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Why Are My Thyroid Antibodies Still High?

For those people with Graves’ Disease and Hashimoto’s Thyroiditis who follow a natural treatment protocol, one of the primary goals should be to suppress the autoimmune response.  As you probably know, most endocrinologists don’t pay attention to the autoimmune component, as they just focus on getting the TSH and thyroid hormone levels within the normal lab reference range.  But remember that Graves’ Disease and Hashimoto’s Thyroiditis are not thyroid conditions, but instead they are autoimmune conditions which affect the thyroid gland.  Although not everyone with an autoimmune thyroid condition will test positive for thyroid antibodies, many people do have elevated levels.  And it’s not uncommon for these antibodies to remain high even after following a natural treatment protocol for a prolonged period of time.  Why is this the case?

Before I answer this question, let’s briefly discuss the different types of thyroid autoantibodies.  Hashimoto’s Thyroiditis is characterized by thyroid peroxidase antibodies and/or thyroglobulin antibodies.  Graves’ Disease is characterized by TSH receptor antibodies, also known as TSI antibodies.  There are a few other types of thyroid antibodies, but these are the most common ones associated with these conditions.  It’s also possible for people to have both types of antibodies, as I’ll frequently see people have both TSI antibodies and TPO antibodies, and every now and then I’ll see someone with all three of these antibodies.

What Causes Elevated Thyroid Antibodies?

In order to better understand why thyroid antibodies might remain elevated after following a natural treatment protocol, it is probably a good idea to discuss why these antibodies become elevated in the first place.  Once again, Graves’ Disease and Hashimoto’s Thyroiditis are autoimmune conditions.  There are many different types of autoimmune conditions, and the primary difference is that each one attacks different tissues of the body.  While Hashimoto’s Thyroiditis involves antibodies that attack and damage the thyroid gland, the TSH receptor antibodies of Graves’ Disease attack the TSH receptors.  Other autoimmune conditions will attack other parts of the body.  For example, with multiple sclerosis the immune system attacks the myelin, which covers the nerve cells of the brain and spinal cord.  Another example involves rheumatoid arthritis, which is a condition where the immune system attacks the synovial joints.

Although autoimmunity involves a genetic component in most cases, not everyone with a genetic marker develops an autoimmune condition.  It takes a combination of genetic, lifestyle, and environmental factors to trigger an autoimmune condition.  This isn’t just my opinion, as there are many journal articles which discuss this as well, and studies involving identical twins prove that genetics alone won’t lead to the development of an autoimmune condition.  So when someone develops an autoimmune condition, they most likely had a genetic predisposition, but something triggered the autoimmune response, and this causes the formation of thyroid antibodies.

Removing The Autoimmune Trigger Is The Key

If someone follows a natural treatment protocol and if their thyroid antibodies remain elevated, this usually indicates one of the following three problems:

1) The autoimmune trigger hasn’t been removed. This probably is the most common reason why elevated thyroid antibodies will remain high.  For example, one of the common autoimmune triggers is a leaky gut.  As a result, if I confirm that someone has a leaky gut and then help the person correct this problem by removing the leaky gut trigger and repair the gut, if this was the one and only trigger then it should  resolve the autoimmunity issue, and thus normalize the thyroid antibodies.  However, it is possible for someone to have multiple triggers.  In other words, it is possible for someone to have a leaky gut, but perhaps the main factor which triggered the autoimmune response was a certain toxin.  In this scenario, while it’s important to correct the leaky gut, the toxin issue would need to be addressed in order to normalize the thyroid antibodies.

This has happened to me numerous times while working with patients, as I’ve dealt with many people who have leaky gut syndrome, and while correcting this problem will frequently be the key in restoring the person’s health back to normal, this isn’t always the case.  Having multiple triggers admittedly is frustrating to both the doctor and patient.  And sometimes it can be a challenge to find all of the triggers.  This is especially true with a factor such as toxins, as there are so many toxins we’re exposed to, and it’s impossible to test for all of them.  Plus, even if it were possible to measure all of them, we need to keep in mind that not everyone reacts the same to toxins.  This is demonstrated by the Chemical Immune Reactivity Screen from Cyrex Labs, as this test measures the immune system response to certain toxins.  For example, one person might not have any problems when being exposed to large amounts of formaldehyde, whereas another person might have a negative reaction when exposed to smaller amounts of this toxin.  And the same concept applies with other toxins.

2) The autoimmune response hasn’t been suppressed. Many times just removing the trigger alone won’t “balance” the immune system.  So for example, if someone has a leaky gut due to eating gluten, if the person completely removes gluten from their diet and successfully goes through a gut repair protocol, the autoimmune component still might be active.  Another example involves exposure to a pathogen which triggered the autoimmune response, as while addressing the pathogenic infection is necessary, doing so might not suppress the autoimmune response.  In a previous blog post entitled “The Role Of Cytokines In Autoimmune Thyroid Conditions“, I spoke about something called nuclear factor kappa B (NFkappaB).  I discussed how this becomes chronically activated in autoimmunity, and while it is essential to remove the autoimmune trigger in order to restore the person’s health back to normal, NFkappaB might remain active even after removing this trigger.  When this scenario arises it becomes necessary to do things to help suppress the autoimmune component of the condition.  Certain nutrients which can help with this vitamin D, omega 3 fatty acids, curcumin, and resveratrol.

3) Other compromised areas of the body need to be healed. Getting back to the leaky gut example, if a pathogen such as H. Pylori or candida caused a leaky gut, then not only is it important to get rid of the pathogen, but it is also important to restore the health of the gut.  Some will assume that removing the trigger which caused the leaky gut is enough, but many times this isn’t the case.  Another example involves gluten, as if someone has a condition such as Celiac disease and consumes gluten, and this in turn caused a leaky gut over time, in addition to eliminating gluten from that person’s diet, certain measures usually need to be taken to repair the gut.  Another example involves stress.  Let’s look at the scenario where someone is dealing with chronic stress, which in turn causes HPA-axis dysregulation and weakened adrenal glands, thus making the person more susceptible to inflammation and resulting in autoimmunity.  While the person needs to improve their stress handling skills, doing this alone won’t always restore the health of the adrenals and the HPA-axis.

So in summary, in order to reverse autoimmunity and thus lower elevated antibodies one needs to 1) remove any autoimmune triggers, 2) suppress the autoimmune response, and 3) address other compromised areas of the body which might be contributing to the autoimmune component.  This can be very challenging, which is why I recommend for those looking to restore their health to work with a competent natural healthcare professional who has experience dealing with these conditions.  But even when working with someone it can be a challenge.  Although some people gradually improve with no setbacks, other cases are more challenging.  Obviously poor patient compliance can be a big issue, but some people don’t receive optimal results even when they are fully compliant.  And when this is the case one needs to look at these three factors I just mentioned.

Warning: The Thyroid Antibodies Can Fluctuate

While it’s great to see the thyroid antibodies gradually decrease as someone’s health improves, this doesn’t always happen.  In some people the thyroid antibodies will fluctuate, and so it’s not uncommon to see them decrease, and then to do another blood test one or two months later and see the antibodies increase.  This not only can become frustrating to the patient, but at times it can also become confusing, as their TSH and thyroid hormone levels might be improving, yet the thyroid antibodies will sometimes further increase.  Just remember that the thyroid antibodies don’t always gradually decrease, and they probably won’t normalize until the trigger has been removed and the autoimmune response has been suppressed.

Should The Autoantibodies Be Zero In A Healthy Person?

A question I get asked every now and then is whether or not the thyroid antibodies should be zero, or is just having them fall below the reference range sufficient?  First of all, if someone is negative for thyroid antibodies, many times the lab won’t give a specific value.  For example, for the thyroglobulin antibodies a common reference range used is between 0 to 40 IU/mL (keep in mind that the reference range may differ depending on the lab you use), and you might show up as being less than 20.  In this example you would be considered to be negative, although you wouldn’t know the exact number, and there is the possibility that the value wouldn’t be zero.   To me this is satisfactory.  However, if someone has TSI antibodies of 125%, and the normal reference range is <140%, one might not consider this to be satisfactory since they still have some TSH receptor antibodies present.  If someone has TSI antibodies of 400 and then this eventually gets them down to 125 and it remains there, then in my opinion this is considered to be excellent progress, although I of course would prefer to see them get even lower than this.

Just remember what I said earlier about the antibodies fluctuating.  Some people do experience a gradual decrease in their antibodies, and so for example, if someone had TPO antibodies that were 1,500, and then they gradually decreased over time until they were undetectable, then this would of course be a positive finding.  However, if they were 1,500 and then one month later they were undetectable, then I would be more suspicious of the levels fluctuating.  Either way I would want to retest the levels in a month or two, but if someone experienced a gradual decrease in the antibodies over a number of months until they eventually were undetectable I would be more confident about the autoimmune response being suppressed.

Another thing to keep in mind is that not everyone with an active autoimmune component will test positive for thyroid antibodies.  Although the majority of people with Graves’ Disease and Hashimoto’s will have positive thyroid antibodies, some people with autoimmunity don’t test positive for elevated autoantibodies.  When this is the case this obviously makes it more challenging to determine if the autoimmune response has been suppressed.  But even if someone has elevated thyroid antibodies you don’t just want to rely on this alone to monitor their progress.  This is why other types of testing is important, as if someone has tested positive for a leaky gut or compromised adrenals, then of course you want these conditions to be corrected.  And even though you don’t want to rely on signs and symptoms, this can be important.  For example, if someone has a depressed TSH and elevated thyroid hormone levels, negative TSI antibodies, but they have swelling and bulging of the eyes, then this is a pretty god indication that they have Graves’ Disease, even though the TSH receptor antibodies tested as negative.  In this scenario one would look for an improvement not only with the TSH and thyroid hormone levels, but with the eye symptoms as well.

In summary, for those with an autoimmune thyroid condition who are following a natural treatment protocol, one of the goals is to normalize the thyroid antibodies.  However, if the thyroid antibodies remain elevated after following a natural treatment protocol, this means that either the autoimmune trigger hasn’t been removed, the autoimmune response hasn’t been suppressed, and/or other compromised areas of the body need to be healed.  It’s also important to understand that not everyone with Graves’ Disease or Hashimoto’s Thyroiditis has elevated thyroid antibodies, and it also is important to understand that the thyroid antibodies can fluctuate.  Even though it can be challenging to reverse autoimmunity, this is possible to accomplish.


 

28 Comments

  1. Kristine says:

    Could this be why I am suddenly feeling lethargic all day long, or is that about summer ending?
    I sleep really well, but when I wake up, I end up feeling so weak most of the day, I can barely get anything done.
    Very frustrating as the cold weather approaches.

    • trudi says:

      Low iron and/or cortisol issues could be the culprit.

    • Dr. Eric says:

      Hi Kristine,

      I suppose summer ending could be a reason why you’re feeling lethargic, although if you’re feeling weak throughout most of the day it probably is related to something else. If you have elevated thyroid antiboides damaging your thyroid gland then this could be a factor, but of course there can be other factors which can cause lethargy and weakness, such as a nutrient deficiency (i.e. iron or vitamin B12), an infection, etc.

  2. Laura says:

    So then what would you consider a high TPO antibody count? My last count was 247 (I have Grave’s and am on Tapazol). Highest count I’ve had was 312. Have been trying gluten free diet for about 4 months.

    • Dr. Eric says:

      Hi Laura,

      I definitely would consider 247 to be elevated, and while you can’t always rely on the lab reference ranges, if the TPO antibodies are above the reference range I of course would consider them to be high, but I would be cautious even if they were within normal limits but were on the high side of being normal. That’s great about going on a gluten free diet!

  3. Sheba says:

    I was “loosely” diagnosed with a thyroid condition when, at my yearly checkup, I mentioned that my throat was swollen and I wondered if I had chronic swollen glands. My doctor immediately announced I had Hashimoto’s Disease. Later, after my lab results, he said I had Grave’s Disease. He tried to intimidate me by horrifying me with the threat of a thyroid storm. Admittedly, the idea is terrifying. I went to a naturopath who muscle tested me. He gave me a diet prescription of foods that I tested sensitive to. He also prescribed two natural supplements for adrenal support and female hormone support. My doctor demanded I make an appt. with an endocrinologist. I did. I spent three months prior to my appointment with the endocrinologist practicing an elimination diet – no gluten, dairy, nightshades, paprika, peaches, etc. I am a registered dietitian so I did not have too much difficulty streamlining my diet. I took the supplements. My symptoms improved over time. Less diarrhea, less racing heart, less feeling hot. I lost ten pounds but I was eating way differently. I have been sleeping very well. My heart rate is still high but not pounding in my ears. Three months later…. Endocrinology appointment. Kind of looking forward to seeing new blood work. The doctor saw my labs from three months ago and declared that she knew all she needed to know. She wouldn’t test my blood again. She prescribed two medications and said I had to take them and she would test my blood in two months after being on the Meds. She also seemed horrified that I had not been medicated thus far. She said I was in extreme danger of having a thyroid storm. Admittedly, my eyes are suffering but these Meds will not help with this. They are thyroid oriented medications. I feel so much better beside my eyes and my increased heart rate. Should I demand more blood work or just continue with my natural protocol? I have tremendous stress with my job, which will not change. What else can I do? I felt the endocrinologist was accusing and made me feel irresponsible. Any help would be appreciated.

    • Dr. Eric says:

      Hi Sheba,

      It sounds like you might want to look for a different endocrinologist, although many of them practice similarly. Another option is to work with a medical doctor who practices functional medicine. Either way, since it had been three months since the last blood test it would have been nice to see updated labs, as while you don’t want to rely on blood tests alone when following a natural protocol, it still is a good idea to monitor these levels regularly. I will add that it is a good idea to manage the cardiac symptoms, as while it sounds like the palpitations have improved, if you have an elevated heart rate and don’t want to take the medication then you might want to consider taking herbs to help with this, which you might already be doing. Obviously I think it’s great that you’ve avoided gluten, dairy, nightshades, etc. As for the tremendous stress you’re dealing with, even if you can’t reduce the amount of stress, hopefully you are doing things on a daily basis to help manage the stress, as this is very important.

    • jen says:

      Hi Sheba,

      I am not a doctor or any other kind of health professional but I do have Graves disease and am familiar with your symptoms. I wanted to let you know that my eye issues did improve with just treatment of my thyroid. I’m not sure why but when my thyroid is regulated my eyes pop back into my head and my goiter decreases dramatically.

      Best, Jen

  4. jill says:

    Please provide this article to my endocrinologist, Dr. Khan Pham at Watson Cliic in Lakeland Florida. She does not treat the “immunity” portion of Hashi’s. I am always tired, feeling like I am fighting the flu. same as Kristine. ON Paleo diet 6 weeks, better but not by much. Please spread the word to all endocrinologists about this. Thanks.

    • Dr. Eric says:

      Hi Jill,

      Even if I forwarded this article to your endocrinologist it probably wouldn’t do much good, as most endocrinologists don’t focus on the autoimmune component simply because they aren’t taught to do so in medical school. And while some medical doctors are open minded and try to learn more about functional medicine, most are close-minded and will continue to prescribe drugs to manage the symptoms and focus more on the blood tests than the patient.

  5. Cindy says:

    Dear Dr.Eric,
    I was diagnosed with Hypothyroidism in 2007 and given Synthroid. I took it for years. Three years ago, I was sent to a Rheumatologist to find out why I was hurting so much in my body. He checked my antibodies and concluded that I had Hashimoto’s and Fybromyalgia and prescribed pain meds and antidepressants. I took neither, but did start back taking the Synthroid. I prayed and asked the LORD about healing my body, and found out about juicing to heal my body. I juiced organically for about 3 months. I got sicker at first, but I did get better as far as the pain and major fatigue. I had spent years drinking diet coke and had many food allergies since birth. I no longer eat gluten, corn, milk, soy, or eggs. Gluten since January. I couldn’t keep up with the juicing, but do so sporadically now. I take Selenium, zinc, Lysine,Omegas, and probiotics, and now I am taking a Metabolic Thyroid supplement that has Bovine-adrenal, liver, pituitary, thyroid, with chromium GTF, broccoli, burdock root, guar gum seed,, kelp thailus, l-tyrosine, plant polysaccharides, sculcap herb and b-12 and I am taking some iodine and I use pink salt. Sometimes I take EmergenC. I do have stress in my life. I am much better at handling it though. I have psoriasis since I was 8 and it is pretty bad in my scalp. I have extremely dry skin and I keep having red, itchy skin around my eyes with swelling and my eyesight is blurry sometimes with it. I haven’t done away with nightshades. I feel like I have nothing to eat as it is!! I know this is a lot, but I am so tired of feeling sick!! I hope you can give me some advice. I can not fine an endo that will treat this any other way than prescribing Synthroid. Oh, by the way I quit taking the Synthroid. I try to read all of your info that you send. Thank you!

    • Dr. Eric says:

      Hi Cindy,

      It sounds like you’ve done some great things for your health, and I commend you for this. It’s also great that you have improved your stress handling skills, as this will only help. Many people with Hashimoto’s Thyroiditis have a leaky gut, and a leaky gut/intestinal dysbiosis can be causing the psoriasis as well. You’re unlikely to find an endocrinologist that will do anything else other than tell you to take medication, but I’d try to find a local medical doctor who practices functional medicine to work with, as they will try to detect and address the cause of the problem, and if you need to take thyroid hormone medication while addressing the cause then they might be willing to prescribe a more natural form, such as Armour or Nature-Throid.

      • Cindy says:

        Thank you, Dr. Eric. My chiropractor sold me the Metabolic Thyroid supplement and the iodine, she is the only doctor that I have found so far that thinks natural healing is where to begin. I do have more energy now than before, but I have begun putting on weight now too. Ugh!! I will look into leaky gut more. Thank you!

  6. viswa says:

    Hi Doc,
    my daughter 8 years has visible neck swelling for last 3 years..ultra sound normal excpet prominent lymph nodes..but recently antithyroglob test was conducted and value was 500( normal was 100)..how to proceed?..T3/T4 normal TSH lsightly high 5.6…we are worried as in family elders had multiple myeloma, throat cancer etc ..How to assure?

    • Dr. Eric says:

      Hello,

      Were the thyroglobulin antibodies elevated, or the actual thyroglobulin levels? If the thyroglobulin antibodies were elevated then I would recommend for you and your daughter to work with a natural healthcare professional to help with this. If the actual thyroglobulin levels are significantly elevated then your endocrinologist/medical doctor should further look into this. And if they won’t then you probably need to find another doctor.

      • viswa says:

        Dear Dr Eric

        Thank you , the antibodies were elevated . We met a pediac but couldnt confirm if it is hyper or hypo or grave or hashi . but my choild is mot tolerant to heat , she always like cold. Also the neck swelling some say is kind of goiter ! She has referred to a pediac endocronoloist on 12th december, hope we would get our answers. The visible swelling on neck is a concern that is there for 3-4 years . Is there a way to reduce the swelling ? if antibodies are attacking the thyroid tissues and causing inflamation , then why her thyroid still is of normail size in ultrasound ? Is the lymph nodes that are swollen/ is thier natural way to cure this ? We are in australia now moving from mebourne to adelaide, hope a natural way to correct her immunity condition is there ?

        • Dr. Eric says:

          Hi Viswa,,

          I’m not sure why they couldn’t determine whether it was Graves’ or Hashimoto’s based on the antibodies, as TSI/TSH receptor antibodies are specific to Graves’ Disease, while thyroglobulin antibodies and thyroid peroxidase are found in Hashimoto’s, although TPO antibodies are also commonly found in Graves’ Disease. If she has a mild goiter then this can be reversed in many cases, but if someone has a moderate to severe goiter then it is unlikely that it will completely go back to normal. But either way the autoimmune component needs to be addressed, and so I would recommend working with a natural healthcare professional to help you with this.

          • viswa says:

            Dear doc
            thanks, i indeed am proceeding to consult a naturopath . Is test like ANA required before we meet up with naturopath , can you please recommend someone in australia.On a best case scenario is there any chance we can meet you ? Her goiter like tenderness was examined by endocrinologist many times, they say its soft/tender and of no concern, Scan shows EUthyroid with no issues . But she has this ring like bulge for last 3 years. Her antibodies ( antithyroglobulin ) was tested again this time it was 480 ( last time 500) . but TSH T3 T4 is normal now. We are bit perplexed as , like you hinted, in our case as well, the endocrino is waiting to develop thyroid issues to treat her !. I 100% believe as she is young at age 9 she stands great chance to heal naturally ,,Pls advise

          • Dr. Eric says:

            I’m not familiar with any natural healthcare professionals in Australia, although you can visit the website for the Institute of Functional Medicine and perform a search. If you are unable to find anyone I do conduct remote consultations through Skype for people who live overseas.

  7. viswa says:

    Tnanks, I would like to initiate the skype consultation, Kindly forward the modalities to surajvp09@gmail.com Thx

  8. Merav says:

    HI doc. I read your article and am interested in how I can identify my trigger(s). How can i know if i have leaky gut or something else. I looked at the leaky gut symptoms and the only ones i have are an autoimmune and thyroid issues, which are already my primary problem, so i do not know if they are cause by leaky gut or not.

    I was diagnose with having a very elevated hyperthyroid a few months ago. My T3, T4, Tpo, thyroglobulin antibody, thriiodothyronine, and Stim immunoglobulin levels are very high. AND my TSH levels are low. I am on a low lose of methimazole twice daily. I was feeling incredibly fatigued, sick, lifeless, and the prescription is helping a little but definitely not solving my problems.
    I am wondering if there are any homeopathic or natural supplements I can add to my diet to help me get healthy faster. I am going to stat eating 2-4 brazil nuts to add some selenium to my diet as well as drinking some Lemon balm tea in the morning ( I have heard this is a good addition to fight a hyperthyroid). I am also taking a large blend of probiotics and sprouted grains,seeds,nuts,etc. (hopefully to help if i do have a leaky gut)
    I am on state insurance and my doctor hardly ever gets back to my with answers to my questions, so i am kind of on my own here and need some help. Any advice is greatly appreciated.

    • Dr. Eric says:

      Hi Merav,

      Identifying triggers usually involves a combination of taking a good case history and doing the proper testing. There are tests one can do for a leaky gut, although this isn’t something I do on all of my patients. I recommend saliva testing to most of my patients to evaluate the adrenals, and sometimes I will do an organic aids test or a stool panel, although it depends on the person. There are plenty of natural supplements out there, and this also will differ from person to person, although I always recommend nutrients to decrease inflammation and modulate the immune system (i.e. fish oils, probiotics, vitamin D3, turmeric, etc.), and so you might want to check out some of the articles I’ve written on these topics.

      • Marwa says:

        My Thyroid hormones had normalized after taking thyroid hormone medicine for 4 months now. However my antibodies have shown drop only in the TPO antibody while TG Antibody is still the same.is this sign of recovery.and what is the effect of those antibodies on pregnancy?

    • Maria says:

      Hi there I had to avoid all grains. I too have Graves’ disease!

  9. Lubna says:

    Dear Dr. Eric,
    I am suffering with Graves disease since Dec 2012 & it has been quiet fluctuating since then the anti bodies are also at a higher level & my doctor insists we can’t treat it has to get back to normal by itself, now I am 10 weeks pregnant & my antibodies are again on a higher end as per my doctor, he stopped my medication in Jan this year I was Noemarkizol & since then just the blood test,. can you please advice if this safe at this stage of my pregnancy. Waiting your advice.
    Regards,
    Lubna.

  10. Amit says:

    Hello Doc – I ready your post with great interest and engagement.
    I have normal TSH, T3, T4 but TSI is 176 (down from 217 11 months ago).
    Initially I was diagnosed with Hypo in Oct15, then doc said I have Hyper in May16.
    At that point I stopped taking all medications since docs couldnt decide what I had.

    Seems I am improving (I am a big believer in eastern medicines – yoga/ayurveda/simple lifestyle etc) – I feel my symptoms are largely stress (emotional/work) driven – and I should continue to invest there and keep away from medicines. I feel directionally I am moving there (do meditation/yoga) – your thoughts please?
    regards,
    A.

  11. Nathalie says:

    Hello DR,
    I am 34 years old.
    I have Grave (Basedow) since 2011 with a light exophtalmos, and last year they removed my thyroid completely. Since then I have been on L-thyroxine 100, then 125 and since 3 months ago 137,5 who seems to be the good one for me as now my TSH is stable. My antibodies on the other hand is still to high so my doc add 10mg of strumazol on the treatment. Since I started it 2 weeks ago I have pain stomach and I don’t digest properly. I also don’t taste the food properly.
    Also I might have the celiac disease since I have all the symptoms. I am kind of lost and tired after the surgery I thought all will be over but it’s not.
    What Can I do?
    Thank you for your help

  12. Joy says:

    Hi
    I have been in and out of remission for Grave’s Disease since 2007. Treatment with Tapazole until labs are normal and then lowering dose until development of leukopenia, at which point my endocrinologist takes me off completely. This happens each time and my remissions seem to last up to two years, then symptoms and abnormal lab values return.
    So, you are right in pointing out that the problem is the development of auto-antibodies and the reasons for their triggering.
    I would like to get tested for possible triggers. Who would I consult for these tests? An allergist? I believe my gut to be healthy due to not having any gut issues, but may have other triggers causing the continued autoimmune response .
    Any suggestions would be appreciated.

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