is rather goitrogenic and inhibits the production of thyroid hormones. This can result in a hypothyroid phase of Grave's disease, or lowish thyroid hormone levels.

The third type of TRAB has been known about for a long time too, but because when it binds to the TSH receptor it doesn't prevent TSH from also binding there it has been called 'neutral' TRAB. Recent research (over the past 5 years or so) has been suggesting that it's action may involve apoptotic signalling to the cell, triggering cell death. It's possible that when studies refer to TRAB as sometimes being involved in Hashimoto's thyroiditis, that this form of TRAB is the main player- but that's speculation on my part. I haven't really found much in the freely available medical literature that expands on the rather oblique references to TRAB in Hashimoto's.

An individual can have a mixture of these different types of TRAB and the balance of these can shift over time, so what actually happens in, or to, the thyroid gland can be uniquely individual.

As an example when I was diagnosed, (with quite high FT3 and FT4) my TRAB was 10.2 (ref <1.85), later briefly rising to 15.6. I think it's fairly safe to assume that quite a bit of this was the stimulating type of TRAB. Now, even though I'm in remission from that hyperthyroid phase and have been for around 3 years, my TRAB seems to have stalled at 4.2 (<1.85) - I feel that my thyroid hormones, although within the population reference intervals, are a bit too low for anywhere near optimal bodily function and that I'm functionally a bit hypo. My TRAB is obviously not predominantly of the stimulating type at present. Because I was curious about this I paid to have TSI privately tested; it's still there, but at a threshold level of 0.36 (where <0.10 is considered negative, 0.10 - 0.55 are threshold levels an >0.55 suggest 'active' Grave's)

If it was possible to check for blocking and/or neutral TRAB levels outside of research circles I'd like to test those too, but as it is Medicare covers TRAB every six months or so and only the stimulating TRAB is available via private testing, so there's a bit of guesswork involved in interpreting the current make-up of my TRAB.

The upshot of all this is that it's entirely possible to be slightly or overtly hypothyroid with positive TRAB - it all depends on what type of TRAB is binding to the TSH receptors on our thyroid glands, what signals they are sending to the cells, and how those cells respond.

Shifting gears a little, I can see why you are a bit concerned about the white blood cell count :( especially in view of the lymph node swelling. It might be that your doctor checks this again in a month or so to determine whether this is a one off or the beginning of trend, these results might be considered only slightly low and nothing to worry about, I don't know enough about it to say, sorry.

Allies (again :) )

I just got my TRab level.And it's such a surprise! <0.21 U/L ([color=#000000;text-align:left;]NEGATIVE: < / = 1.0 U/L)[/color]

 

I tend to think the lab hasn't done the tests well because I can't be negative. Or they probably just don't detect the kind of antibodies I have, because as you said, there are many types. I don't know how much even the labs can be trusted.

 

From what I read about Grave's, no antibodies would mean remission, so it baffles me.



#16 Allies

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Posted 01 September 2021 - 05:29 PM

Hi Somenume :)

That's rather perplexing! I did find a Newcastle (VIC) laboratory that looks like it uses a similar set of reference points to determine TRAB positivity:

TRAB >1.8 IU/L is regarded as positive
TRAB 1.0 to 1.8 IU/L is equivocal
TRAB <1.0 IU/L is regarded as negative

A positive reference point of around >1.8 does look like it's measuring overall TRAB rather than just the stimulating type, as these tests seem to be more standardised and usually have a cut-off point in that ball park, with very little variation. The pathology lab that ran your test might have been using a similar test kit. If your test was run through the Medicare system it's also highly likely to have been overall TRAB as that is what Medicare covers (I don't think that has changed in the recent past)

Tests measuring just the stimulating TRAB (TSI) seem to be more diverse and people get all sorts of different types of reference intervals and even percentages on their laboratoy reports depending on which of the TSI testing kits is used. It seems a lot less standardised than the general TRAB test. This might be because existing TSI tests are often improved and new tests developed. TSI tests also seem to be quicker (at least in my experience) as the tests are more automated.

Of course mistakes can happen with blood tests (infrequently), and some blood test results can be messed up by things like the patient taking high doses of biotin or having heterophile antibodies (usually related to exposure to animals, particularly mice) - I don't know if TSH receptor antibody tests can be effected by the later two, but I guess any test could be effected by contaminated blood samples or human error. None of these things is thought to be particularly common, path labs are pretty careful. I do wonder though how some pathology laboratories are coping with hugely increased demand in recent times and if it's possible that mistakes could happen slightly more frequently due to increased stress and fatigue? If by chance there was some lab or blood handling error, depending on when this occurred, other blood tests taken at the same time might also have been affected - which might call into question the wbc as well? (That is pure speculation, so take with a grain of salt!)

Anyway, assuming that the test was total TRAB your levels look to have dropped quite a bit! Most TRABs are immunoglobulins of the IgG type, which itself has several subtypes one of which has a comparatively short half-life - most though take two to three months to be cleared from the system. I think occasionally TRABs might be IgA types and these are much shorter lasting. So perhaps your particular TRABs were one of these faster clearing types of immunoglobulin - although I'm grasping a little here as my understanding at this level is pretty basic. (I think this is a big difference between doctors and patients; doctors start studying and build their knowledge from the bottom up, whereas interested patients often start where they are and work backwards! )

If the test was total TRAB (which I think is likely), and the result is sound (which is usually the case) then that's a good thing as it would indicate some improvement in the thyroidal aspects of what's going on :) and if we're being positive here, we could further imagine that with any improvement the ripples spread outwards and further improvements may follow in other areas :D

It will be interesting to see what your doctor makes of these results.

Sorry I don't half go on!

Allies
:D

#17 Somenume

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Posted 07 September 2021 - 10:21 AM

Hi Somenume :)

That's rather perplexing! I did find a Newcastle (VIC) laboratory that looks like it uses a similar set of reference points to determine TRAB positivity:

TRAB >1.8 IU/L is regarded as positive
TRAB 1.0 to 1.8 IU/L is equivocal
TRAB <1.0 IU/L is regarded as negative

A positive reference point of around >1.8 does look like it's measuring overall TRAB rather than just the stimulating type, as these tests seem to be more standardised and usually have a cut-off point in that ball park, with very little variation. The pathology lab that ran your test might have been using a similar test kit. If your test was run through the Medicare system it's also highly likely to have been overall TRAB as that is what Medicare covers (I don't think that has changed in the recent past)

Tests measuring just the stimulating TRAB (TSI) seem to be more diverse and people get all sorts of different types of reference intervals and even percentages on their laboratoy reports depending on which of the TSI testing kits is used. It seems a lot less standardised than the general TRAB test. This might be because existing TSI tests are often improved and new tests developed. TSI tests also seem to be quicker (at least in my experience) as the tests are more automated.

Of course mistakes can happen with blood tests (infrequently), and some blood test results can be messed up by things like the patient taking high doses of biotin or having heterophile antibodies (usually related to exposure to animals, particularly mice) - I don't know if TSH receptor antibody tests can be effected by the later two, but I guess any test could be effected by contaminated blood samples or human error. None of these things is thought to be particularly common, path labs are pretty careful. I do wonder though how some pathology laboratories are coping with hugely increased demand in recent times and if it's possible that mistakes could happen slightly more frequently due to increased stress and fatigue? If by chance there was some lab or blood handling error, depending on when this occurred, other blood tests taken at the same time might also have been affected - which might call into question the wbc as well? (That is pure speculation, so take with a grain of salt!)

Anyway, assuming that the test was total TRAB your levels look to have dropped quite a bit! Most TRABs are immunoglobulins of the IgG type, which itself has several subtypes one of which has a comparatively short half-life - most though take two to three months to be cleared from the system. I think occasionally TRABs might be IgA types and these are much shorter lasting. So perhaps your particular TRABs were one of these faster clearing types of immunoglobulin - although I'm grasping a little here as my understanding at this level is pretty basic. (I think this is a big difference between doctors and patients; doctors start studying and build their knowledge from the bottom up, whereas interested patients often start where they are and work backwards! )

If the test was total TRAB (which I think is likely), and the result is sound (which is usually the case) then that's a good thing as it would indicate some improvement in the thyroidal aspects of what's going on :) and if we're being positive here, we could further imagine that with any improvement the ripples spread outwards and further improvements may follow in other areas :D

It will be interesting to see what your doctor makes of these results.

Sorry I don't half go on!

Allies
:D

hi,

 

Doctor said the swollen lymph nodes aren't related to the thyroid as when they're related to it they usually aren't painful or palpable.

And also said the thyroid is just minimally swollen..

Not helpful at all. But as I waited for the results and all that, the symptoms kinda got better on their own.

 

Also found out I have a vit A deficiency. So I guess if I fix this too, I might feel better.

I'm very afraid of catching covid too so I don't think I'll try to make any appointments anymore as I've never gotten any real solution for the goiter.



#18 Allies

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Posted 10 September 2021 - 04:47 PM

Hi Somenume,

I'm glad things are getting better :D, with any luck the goitre and lymph nodes will settle down as things improve further :)

If you have a known deficiency, addressing that is a good place to start :) Remember that vitamin A is a fat soluble vitamin, so it's much harder for our bodies to get rid of excess and it's also possible to overdo this one. So if you are planning to take supplements it's probably a good idea to take note of the dosage advice. If you are planning to use food, I think it's similarly possible to overdo vitamin A by consuming lots of organ meats (particularly liver, which is very high in vitamin A)

A lot of things about covid scare me and make me anxious too :(

#19 mmztcass

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Posted 12 September 2021 - 04:17 PM

Hi everyone:

 

I just realized this.  Australia is approaching Spring season whereas here in the States we are going into the Fall season.  

 

I wanted to mention about seasonal allergies.  I have gotten swollen lymph nodes under my pits starting at near the end of February about three weeks before Spring season begins due to the rising pollen along with the extreme chronic fatigue.  Then I have had to take the liquid herbal tinctures from my ND to tame everything down.

 

I never used to have this issue until about two and a half years ago and had forgotten about that.  I mentioned in one of the above post that it had been 21 years since I've started my thyroid issues.  

 

Just wondering if this is something else to consider?

 

{{{hugs}}} 







Also tagged with one or more of these keywords: lymphadenopathy, graves, lymph nodes, swollen, goiter


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