The Wellness Q&A with Elaine Moore

Welcome to the Wellness Q&A where members can ask Elaine Moore any health-related question. Moore is a medical writer and retired clinical laboratory scientist with over 30 years experience in immunology. Get started by selecting Member Questions. This is a question-and-answer forum, and each thread represents a member question or set of questions. The question will only appear once it's answered. Thank you for joining.

Remission
Last Post 02 May 2024 03:55 PM by Elaine Moore. 1 Replies.
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eakallUser is Offline New Member New Member Posts:
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28 Apr 2024 07:58 PM
    Hi Elaine,

    Hope you are well. I haven't been on here recently and it's good to be back, I am still chugging along with my subclinical Graves and 5 mg mmi daily since mid 2020. My antibodies will not come down and stay elevated. My endo says remission unlikely. 5 mg MMI daily keeps me euthyroid with an optimal TSH for me and feeling good but why is remission so illusive in some? Where should FT3 and FT4 fall as far as the ranges?- upper third? All the best to you!
    Elaine MooreUser is Offline Veteran Member Veteran Member Posts:4084
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    02 May 2024 03:55 PM
    Hi,
    I'm doing well and staying in my clinical trial for endometrial cancer since the drugs are working. I've been NED (no evidence of disease) since March 2022. I stll have high TSI antibodies because I'm allergic to trees and live in a forest.
    TSI will stay elevated if you have allergies that aren't in control, have a low level of 25OH vitamin D, or have lots of stress. Covid and Covid vaccines cause a rise in thyroid antibodies. It's not unusual to have lifelong elevations of TPO and thyroglobulin antibodies. The TSI antibody test is the only one you need and it's often elevated for a long time. The reference range for the test is the level in which hyperthyroidism can occur. In most tests it's 130% activity. If it's down to around 70% you're moving toward remission.
    On MMI you want to be on the lowest dose needed to keep FT4 near the high end of the reference range. If FT4 falls too low this prevents remission as your gland speeds up activity trying to correct the problem. This causes a rise in antibodies.
    Dosing is never based on the TSH in Graves' since TSI falsely lower the TSH level. I'm not sure you can establish an optimal TSH since many Graves' patients have lifelong low TSH levels. Hope this helps, Elaine
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