Reasons for high levels of thyroid hormone receptor antibodies

Elevated thyroid hormone receptor antibody TRAb is usually caused by autoimmune thyroid diseases, mainly including Graves' disease, Hashimoto's thyroiditis, postpartum thyroiditis, subacute thyroiditis, and drug factors.

1. Graves' disease: As the main cause of elevated TRAb, Graves' disease is an autoimmune hyperthyroidism. TRAb stimulates thyroid hormone receptors, leading to excessive secretion of hormones by the thyroid gland. Patients often present with characteristic features such as protruding eyes and anterior tibial myxoedema. Laboratory tests show a decrease in TSH and an increase in FT3/FT4.

2. Hashimoto's thyroiditis: In addition to TPOAb and TGAb, approximately 15-30% of Hashimoto's thyroiditis patients can detect TRAb in their bodies. These antibodies may manifest as blocking or stimulating types, and may cause transient hyperthyroidism in the early stages of the disease, which often develops into hypothyroidism in the later stages. Ultrasound examination shows diffuse hypoechoic changes in the thyroid gland. 3. Postpartum thyroiditis: During the process of immune system reconstruction after pregnancy, some mothers may experience abnormal thyroid autoantibodies. TRAb positivity often occurs within 6 months postpartum and may go through three stages: hyperthyroidism, hypothyroidism, and recovery. Most patients can recover their thyroid function on their own within one year, but about 20% will develop permanent hypothyroidism.

4. Subacute thyroiditis: The thyroid inflammatory response caused by

viral infection may lead to transient elevation of TRAb. The typical symptoms of the patient are neck pain accompanied by fever, a decrease in thyroid iodine uptake rate, and an increase in thyroid hormone levels showing a separation phenomenon. The course of the disease usually lasts for 2-3 months and is mostly self-healing.

5. Drug factors:

Certain iodine containing drugs such as amiodarone, interferon alpha, interleukin-2, etc. may induce thyroid autoimmune reactions. Lithium preparations also often cause fluctuations in TRAb levels. Drug induced thyroid dysfunction usually subsides after discontinuation of medication, but some patients require short-term thyroid hormone replacement therapy. Patients with elevated TRAb levels should regularly monitor thyroid function, and it is recommended to maintain a balanced diet and increase intake of trace elements such as selenium and zinc in moderation. Avoiding high iodine foods such as seaweed and seaweed, and maintaining a regular daily routine can help regulate the immune system. Hyperthyroidism patients should limit their caffeine intake, while hypothyroidism patients can consume foods rich in vitamin A appropriately. Moderate exercise such as yoga and walking can improve immune function, but vigorous exercise should be avoided when hyperthyroidism is not under control. Symptoms such as palpitations and sudden weight changes should be promptly followed up, and pregnant women should strengthen thyroid function monitoring.