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HomeExclusiveWhat Does An Elevated Thyroid Peroxidase Antibody Mean

What Does An Elevated Thyroid Peroxidase Antibody Mean

Everything To Know About Thyroid Peroxidase Antibodies

Thyroid peroxidase antibodies/thyroid peroxidase
  • note:
  • This article was written by a Medical Doctor and reviewed by the thyroid health experts at ThyroMate.

    ThyroMate articles uses only proven, accurate, credible sources in order to provide accurate, fact-checked information about thyroid health that is helpful and objective. All references are linked throughout the article and sources for each are cited at the end. Visit these links to learn more about the research studies and conclusions drawn from the research methods.

    Information contained on this website is not a substitute for medical advice, diagnosis, or treatment. You should always consult your physician for questions related to your health.

You have probably heard or come across the term thyroid peroxidase antibodies, but may not be quite sure what it means.

Indeed, TPO antibodies are frequently mentioned in terms of thyroid health and diseases that affect it. Proper management of thyroid diseases and keeping the gland healthy require a thorough understanding of thyroid hormones, enzymes, tests, and other aspects that provide insight into the way the butterfly-shaped gland functions.

Thats why in this article we are going to talk about TPO antibodies.

Before we discuss TPO antibodies, it’s useful to give a brief introduction to thyroid peroxidase.

Thyroid peroxidase is defined as a key enzyme in the biosynthesis of thyroid hormones. The enzyme catalyzes iodide oxidation, thyroglobulin iodination, and coupling of iodothyronine.

Why Take The Tpo Antibodies Test

TPO are antibodies that exist in the follicle cells of the thyroid gland. TPO is the most common test to detect an autoimmune disease of the thyroid gland like the Hashimoto and Graves disease.

If you have symptoms of Hashimoto Thyroiditis then, you are advised to order the TPO Antibody test. These include weight gain, fatigue, having a pale and puffy face, constipation, experiencing unexplained joint and muscle pains, having brittle hair, depression and having a slow heart rate. Since these symptoms can be similar to other health conditions, it is essential to get your TPO Antibodies tested and have the right diagnosis and treatment plan.

You need to get your TPO Antibodies tested if you experience symptoms of Graves disease that consist of a racing heartbeat, hand tremors, trouble sleeping, losing weight, feeling the muscles weak, as well as having bulging eyes. Skin symptoms can also accompany this auto-immune disease, and consist of developing a dermopathy: development of lumpy red thick skin in front of the shins.

The TPO Antibodies test is also ordered to monitor the treatment of thyroid cancer. From another angle, it is encouraged to be taken in case the person is having reproductive difficulties like miscarriages, pre-eclampsia, premature delivery and in-vitro fertilization.

Thyroid Antibodies Change A Great Deal

This point happens to fall along the same lines as the previous one. Thyroid antibodies have a habit of revealing themselves in unexpected ways.

They have a bit of an elastic nature, where they are forever in motion and changing.

If it happened that you checked your antibody scores three times a day, for three weeks, you may see different scores every single time.

What does it mean, though? It means that the measurements of thyroid antibodies are simply not consistent and not predictable.

This means that when you are on treatment, you cannot base changing thyroid antibody levels on recent developments in your healthcare routine.

It truly takes multiple readings, over a large period of time, in order to identify and understand the trends in your thyroid antibody levels. There is so much randomness found throughout, that we need to have a large picture of understanding in order to rule most of it out.

Bottom Line: Thyroid antibodies have the potential to be up, down and all over the place. The biggest takeaway from this is that they do wander around and that a higher score does not mean that you are doing something wrong. At the same time, it also does not mean that you are doing something right it might just be completely random. So, you should not base your decisions on your thyroid antibody levels entirely.

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The Easiest Way To Test Your Thyroid

If your doctor doesnt know about, refuses to check your thyroid or thyroid antibodies levels or doesnt order any other tests besides standard thyroid tests like TSH or TSH plus total T4, the easiest way to have your blood work done and get the answers is to order your Thyroid Home Test Kit online from a private lab.

The best part is you dont need doctors referral or medical insurance and dont even need to go to the lab . The thyroid test kit will be mailed to you and you mail it back to the lab and access your test results right after they are ready.

All lab tests are easy to order, have FREE shipping , with results sent directly to you within days. All from the safety of your home.

What Is Being Tested

The Link between the Thyroid and Infertility ~ The Paleo Mom

Thyroid autoantibodies are antibodies that develop when a persons immune system mistakenly targets components of the thyroid gland or thyroid proteins, leading to chronic inflammation of the thyroid , tissue damage, and/or disruption of thyroid function. Laboratory tests detect the presence and measure the quantity of specific thyroid autoantibodies in the blood.

The thyroid is a small, butterfly-shaped gland that

Thyroid autoantibodies are antibodies that develop when a persons immune system mistakenly targets components of the thyroid gland or thyroid proteins, leading to chronic inflammation of the thyroid , tissue damage, and/or disruption of thyroid function. Laboratory tests detect the presence and measure the quantity of specific thyroid autoantibodies in the blood.

The thyroid is a small, butterfly-shaped gland that lies flat against the windpipe in the throat. The primary hormones that it produces, thyroxine and triiodothyronine , are vital in helping to regulate the rate at which the body uses energy . The body uses a feedback system in which thyroid stimulating hormone stimulates the thyroid to produce T4 and T3 as needed. This system helps maintain a relatively stable amount of the thyroid hormones in the blood. When thyroid antibodies interfere with this process, they can lead to chronic conditions and autoimmune disorders associated with hypothyroidism or hyperthyroidism, such as Graves disease or Hashimoto thyroiditis.

Thyroid antibody tests include:

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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.

How Are Recombinant Tpo And Tpo Mimetics Used In Medicine

Ongoing and future studies will help define the clinical role of recombinant TPO and TPO mimetics in the treatment of chemotherapy- and nonchemotherapy-induced thrombocytopenia. Thrombocytopenia is a common problem in the management of patients with cancer and other conditions that affect hematopoietic cells.

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How Is The Tpo Antibodies Test Performed

TPO antibodies test is, basically, a blood test. Your healthcare provider or a lab technician will take a sample of your blood in order to measure how many antibodies are in it.

The blood sample is collected by inserting a needle into a vein in the arm. You might feel a little sting when the needle goes in or out. The whole process lasts five minutes maximum. TPO antibodies test requires no special preparations.

However, you should inform the doctor if you’re taking some medications, supplements, or herbs. Some drugs and supplements may impair the results.

Based on the information you provide, the doctor will suggest whether you can continue taking the medication or supplement even on the day of the test or not.

Follow the doctors recommendations religiously in order to get accurate results and precise diagnosis or insight into your condition.

How Often Should You Test Your Thyroid Antibodies

Thyroid Peroxidase Antibody Test | Anti TPO Test

I often hear from readers who say that their doctors refuse to retest their thyroid antibodies, stating that once a person is thyroid antibody positive, they will always be positive, so retesting the antibodies is useless. I disagree. Tracking your thyroid antibodies can give you an idea of how aggressive the attack is on your thyroid gland. While other lab markers and symptoms should be considered, generally, a lower thyroid antibody number indicates that your condition is improving, while a higher antibody number may indicate that you are having a flare-up or that your condition is worsening.

Tracking antibodies can give you an idea of whether the interventions youre utilizing are working, i.e. is your change in diet leading to an improvement in your condition?

When implementing active interventions, you can check antibody levels every 1-3 months to see a trend however, it will take anywhere from 3 months to 2 years to see the full impact of an intervention.

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Can You Lower Your Thyroglobulin Antibody Levels

But you have to understand the mindset that most doctors have when it comes to your antibody levels.

They don’t really care what your antibodies are because they only care about your thyroid function.

Because of this, it’s up to YOU to understand the types of therapies that can help reduce your levels.

And it will probably be up to you to request frequent retesting of your antibody levels .

You can and should track your thyroglobulin antibody levels periodically to see if whatever therapies you are doing are helping.

If they are helping then you should see your result decreasing.

So, for instance, if your initial result with 212 IU/ml but then you institute various changes including improving your diet, exercising more, improving your sleep, taking certain supplements, using LDN, and so on, you should see your level drop over the next few months.

Rechecking your thyroglobulin level in a few months may look something like this:

Result: 112 IU/ml.

It’s possible to see even more dramatic drops in your thyroglobulin levels provided you are doing the right therapies!

I’ve listed a handful of therapies above and they all may potentially help reduce your antibody levels and, therefore, improve thyroid function.

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.

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Treatment For Hashimotos Thyroiditis


Patients with elevated TPO antibodies but normal thyroid function tests do not necessarily require treatment. Similarly, patients with only slightly elevated TSH may not require medication, either. They should repeat testing after 3-6 months to monitor thyroid status.

Overt hypothyroidism , however, can be controlled by replacing the amount of thyroid hormone that your thyroid gland can no longer make with thyroid hormone replacement medication. Hypothyroidism is not curable, but you can take medication to bring your TSH and thyroid hormone levels back to normal.

What Do High Tpo Levels Indicate

What Your Thyroid Test Results Really Mean

Answered by: Prof Dinesh Dhanwal | Prof of Medicine and Head of Endocrinology, Maulana Azad Medical College, New Delhi

Q: I have a slightly elevated level of TSH and normal T3 and T4 levels . The Anti TPO is very high and the doctor has suggested 50 mg of Eltroxin . Do I need to take the tablet on a life long basis? At present, I don’t have any clinical manifestations. What are the clinical manifestations of very high Anti TPO levels? What are the clinical implications of Hashimoto’s or AITD? Can we solve this problem by diet or physical exercise. I am 45 years and my BMI is 28.50. Please explain the significance of these and explain how I will get effected if medication is not taken.

Going by the details you have provided you have subclinical hypothyroidism, which means that you do not have symptoms but TSH is slightly high with normal T4/T3. The most common cause is autoimmune thyroid disease, which is confirmed by positive anti-TPO. Positive anti-TPO means you have these antibodies in your body which act against the thyroid cells leading to hypothyroidism. Most often this is a progressive disease.

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Without verifying the presence of thyroid antibodies, these symptoms can lead to a missed diagnosis or misdiagnosis.

When Is It Ordered

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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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

Thyroglobulin Antibodies Vs Thyroid Peroxidase Antibodies

How to get your thyroid peroxidase antibody, TPO, under control for good!

We’ve spent our time here talking about one of the major antibodies that your body can develop to attack your thyroid gland but it’s not the only one.

Another important antibody is known as anti TPO antibody or anti thyroid peroxidase antibody.

Thyroid peroxidase is a protein found inside of thyroid cells which helps your body create thyroid hormone.

Thyroglobluin is found in the same place but serves a slightly different function.

Antibodies to both thyroglobulin and thyroid peroxidase can impair thyroid hormone production and function in slightly different ways.

So both antibodies are important when testing for the autoimmune disease known as Hashimoto’s thyroiditis.

But you should be aware that not everyone who has elevated thyroglobulin antibodies will necessarily have elevated TPO antibodies and vice versa.

It’s possible for you to have only ONE set of antibodies present and elevated and the other to be completely normal.

In fact, statistically speaking, it’s more common for TPO antibodies to be elevated and present than it is for thyroglobulin antibodies to be elevated by itself.

It doesn’t necessarily mean anything, though, as BOTH antibodies have been associated with autoimmune thyroiditis and you should aggressively try to treat and manage either or both if they are elevated.

What’s interesting is that each of these antibodies targets different portions of the thyroid and, therefore, thyroid function.

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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 Elevated Anti

Thyroid peroxidase is the enzyme that attaches iodine to the amino acid tyrosine to form thyroxine . Autoantibodies against TPO attack the thyroid gland itself, initially causing the release of T4 followed by a compensating decrease in TSH.

Anti-TPO antibodies should be investigated even if other thyroid biomarkers are normal or even optimal. Elevated antibodies could be an early sign of developing autoimmune thyroid disease.

Researchers suggest anti-TPO should be added to TSH and thyroid hormone measurement or used as a standalone marker for detecting early stages of autoimmune thyroiditis. Anti-TPO is considered a more sensitive autoimmune marker than anti-thyroglobulin antibodies which are more sensitive for detecting differentiated thyroid cancer. However, both antibodies may be detected up to 7 years prior to a diagnosis of autoimmune thyroid disease so early assessment is prudent.

Chronic autoimmune thyroiditis, known as Hashimoto thyroiditis or chronic lymphocytic thyroiditis, is the primary cause of hypothyroidism in developed countries. It is characterized by the destruction of thyroid tissue by the bodys own immune system.

Though biochemical evidence may not be present early in the disease, the hallmark blood chemistry profile once Hashimotos has progressed is an elevated TSH, decreased free and total thyroid hormones, and in most cases elevated anti-TPO. Antithyroglobulin and TSH receptor-blocking antibodies may be present as well.

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