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What Are Thyroid Peroxidase Antibodies Levels

Symptoms Associated With High Thyroid Peroxidase Antibodies

Thyroid Peroxidase Antibody Test | Anti TPO Test

Thyroid peroxidase antibodies typically do not cause any major symptoms by themselves.

They can sometimes be associated with minor symptoms including a minor decrease in energy, feeling run-down, or just feeling “blah”.

These symptoms occur as your body attempts to deal with the immune dysfunction present as well as minor changes to thyroid function.

Most of the major symptoms associated with TPO antibodies come from the direct damage to the thyroid gland.

Remember the war zone that I mentioned previously?

Inflammation and damage to the thyroid gland may result in changes to thyroid function and this change to thyroid function results in symptoms that are hard to miss.

These symptoms vary based on whether you have a diagnosis of HYPERthyroidism or HYPOthyroidism .

You can use your symptoms, in conjunction with your antibodies and thyroid lab tests, to see where you fit.

#1. Symptoms of Hashimoto’s Thyroiditis:

  • Fatigue

#3. You may be asymptomatic.

Don’t forget that some people, especially those who are pregnant, may have no symptoms at all!

We don’t know how many people fit into this category, though, because most people do not get tested for thyroid peroxidase antibodies unless they are feeling poorly at which point they can be diagnosed.

It’s also possible to be asymptomatic in the early stages of your disease, especially if you catch it early enough.

Treatments For Autoimmune Thyroid Disease

Falk: What are the various treatment options?

Kirk: In an underactive thyroid, its a little more simple. We as endocrinologists are fortunate in that if a gland under functions we can usually replace whats missing, so if a thyroid gland is under functioning we can provide thyroid hormone which is a synthetically made hormone but mimics human thyroid hormone. On the other hand, if a gland is over functioning, there are a number of different options. We can give people medications, or we can give more permanent treatment with radioiodine or even surgery in some cases.

Falk: There are actually a lot of thyroid preparations out there that patients are exposed to. Theres the synthetic version and all sorts of other thyroid preparations. How should a patient talk with their physician about what kind of thyroid replacement medicine they should take?

Falk: Is that preparation as easy to use as the synthetic levothyroxine?

Kirk: Its not quite as easy to titrate, meaning to adjust the dose, as its not as predictable. Everybody may absorb it differently. It has a couple of different thyroid hormones in a fixed concentration. Its definitely doableits not incredibly complex if youre used to doing it, but its not nearly as simple or predictable as using human synthetic thyroid hormone or levothyroxine.

What Are Thyroid Peroxidase Antibodies

What I just described is what thyroid peroxidase does inside of the thyroid gland but this is completely different from thyroid peroxidase antibodies.

If you’ve been told that you have thyroid peroxidase antibodies, also referred to as TPO antibodies, then this information applies to you.

Your body creates antibodies to things that it wants to kill or get rid of.

In the healthy state, you should really never see antibodies to any part of your own body or tissues.


Because why would you want to get rid of something that is supposed to be in your body!

Antibodies are usually created to help your body eliminate infections or viruses but they can sometimes be created by your immune system to target your own body.

When this happens you are said to have an autoimmune disease .

We can break apart the word to understand exactly what it means:

Auto , immune , and disease .

In the case of thyroid peroxidase antibodies, your own body is creating antibodies that target, damage, and destroy, the thyroid peroxidase enzyme.

These antibodies are produced by the immune system and flow through your entire body until they find their target.

Once they reach their target their goal is to destroy it.

And because their target is located in the thyroid gland, your thyroid becomes the site of a war between your immune system and thyroid peroxidase.

As you might imagine, this results in damage to your thyroid gland which can become permanent if the damage is severe enough.

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Stage : Hashimotos Progresses And There Is A Progression To Other Immune Disorders

In stage 5, as Hashimotos progresses, we unfortunately have a progression to other immune disorders as well. At this time, a person may get diagnosed with Rheumatoid Arthritis, Lupus or any of the other types of autoimmune conditions.

So as you look at the progression of disease, note that our earliest warning about Hashimotos, and our best opportunity for early intervention, is during Stage 2 when we initially find evidence of thyroid antibodies.

When Is It Ordered

What You Must Know  How Hashimotos Damages Your Thyroid ...

Testing may be ordered when an individual has abnormal TSH and/or free T4 test results or signs and symptoms of a low or high level of thyroid hormones or the presence of a goiter, especially if the cause is suspected to be an autoimmune disease.

A low level of thyroid hormones can cause symptoms, such as:

  • Weight gain
Graves diseaseWhen a person has symptoms of hyperthyroidism

If a pregnant woman has a known autoimmune thyroid disease or has another autoimmune disorder and thyroid involvement is suspected, then one or more of the thyroid antibodies may be ordered early in the pregnancy and then again near the end. These tests are used to help determine whether the baby may be at risk of thyroid dysfunction. Thyroid antibodies can cross the placenta and cause hypothyroidism or hyperthyroidism in the developing baby or newborn.

Thyroid antibody testing may also be ordered when a person with another autoimmune disorder has symptoms of thyroid dysfunction and/or when she has reproductive difficulties that a healthcare provider suspects may be associated with autoantibodies.

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Data Collection And Laboratory Measurements

In order to accurately obtain clinical data during medical examination, interviewers were trained specially. Body weight and height were measured with an automatic body composition analyzer and BMI was calculated. Systolic blood pressure and diastolic blood pressure were recorded at rest.

A fasting blood sample was collected. HbA1c, triglycerides , and high-density lipoprotein cholesterol levels were also measured using standard procedures at SRL, Inc. HbA1c and TG levels were measured by the enzyme method while the HDLc level was measured by the direct method. TSH, free T3, free T4, and TPO-Ab were measured by standard procedures at the LSI Medience Corporation TSH, free T3, and free T4 were measured by chemiluminescence immunoassay, and TPO-Ab was measured by electrochemiluminescence immunoassay.

A normal range of TPO-Ab was defined as below 16IU/mL. Maximum values for the left and right common carotid arteries of the CIMT were calculated with an semiautomated digital edge-detection software following a protocol that has been described in detail elsewhere. The higher values of the right and left CIMT not including plaque measurements were then calculated, and the maximum CIMT value was then used for analysis. Since a previous study reported the normal CIMT value as < 1.1 mm, we defined atherosclerosis as CIMT 1.1 mm.

The Connection Between Thyroid Peroxidase Antibodies Hashimotos And Graves Disease

Does the presence of elevated thyroid peroxidase antibodies guarantee that you have Hashimotos?

Definitely not!

Elevated TPO antibodies are seen in 90-95% of patients with Hashimotos and 50 to 80% of patients who have Graves disease.

The best way to determine what your antibodies mean for you is to look at your thyroid lab tests, your thyroid peroxidase antibodies, and your symptoms:

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Risks And Side Effects

There are few risks or side effects associated with a blood test. Because veins vary in size, your healthcare provider may occasionally have difficulty obtaining the blood sample.

Any time your skin is broken, theres a slight risk of infection. You should notify your doctor right away if the area of the blood draw swells or starts to produce pus.

Other minimal risks include:

What Does It Mean If Your Thyroid Peroxidase Antibodies Result Is Too High

Thyroid peroxidase antibodies/thyroid peroxidase

Thyroid peroxidase antibodies are autoantibodies, which means the body mistakenly produces these antibodies that act against a normal protein, TPO. As such, thyroglobulin antibodies usually indicate an autoimmune disease. TPO antibodies are present in roughly 90% of people with Hashimotos thyroiditis and in half to three-quarters of people with Graves disease. Thyroglobulin antibodies may be detectable in people without symptoms of thyroid hormone imbalance . When hypothyroidism causes symptoms, it may cause weakness and fatigue, cold intolerance, shortness of breath, weight gain, constipation, cognitive problems, dry skin, hoarseness, and swelling . In about 10% of cases, TPO antibodies will be detectable in non-autoimmune thyroid disease such as pernicious anemia and type 1 diabetes mellitus.

Some specific causes of thyroid peroxidase antibodies are:

  • Hashimotos thyroiditis/chronic autoimmune hypothyroidism

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But My Doctor Said My Tsh Level Is Normal

My doctor said my TSH level is normal, so why should I worry about testing for thyroid antibodies?

I cant tell you how many times I hear this in my clinical practice and from readers. And I thought this myself many years ago. I spent almost a decade undiagnosed because I only had my TSH tested, and my thyroid diagnosis was completely missed. I had been told that my thyroid was normal even though my TSH was 4.5 IU/mL. That left me struggling with progressively worse symptoms for almost ten years symptoms like chronic fatigue, anxiety, depression, hair loss and many others.

This is why Im so passionate about advocating for you to get the proper tests and for you to understand your tests. Had I known then what was happening in my body, I could have taken on the lifestyle modifications and treatment steps necessary to not only alleviate my progressing symptoms but also prevent further damage to my thyroid.

Thyroid antibodies are going to be the first indication of a thyroid problem in many cases. They can be elevated for 5, 10, sometimes even 15 years before a change in TSH is even detected! Keep in mind that the presence of thyroid antibodies means that there is an active destruction going on against your thyroid.

Elevated thyroid antibodies, even in the presence of a normal TSH, means that its only a matter of time before your thyroid becomes destroyed to the point it can no longer produce sufficient amount of hormones.

Thyroid Antibodies An Early Warning For Hashimotos

In Hashimotos, we know there are 5 stages relating to the initial development and also worsening of the disease. A quick review of these stages is helpful in understanding the importance of knowing your thyroid lab results.

It also really demonstrates the importance of specifically knowing your results relating to the presence of elevated thyroid antibodies.

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Elevated Thyroid Stimulating Immunoglobulins

If you have elevated TSI antibodies, even if your TSH level is normal, you most likely have Graves disease, an autoimmune condition. In Graves disease, the TSI antibodies cause your thyroid gland to make too much thyroid hormone. As TSI antibodies cause overproduction of thyroid hormone, a TSH in the reference range drops, and you can become hyperthyroid fairly quickly.

What should you do?

If you have thyroid symptoms, but your TSH test result falls within the reference range, an important next step is to request that your doctor order thyroid antibody tests. If your symptoms suggest hypothyroidismfatigue, weight gain, depression, hair lossyou should request a TPO antibody test. If your symptoms suggest hyperthyroidismanxiety, insomnia, weight loss, diarrhea, elevated heart rate/blood pressureyou should request a TSI antibody test.

Is There Anything Else I Should Know

Thyroid Gland Disorders

The sensitivity and specificity of thyroid antibody testing is improving but is still not as good as health practitioners would like it to be. All of the thyroid antibody tests have changed over time. This is part of the reason that the tests have historically acquired many different names. There are also many distinct methodologies and each has different reference ranges. If someone is having several tests done at regular intervals for monitoring purposes, it is best to have test done by the same laboratory each time, using the same methodology.

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What Are The Thyroid Antibodies That Need To Be Tested

There are three main types of antibodies in Hashimotos that are potentially going to be present. Two of them are created by the immune system to target the thyroid gland as if it were a foreign invader like a pathogen, and those are Thyroid Peroxidase and Thyroglobulin antibodies.

80-90 percent of people with Hashimotos will haveeitherTPO or TG antibodies, or both. The more elevated the thyroid antibodies are, the greater the likelihood of developing overt hypothyroidism as well as possibly additional autoimmune conditions.

Where do these antibodies come from? The current scientific thinking is that activated B-cells in the thyroid gland and lymph nodes secrete these antibodies, and that they react solely as markers but dont necessary attack the thyroid gland themselves. They likely activate T-cells, which then do the actual damage on the thyroid gland.

The third type of thyroid antibodies is TSH-Receptor antibodies, including thyroid-stimulating immunoglobulin . This particular marker is elevated in more than 90 percent of people with Graves disease. TSH-R antibodies are also more common in people who have thyroid cancer.

Another TSH-R antibody is known as TSH-binding inhibiting immunoglobulin . This is elevated in > 50 percent of people with Graves disease.

Stage : Subclinical Hypothyroidism Occurs

Stage 3 is when subclinical hypothyroidism occurs, and in this stage, people are going to have an elevated TSH in addition to having thyroid antibodies. They will also have immune cell infiltration into the thyroid gland, although their T3 and T4 levels are still going to be normal. Many people will have some symptoms of hypothyroidism or autoimmune symptoms at this stage.

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Significance Of Testing Anti

Hamid Nawaz Tipu

1Immunology Department, Armed Forces Institute of Pathology, Rawalpindi, Pakistan

2Chemical Pathology Department, Armed Forces Institute of Pathology, Rawalpindi, Pakistan


Background. We hypothesized that anti-thyroid antibodies are more often positive in individuals with deranged thyroid profile. Methods. This prospective cohort was done in Immunology Department, Armed Forces Institute of Pathology, Rawalpindi, Pakistan, from Jan 2017 to Oct 2017. All the samples that were referred to us for testing anti-thyroid antibodies and thyroid profile were included in the study. There were no exclusion criteria. Tests for anti-thyroid antibodies were performed by ELISA and thyroid profile by chemiluminescence. SPSS 23.0 was used for statistical analysis. Results. Over a course of a ten-month study period, we received a total of 316 serum samples for anti-TPO/TG antibodies along with thyroid profile testing . These included 115 males and 201 females . Their age ranged from 3 to 89 years . Anti-TPO antibodies were more often positive when TSH was deranged . Anti-TPO antibodies are more often raised in females, in terms of both prevalence and mean rank . As anti-thyroid antibodies are more often present when TSH is deranged, such individuals should be screened for anti-thyroid antibodies. This importance of screening is compounded by the fact that anti-thyroid antibodies may be positive in a significant percentage of elderly people.

1. Introduction

3. Results

What Is Thyroid Peroxidase

What are TPO antibodies?

Thyroid peroxidase is an enzyme made in the thyroid gland that is important in the production of thyroid hormone. TPO is found in thyroid follicle cells where it converts the thyroid hormone T4 to T3.

The thyroid gland is located in the lower part of the neck, below the Adam’s apple, wrapped around the trachea .

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Not Sure What To Expect From The Paloma Health At

Lab Results

Your complete thyroid blood panel should include TSH, free triiodothyronine , free thyroxine , and TPO antibodies. Having this information helps to determine the cause of your under- or over-active thyroid.

Lab results read as “positive” or “negative” concerning whether you have TPO antibodies present in your blood sample.

Suppose you show a negative result for TPO antibodies. In that case, it means that there were no TPO antibodies discovered in your blood. Therefore, if you have symptoms of a thyroid condition, it is unlikely that an autoimmune disorder causes them.

If you show a positive result for TPO antibodies, it may mean you have:

Hashimoto’s disease

The diagnosis is made if you have high levels of TPO antibodies and high levels of thyroglobulin – a protein produced by the thyroid.

Grave’s disease

The diagnosis is made if you have high levels of TPO antibodies and high levels of thyroid-stimulating hormone receptor antibodies.

Thyroid ultrasound

A TPOAb test is not the only indicator of Hashimoto’s. A study from California Northstate University suggests that 10% of patients with Hashimoto’s may have negative blood work for TPO antibodies.

While there is a low probability that you need other tests to confirm Hashimoto’s disease, a thyroid ultrasound can help diagnose, if necessary. The ultrasound assesses the size of the thyroid, the pattern and structure of tissue, and the presence of nodules.

Use the same laboratory

Ask A Laboratory Scientist

This form enables patients to ask specific questions about lab tests. Your questions will be answered by a laboratory scientist as part of a voluntary service provided by one of our partners, American Society for Clinical Laboratory Science. Please allow 2-3 business days for an email response from one of the volunteers on the Consumer Information Response Team.

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What The Results Mean

Blood test results are processed within a week. In some cases, doctors receive them within a few days. Your doctor will explain your specific results to you. A test that comes back as negative for antithyroid microsomal antibodies is considered a normal result. These antibodies are usually not found in a healthy immune system.

If you have an autoimmune disease or thyroid disorder, your antibody levels may rise. A positive test indicates an abnormal result and may be due to a variety of conditions, including:

  • Hashimotos thyroiditis, which is a swelling of the thyroid gland that often results in reduced thyroid function
  • Graves disease, which is an autoimmune disorder in which the thyroid gland is overactive
  • granulomatous thyroiditis, or subacute thyroiditis, which is a swelling of the thyroid gland that usually follows an upper respiratory infection
  • autoimmune hemolytic anemia, which is a drop in the number of red blood cells due to increased destruction by the immune system
  • nontoxic nodular goiter, which is an enlargement of the thyroid gland with cysts called nodules
  • Sjogrens syndrome, which is an autoimmune disorder in which the glands that produce tears and saliva are damaged
  • systemic lupus erythematosus, which is a long-term autoimmune disorder affecting your skin, joints, kidneys, brain, and other organs
  • difficulty with in vitro fertilization


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