Antibodies to the receptor for thyrotropin (i.e., TSH) can cause thyroid dysfunction and even overt disease such as Graves'. The TRAbs interact with the TSH receptor and can either stimulate or block the receptor depending on the specific type of antibody.
Evaluating TRAbs is particularly useful in working up Graves' in which unregulated stimulation of the receptor tends to dominate, increasing production of thyroid hormone. Research suggests it is the action of TRAbs that causes many of the systemic effects of Graves', including effects in the eyes, skin, bone, heart, and liver. In Hashimoto's autoimmune thyroiditis, TRAbs tend to block the receptor and decrease thyroid hormone production.
Low TRAbs suggest the absence of autoimmune thyroid disease, while elevated TRAbs can be associated with Graves' and its more severe symptoms, Hashimoto's, and false elevations due to high biotin intake/levels.
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