In this Q&A episode, Dr. Eric answers listener-submitted questions all about thyroid antibodies—what they are, why they matter, and how they impact both Graves’ disease and Hashimoto’s thyroiditis. He begins by clarifying the three main thyroid antibodies—TPO, TSI/TRAB, and thyroglobulin antibodies—and explains why understanding these markers is critical when assessing true remission.
Throughout the episode, Dr. Eric addresses common concerns such as: Can you be in remission if antibodies are still positive? How often should antibodies be tested? Can diet alone normalize them? He also explores the role of environmental triggers, gut health, gluten, iodine, and even supplements like selenium, black seed oil, and low-dose naltrexone (LDN). You’ll hear practical guidance on why antibodies fluctuate, what “optimal” really means (not just “within range”), and why many conventional endocrinologists don’t routinely monitor these markers.
If you’re confused about your antibody results—or wondering why you relapsed after being told you were “in remission”—this episode will help you connect the dots. If you want a clearer, more balanced understanding of thyroid antibodies and what they really mean for your recovery, you’ll get a lot out of this episode.
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Dr. Eric Osansky:
This is an opportunity to get questions answered related to thyroid antibodies. For those who are not familiar with me, I am Dr. Eric Osansky. I am a chiropractor, clinical nutritionist, and functional medicine practitioner. I have been helping people with thyroid and autoimmune thyroid conditions since 2009.
I was personally diagnosed with Graves’ and restored my health by taking a natural approach. This will be on the podcast. This is the first time. For those who are in the future listening to this on the podcast, this was recorded on Substack. If you aren’t subscribed to my Substack, Healing Graves’ Naturally, you can do so by visiting SaveMyThyroid.com/GravesNewsletter.
My podcast, even though it does focus a little bit more on hyperthyroidism and Graves’, I do get some people who listen who have Hashimoto’s. Most of the questions today will relate to hyperthyroidism and Graves’, but some of them will relate to Hashimoto’s. A lot of people with Graves’ also have antibodies to Hashimoto’s as well. Even some of the questions that relate to Hashimoto’s will be relevant to those with Graves’. There is also overlap when it comes to finding and removing triggers with different types of auto antibodies.
I might not get to all questions. Again, I’m just sticking to questions that relate to thyroid antibodies. If people have questions that are not related to the topic, again, I won’t be answering that here. I might be having another live stream later this month. This is going to just focus on thyroid antibodies.
Let’s start by talking about the different types of thyroid antibodies. There are three main types of thyroid antibodies. The most common are thyroid peroxidase (TPO) antibodies. Those are more common in those with Hashimoto’s but also very common in those with Graves’. According to the literature, approximately 60-80% of people with Graves’ have TPO antibodies. I do see that a lot in my patients. With Hashimoto’s, around 90% of people have those antibodies.
I am not going to go into great detail here. If you want to learn more about the antibodies, I have individual podcast episodes. If you’re not familiar with my podcast, for those who are listening to this live, my podcast is Save My Thyroid. I have individual episodes that focus on each of these antibodies. TPO is one type of antibody, the most common type.
The second type is thyroid stimulating immunoglobulins (TSI), which are specific to Graves’. TSI is a type of TSH receptor antibody (TRAB). You can test either one or both on a blood test.
The third main type of thyroid antibody is thyroid globulin (TG), which is more specific for those with Hashimoto’s.
There are other antibodies. There are thyroid inhibitory immunoglobulins (TII), which I have a podcast episode on, too. But those first three are the main three you can test for at just about any lab.
A lot of people have 2-3 antibodies. When I dealt with Graves’, I only had TSI. I didn’t have TPO or TG. Very common for people to have TSI and TPO. Not as common but not rare for people to have TSI, TPO, and TG,all three of the main antibodies. If TSI is positive, usually TRAB will be positive, too, and vice versa. There are exceptions.
As far as normalizing antibodies, because I don’t think anybody specifically asked that question when it comes to antibodies, at least not directly. I figured I would say in order to lower antibodies, you want to find and remove triggers and heal the gut. I have spoken about the triad of autoimmunity. I wrote about that in my first Substack article. I have discussed it on the podcast numerous times.
The triad of autoimmunity has three components necessary for autoimmunity to develop. One is a genetic predisposition. Two is exposure to one or more environmental triggers. Three is increased intestinal permeability, or a leaky gut. You can’t change the genes, but fortunately, by finding and removing triggers and healing the gut, you can reverse the autoimmune component in those with Graves’ as well as those with Hashimoto’s and any other autoimmune condition.
I have spoken about forming categories of triggers, which include food, stress, chemicals, and infections. That being said, let’s go ahead and dive into the questions.
I’m going to start with the questions that were emailed to me. I sent out a few emails. I said there were a few ways to respond. One was to email, and another way is to ask on the live call. With the live call, it might be challenging because there might be questions that don’t relate to antibodies. We’ll see. I’ll try to get to as many questions as I can. I can’t guarantee I’ll get to all questions because it depends on how many questions we have.
The first question, I kind of already answered: Which antibodies are specific to Graves’?
Those are the TSIs or TRABs.
I kind of also answered this next question: Is it possible to have both antibodies for Graves’ and Hashimoto’s?
Not only is it possible, but it’s actually quite common to have antibodies for both.
Can someone be in a state of remission if they have positive thyroid antibodies?
In order for someone to be in remission, you want those antibodies to be negative. The goal is to go to an endocrinologist’s office and not be diagnosed with Graves’ or Hashimoto’s in the first place. To be fair, they won’t start with the antibodies usually. They will look at the thyroid panel. If they look good, they won’t look at the antibodies. If they were to look at the whole picture, you would want not only the thyroid panel to be within the optimal reference range, but you would want those antibodies to be negative. If the thyroid antibodies are still positive, I don’t consider the person to be in remission.
That’s the problem when going to a regular endocrinologist. Many of them don’t even look at antibodies. They might do an initial test for thyroid antibodies, and that’s it. Some of them do regularly test for antibodies. Again, many of them don’t.
When they put someone on thyroid medication in the United States, commonly methimazole, that person is on the medication for 18 months to two years. If the person’s numbers look good, and they’re at the point where they’re ready to get off the medication-
Maybe they start off with a higher dose. It depends on the person. Some people only start with 5-10mg. Some people, 20-40mg. Let’s say they start off with 20mg. A year and a half later, they reach a point where they’re on 2.5mg, like half a tablet per day. The numbers are looking really good, maybe a little bit more on the hypo side, so the endocrinologist says, “You might be in remission. We are just going to take you off of the methimazole.”
Many times, they won’t look at the antibodies. I can’t say they never do, but they will just go by the thyroid. The antibodies in the background are still positive. As long as you still have thyroid antibodies, there is still a chance. In the case of Graves’, if you have positive TRI or TRAB, there is potential to become hyper again. That’s why a lot of people will relapse when they’re told they’re in remission because they weren’t really in remission.
The simple answer would have been no, I don’t consider someone to be in a state of remission. That’s my definition. Others might have a different definition. Wanted to give the reasoning behind that.
Does eating foods that give me a reaction contribute to thyroid antibodies?
It could. It depends on the food. Just because someone has a sensitivity to food doesn’t necessarily mean it will cause thyroid antibodies. Not always. It could contribute or cause the development of thyroid antibodies. Gluten is probably the most well-known food allergen that can be a trigger. Not necessarily all foods are triggers, but they could be. Certain foods could be.
This question relates to the last question. It’s another diet question. Is it possible to normalize thyroid antibodies through diet alone?
It’s possible, but usually, most people need to go beyond diet and lifestyle. I talk about this in my book The Hyperthyroid Healing Diet. A lot of people who work with me already are following a healthy diet. They’re following an AIP diet, or for those who’ve read my book, a level three diet. The reason they’re working with me is because the diet maybe helped to some extent, but it didn’t successfully put them in remission. Maybe it didn’t even improve their numbers.
I’m not going to say it’s impossible. There are some people who all they do is make dietary changes, and they seem to go into remission. That being said, it’s great to start with diet. That’s something everybody can do on their own: make dietary changes. I find most people do need to go beyond diet and lifestyle. In my book The Hyperthyroid Healing Diet, I have an entire section that talks about going beyond diet and lifestyle.
For those who are just hearing about this book, it is available on Amazon in print as well as on Audible if you prefer listening to books.
I have some questions related to Graves’ and antibodies. I have been told Hashimoto’s can also predispose to or cause Graves’. Is this true?
That’s the first part of the question. Having one autoimmune condition will make you more likely to develop other autoimmune conditions in the future. I can’t say that if someone has Hashimoto’s, that will predispose them to having Graves’. Just the fact that they have had one autoimmune condition will increase the likelihood of having other autoimmune conditions in the future.
Are there specific autoimmune antibodies with Graves’ that impact eye health specifically that can be tested for?
In the case of TED (thyroid eye disease), it’s typically the same TSIs that affect the eyes. They not only attack the TSH receptors of the thyroid gland, but they can also attack the tissues of the eyes, resulting in TED.
Is Graves’ always an autoimmune condition with the presence of antibodies that can be tested for?
It’s an autoimmune condition. There are times where someone can have negative antibodies, like false negative antibodies, which can make it challenging. I wouldn’t say that’s common. That’s why you don’t want to just rely on one test. Sometimes, it can be challenging.
It is always an autoimmune condition, but you don’t always get the presence of antibodies. Most of the time, you will.
My thyroid antibodies were gradually decreasing for six months. All of a sudden, one of my tests showed they increased. Does this mean the trigger hasn’t been found?
Maybe. It’s possible. I would say you can’t just rely on a single test. It’s not uncommon for people to hit roadblocks. I will say that. But you don’t want to overreact with one test. If someone’s antibodies have been decreasing, and all of a sudden, a single test shows they’re increasing, that doesn’t mean that you’re starting to go backwards. It could mean that.
Sometimes, it’s a rollercoaster ride. I have this conversation frequently with people. Sometimes, you will see a person take 2-3 steps forward, and then it seems like they’re taking a step backward. As long as you’re taking more steps forward, that’s okay.
In a perfect world, we want everybody’s thyroid antibodies to gradually decrease without any setbacks. It’s very common for that not to happen and for the antibodies to fluctuate.
In this situation, it could mean that the trigger hasn’t been found. I wouldn’t make that conclusion with just a single test. I would see what the next thyroid antibodies test looks like. If you see a pattern where the antibodies are continuously increasing, that is a sign that more detective work might need to be done.
Even though a few of these questions relate to Hashimoto’s, a lot of people with Graves’ have Hashimoto’s antibodies, but there is some overlap when it comes to addressing Hashimoto’s antibodies.The next question asker was diagnosed with Hashimoto’s last April with a thyroid antibody of 599. She didn’t specify which one. It might have been TPO or TG. She has added many new supplements to her diet, optimized her diet. She avoids seed oils and gluten. Focuses on whole foods. Good quality probiotics. Digestive enzymes. She has healed many of her gut symptoms and contained her GERD symptomsthrough the use of herbal licorice and heartburn relief supplements. She gets her steps in. 7+ hours of sleep. She is doing a lot of good things.
Her question is: I continue to see no movement on the scale, and my weight is about 15-20 pounds higher than my ideal. My overall cholesterol numbers are good, but my LDL markers are still in the high range. After a six month recheck of labs, my thyroid antibodies were still 450. While my overall thyroid numbers look normal, and my thyroid is still functioning, what else can I possibly do to improve my situation? It’s a bit disheartening to feel like I’m doing everything right, and nothing really is changing about my condition.
It sounds like you’re doing a lot right from a diet and lifestyle standpoint. The diet, you’re taking some basic supplements, the multivitamin, Vitamin D, selenium, fish oil. You’re taking a few others as well. Things for the gut.
As I mentioned earlier, most people need to go beyond diet and lifestyle. Usually, if someone comes and sees me, and they have done what you’ve done, because it is common for people when they see me, a lot of people follow a strict diet and supplements, and they aren’t seeing changes still.
That’s where doing a comprehensive health history is part of the evaluation process. Almost always, doing some type of functional medicine testing. Doing comprehensive blood testing, too. Doing adrenal testing, whether it’s a saliva test or dried urine test. I like hair mineral analysis testing. I know it’s not perfect, but I like to do it. Sometimes, I will do a comprehensive stool test like a GI Map or GI Effects. There is mold testing, organic acid testing, stealth infection testing.
I’m not saying everybody should do all these tests, but the point is that usually, we can’t just rely on diet, stress management, and sleep.
If you don’t incorporate a healthy diet, if you’re eating inflammatory foods, stressed out all the time without management, and not getting sufficient sleep, it will be difficult to heal.
If someone is doing all those things right, and their antibodies still aren’t budging, then typically you need to go beyond diet and lifestyle. That’s where doing some testing, ideally working with a practitioner, is what you would want to do.
It’s not an uncommon story. I realize it’s frustrating. The good news is there are other things you can do. If you can’t do anything else from a diet and lifestyle standpoint, then maybe there are other things you can do, like the testing.
Is there any supplement that will make my thyroid antibodies decrease quickly?
There is not a single supplement to lower and normalize antibodies. There is a lot of research with selenium and antibodies. Having healthy Vitamin D levels is important. Having healthy omega-3 fatty acid levels is important.
It comes down to finding and removing triggers. It’s not just about taking supplements. Supplements can to some extent help with antibodies. I’m not suggesting that anybody take specific supplements, but these are ones I commonly recommend to patients. Selenium, Vitamin D, fish oils. There are people who take those and don’t see any change in their antibodies. We dig deeper and do some testing for triggers and work on eliminating them.
On the other hand, some people will take those supplements and notice some improvements. Very rarely are they taking those supplements and seeing a normalization of their antibodies.
Why are endocrinologists so resistant to testing for antibodies?
I brought that up earlier. I mentioned how many endocrinologists will do it one time, and that’s it.
They’re not doing anything to improve the health of the immune system. When you goto an endocrinologist for any type of hyperthyroid condition, they’re focusing more on the thyroid. They’re looking to suppress the thyroid through antithyroid medication or recommending radioactive iodine or thyroid surgery. They’re not looking to improve the health of the person’s immune system. That’s the main reason why many are resistant, and many don’t test thyroid antibodies regularly.
How often should one check thyroid antibodies if they were initially elevated?
I usually recommend a thyroid panel every 6-8 weeks. You could do it every month. Every month is fine if insurance covers it. At the very least, 6-8 weeks. If you could test antibodies every 6-8 weeks, great. If not, every other month. If you’re paying out of pocket because your endocrinologist won’t test for it, maybe you could do every six weeks a thyroid panel, and every three months, do the antibodies.
If you could do them every single time, that’s great. If not, then I would say every other time you do a thyroid panel.
How long does it take to lower thyroid antibodies? Is it still possible to lower thyroid antibodies if they have been elevated for many years?
In my case, it was nine months before everything looked good, including thyroid antibodies. Some people, it’s a year. Some people, it’s over a year.
It definitely is possible to lower and normalize antibodies, even if someone has had elevated antibodies for many years. You could address the autoimmune component, even if someone has been dealing with Graves’ or Hashimoto’s for a long time. The answer is yes, it’s possible.
Should all the thyroid antibodies be normal in order for someone to be considered in remission?
Someone asked something similar. If you want Graves’ to be in remission, you want TSI and TRAB to be within the optimal range. Doesn’t mean they need to be zero. That’s a common question.
When you say “normal,” there is normal and optimal. You don’t want the antibodies to be on the higher end of the range, even if they’re within the range. For example, with Graves’, maybe not the best example because there are different reference ranges. For those in the United States, LabCorps’ range for TSI is 0.55. If someone’s TSIs are 0.53, kind of on the higher side. I’d like to see it at .3 or below.
Let’s say someone’s antibodies are .27, and it’s been below .3 for a while. I wouldn’t say they’re not in remission. It’s not uncommon to have some auto antibodies. Youwant them to be normal, within the optimal range. Doesn’t mean they need to be zero.
I have been on 75mcg of levothyroxine for 30 years for hypothyroidism. Two years ago, in 2024, my TSH was .01, T4 17, T3 5.5. I am not 100% sure, but it looks like those values are outside the United States. In the United States, if someone had a free T4 of 17, it would be really high. Free T3 of 5.5 would also be high. The TG antibodies were 657, and the TPO antibodies were 25. Those are within range according to the lab she used. My levothyroxine was reduced at that time to 25 and 50mcg, alternating levels every other day. My TSH was 3.65. A little bit on the higher side. T4 12. TG 295. Still elevated. TPO went down to 9 in the summer of 2025. I am going for labwork in the summer of this year.
I have healed my gut within the last three years. I generally feel healthy with diet and lifestyle. I am wondering about the significance of TG antibodies.
As I mentioned a few times, I wouldn’t be comfortable with those antibodies being elevated. It’s challenging. I am not saying it’s easy to normalize thyroid antibodies. The purpose of this call is to talk about things that can help with thyroid antibodies.
It’s possible to lower and normalize antibodies. It is not easy. Yes, it will take some detective work to find and remove triggers. It sounds like your gut may have already been healed based on what you said. There could be other triggers. According to the triad of autoimmunity, it’s not just a leaky gut but other environmental triggers could also be a factor.
What is the drawback of taking LDN to lower thyroid antibodies?
The drawback is LDN is a medication that modulates the immune system. The drawback by lowering antibodies is that if you’re also following a natural approach, you don’t know if the natural approach is working. The LDN is masking.
It’s a little similar with methimazole. If someone is taking antithyroid medication for Graves’, you still can monitor the antibodies. The immune system is more important than the thyroid with antibodies. If someone is taking LDN for modulating the immune system, if you’re also trying to find and remove triggers, you don’t know if you’re successful in finding and removing those triggers if the LDN is already normalizing those antibodies.
I was diagnosed with hyperthyroidism due to Graves’ about 2.5 years ago. I was put on 10mg of methimazole, and I have been slowly tapering down to 5mg three times a week. My TSH, T4, and T3 have been normal for about 18 months now. My TSI is just slightly above the .55 that my lab deems undetectable. I am getting another blood test next week, so hopefully I will be under that threshold. My doctor says at this point I can discontinue the methimazole completely with the recheck in 4-6 weeks.
Myquestion is is it safe to stop the medication? Should there be more tapering off? I want to be off of it but don’t want to end up back on it because we dropped off too quickly.
It’s great that that doctor is looking at the antibodies and waiting for the antibodies to be negative. If they are on the higher side, like if it was .52 or .53, I would be nervous. Let’s say it was .25. You’re at 5mg three days a week, which is a low dose. Is it safe to stop the medication?
Keep in mind, I can’t give advice about stopping medication. You’re not asking me that, but in a way, you are. If I say it’s not safe, then you would be continuing with the medication.
I will say, it depends on the person. If the antibodies are well within the range, there is a good chance the person won’t become hyper. Every endocrinologist is different. Some endocrinologists would maybe put the person on 2.5mg three days a week. Some would say let’s do 5mg twice a week rather than completely stopping.
There is not a risk risk, meaning like with beta blockers. I have never seen this happen with beta blockers because I’ve had people on their own abruptly stop beta blockers, but you’re not supposed to do that. You could have a rebound heart attack in the literature. I haven’t seen anything similar with antithyroid medication such as methimazole.
I’m not reallyconcerned about that. The main concern is will someone become hyper again? That is the risk of stopping too soon.
You’re on a low dose three times a week, so you might be fine. I noticed in the chat, which I try not to look at. Someone just said, “My endocrinologist said there is no smaller dosage than 5mg.” That’s true. But a lot of them will just use a pill cutter to cut in half to 2.5mg.
I think we have two or three more questions. Then we will get to the live questions.
I was diagnosed with Hashimoto’s about three years ago. Various symptoms. High TPO. Periodic diarrhea issues, libido issues, tingling in the hands. I have seen a number of practitioners. Not sure if their prescribed plans are working for me. Information indicates that gut issues may be a leading trigger. Trying to find out how to fix it. What test do you recommend to get to the true cause? How to address it?
It depends. People might get tired of that answer. But it does depend. That’s what the health history is for. If someone is having a lot of bloating and gas with certain foods, then maybe they’re better off doing a SIBO breath test, whereas if they are having other symptoms, like heartburn, reflux, maybe looking at H-pylori. You can’t always go by symptoms with H-pylori. More times than not, I will do a comprehensive stool panel, like a GI Map.
It does depend on the symptoms. If someone seems like they might have SIBO, a stool test will look at the large intestine, not the small intestine. I would recommend a SIBO breath test if I’m suspecting SIBO. If we are thinking someone has yeast overgrowth, a stool test will test for it, but it may not always pick it up. You might want to do an organic acids test instead.
Again, I would say the #1 test I recommend is the comprehensive stool test, like GI Map or GI Effects. It does really depend on the case presentation.
If you’re not sure, I would say maybe start with a comprehensive stool test. Like I said, if someone has a lot of gas or bloating, with certain foods, like higher FODMAP foods, like fermented foods, higher fiber foods, then I might start out with a SIBO breath test.
Last question: I tested negative for TSI antibodies in November. TRAB was tested in January and also negative. However, in January, my radioactive iodine uptake scan was 51% over 24 hours. Because I had a high uptake, I met with an endocrinologist, who said it was likely Graves’. My T4 has been going down from 2.3 to 1.9. Still a little high but getting there. TSH is staying between .16-.13 since November. I have been taking a multivitamin with iodine from May-November but stopped in early November after I found out my TSH was low. My T3 has been in the normal range the whole time but has decreased from November to January. Could this still be seronegative Graves’? Could there be another cause of the hyperthyroidism, possibly caused by too much iodine?
I follow a vegan diet and wonder if I’ve been deficient in iodine before taking a multivitamin. Would it be worth testing for antibodies again in the future? Is the Graves’ the only reason the radioactive iodine uptake scan would have been so high?
I recently cut out gluten. Is that necessary for someone without antibodies?
A lot of questions here. It is possible that the iodine can cause hyperthyroidism. I have nothing against iodine. I have had good experiences with iodine. It definitely affects thyroid. Iodine can be beneficial in some cases, but in some cases, it can definitely cause hyperthyroidism. That’s possible.
Elevated uptake usually is related to Graves’. There could be other causes. If someone has toxic multinodular goiter, it might be elevated. Doesn’t sound like that’s the case with you.
If someone follows a vegan diet, and they are not getting any sources of iodine, they could be deficient in iodine. Understand looking to take an iodine supplement. No, you weren’t taking an iodine supplement; you were taking a multivitamin with iodine. I misunderstood. The iodine in a multi, not to say it can’t cause hyperthyroidism, but I commonly give a multivitamin with iodine. I am cautious with iodine, and I talk about this in my books. I’m not anti-iodine, where I recommend 100% avoiding iodine.
In most cases, people run into trouble if they are taking separate iodine supplementation or eating too many high food sources of iodine, like kelp. Some people have subacute thyroiditis, but the uptake test usually wouldn’t be high with that.
You mentioned it could be seronegative Graves’, which is where you have false negative antibodies. As I mentioned earlier, that is a possibility. It’s not too common, but that would make sense.
I do think it would be worth testing for antibodies again in the future. There are different immunoglobulins, which are antibodies. There is IgG, IgA, and IgM, which you can test at a regular lab. If IgG is depressed, that could give false negative antibody results. You might want to look at that and make sure that’s not depressed. It is very possible that you have false negative antibodies for Graves’.
Finally, you asked is cutting out gluten necessary for those without antibodies? In my opinion, I would say it’s a good idea not to eat gluten regularly, even if you don’t have an autoimmune component. If I work with someone who has toxic multinodular goiter, which is hyperthyroidism but not autoimmune, I still recommend avoiding gluten. They may not have an autoimmune component, but gluten could increase permeability of the gut, which is still a factor for a lot of conditions.
You need a healthy gut to metabolize estrogen. Estrogen metabolism could be an issue in some cases of toxic multinodular goiter.
I think it’s a good idea regardless, even if someone doesn’t have Graves’ or Hashimoto’s.
That’s it for the email questions. We had a lot of email questions. Thanks for those questions. Let’s see what questions were put in the chat here. This is not very user-friendly here on the phone. If I miss a question, I apologize. I can see one line at a time and have to scroll very carefully here.
What are your thoughts on blackseed oil for lowering antibodies?
There is some evidence with blackseed/black cumin helping with TPO antibodies. Hashimoto’s, not Graves’. I like it. Definitely has a lot of different properties, some anti-inflammatory properties, some antiviral properties. You still want to do things to find and remove triggers. You can’t have a blackseed deficiency, but you can have a selenium deficiency. Supplementing with selenium isn’t going to normalize your antibodies. Same thing with blackseed. It could help, but I can’t say it’s something I commonly recommend to people I work with.
I need to prioritize supplements. Even though I do like it, it’s not typically something I recommend. I can’t say I have seen any dramatic changes in thyroid antibodies.
If you are allergic to dairy and sensitive to gluten, if you ate these, would it show up as raised antibodies?
It could. Gluten could potentially increase antibodies. Dairy as well. It’s a more common allergen. Gluten, dairy, and corn are foods that could raise antibodies. Not all foods, even if you’re sensitive to them, like if someone has a food sensitivity to broccoli, that is probably not going to increase antibodies. Doesn’t mean you don’t want to address the food sensitivities. But those two can.
Do TRAB and TSI both need to be in the negative range to be considered in remission?
I answered a similar question. Yes, they need to be well within the range. Not necessarily zero, but within the optimal range. Well below the lab reference range to be considered in remission.
My most recent TRAB is less than 1.0. Is this negative? TSI was less than 89%.
Most labs, TRAB is- First of all, less than 1. Most labs, 1.75 is the threshold for TRAB. If it just said 1.0, not less than, it would still be considered normal. Less than 1 is undetectable, which is great.
What if I have elevated TSI and TPO? Does this mean Graves’ and Hashimoto’s? What does remission look like from the perspective of a traditional endocrinologist, taking methimazole and these antibodies disappearing?
An endocrinologist will sometimes look at antibodies, but they often won’t. TSI is more specific for Graves’. TPO is an enzyme that is important for the production of thyroid hormone, so if you have TPO antibodies, you’re more likely to become hypo over time. If you have TSI, that is stimulating the TSH receptor. TPO is more closely associated with Hashimoto’s.
Essentially, you do have antibodies for both Graves’ and Hashimoto’s. Ideally, you want both of those to be in remission.
Most endocrinologists probably won’t even look at TPO with Graves’. They might not even look at TSI. If they look at anything, it would be TSI or TRAB. They would focus on normalizing that.
Have you heard about reishi and butyrate to lower TRAB antibodies? Are they helpful in your opinion?
I have a supplement, Hepatommune Supreme, that offers liver support but has some mushrooms, reishi and cordyceps. You need to find and remove triggers still. There is no evidence in the literature about these decreasing thyroid antibodies. Reishi can modulate the immune system, offer some immune support. Like I said, I wouldn’t necessarily rely on that for lowering thyroid antibodies.
Butyrate is a short chain fatty acid. You can get butyrate through eating fiber-rich foods. It’s definitely important for a healthy gut. A healthy gut is important for a healthy immune system. Butyrate can play a role. I wouldn’t say people have to necessarily supplement with it. I don’t think there is any evidence in the literature showing that it normalizes thyroid antibodies.
There are a lot of things that can be helpful. I don’t want someone taking 30 supplements. I am not shy about recommending supplements. I am not shy about taking supplements or recommending them. There are a lot of good supplements out there. Doesn’t mean you should take all of them. That’s what a lot of people are doing. Let’s look for the one or two supplements that will be gamechangers. Usually, it’s just a combination of diet and lifestyle factors, finding triggers, using targeted supplements. You definitely don’t want to overdo it. But a good question.
Around four years ago, my TRAB was around 10.4. Two years ago, they were around 7, and now 3.34. Can I be faithful that I am n the remission path?
Maybe. It’s great it’s heading in the right direction. It’s taken a while. I am not sure what you’ve done, if you’ve done anything besides cleaning up your diet, managing stress, getting sufficient sleep, finding and removing triggers. If not, I will be biased and recommend doing that.
It does look good. Like I mentioned earlier, someone asked a question about things improving for six months, and then their antibodies increased. Even if it increased, that doesn’t necessarily mean you’re no longer on the right path. If it continues to decrease, or if it decreases with an occasional increase, that’s very common.
I think I got to all the questions. Thank you so much for subscribing to the Substack. For those in the future who are listening to this on the podcast, if you’re not subscribed to the Healing Graves’ Naturally Substack, you can visit SaveMyThyroid.com/GravesNewsletter to do so.
This was great. We had a lot of people showing up on the livestream, which I’m happy about. A lot of emailed questions. Everyone, thank you so much. Thanks for your questions. Hope you have a great rest of your day. Take care, everyone.
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