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.

APRIL 2020


Trav v tgab
Last Post 10 Jan 2021 07:32 PM by Elaine Moore. 1 Replies.
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RowanUser is Offline New Member New Member Posts:
10 Jan 2021 06:53 AM
    Hi Elaine, I had my most recent bloods done in a different lab and they tested tgab where’s usually I get trabs tested. My tgab were 510 ( reference range up to 115) so close to 5 times too high
    What’s the difference between tgab and trab? Should I also get my trab tested?

    I’m also hoping to get pregnant soon but last time I got pregnant my antibodies were negative and I was on a low dose of meds. This time they’ll be positive and I’m worried about it getting bad in the first trimester and harming the baby. An endo once told me graves can go a bit crazy in the first trimester. I wasn’t as worried about it last time as my antibodies were negative but I’m a little more concerned about this now as the Graves is not as inactive I suppose. But I really don’t want to wait for my antibodies to be negative before I start to try again as this could take. Long time and my fertility is not on my side!!

    Thanks so much Elaine, I hope you and your family are keeping well
    Elaine MooreUser is Offline Veteran Member Veteran Member Posts:3515
    10 Jan 2021 07:32 PM
    Hi Rowan,
    You had a test for thyroglobulin antibodies and they’re seen in around 80 percent of patients with Graves’ disease. They usually persist for life and your levels aren’t unusually high. Higher levels are seen in Hashimoto’s thyroiditis. You should have them repeated sometime to compare results. You do want a test for TRAb but ideally it would be a test for TSI, which measures stimulating TSH receptor antibodies. TRAb measures total TSH receptor antibodies including the blocking ones that block TSI and TSH from attaching to the thyroid cell receptor. So they can cause hypothyroidism or prevent TSI from causing hyperthyroidism.

    Ideally you’d have tests for TSI in the first and third trimesters. Patients don’t usually have problems in the first trimester although their results are affected. Because TSH is similar to the pregnancy hormone beta-HCG there’s a false lowering of the TSH result. Because estrogens rise total T3 and T3 are 1.5 times higher and FT4 and FT3 can be higher. In the second half of pregnancy with the immune system slowing down and hormones changing hyperthyroidism typically resolves if present. So I wouldn’t worry.
    Best to you and good luck with everything. Elaine
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