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What Does It Mean When Thyroid Peroxidase Antibodies Are High

A Note From Paloma Health

Thyroid Autoimmunity What Are Healthy Levels for Thyroid Antibodies

The path to thyroid health and well-being can feel painful, long, and frustratingâand it shouldn’t have to be this way! We recommend you work with a trustworthy thyroid doctor to find the optimal functioning of your thyroid. Schedule a free consultation with a care advisor to determine if Paloma Health might be the right fit for you.

The above information is not a diagnosis, treatment, cure for thyroid disease. We recommend that you work with your Paloma Health care team to learn how to optimize your thyroid health.Â;

Is It Possible To Reduce Thyroid Peroxidase Antibodies If They Are Elevated


And this might just be the most important part of this article.;

After all, if you know that TPO antibodies are causing problems in your body, doesn’t it make sense to try and do something about them?

Of course!

But here’s the problem:

From the perspective of your doctor, there’s nothing that can be done about elevated thyroid peroxidase antibodies.;

Doctors take what is called the “sit and wait” approach to managing people who have elevated thyroid antibodies.;

They sit and wait until your own body damages the thyroid gland to the point that you need prescription medication.;

Just because your doctor doesn’t have any medical treatment options for you doesn’t mean you can’t do anything, though!

Seeing a doctor is important, for sure, but when it comes to managing your thyroid antibodies you are probably going to be on your own.;

It may sound difficult but it actually isn’t.;

Making some changes to your lifestyle can have an impact on your immune system and thyroid health and this may directly help your antibodies.;

Doing things like changing the food that you eat can have a huge impact on your antibody levels.;

Avoiding foods that are known to be inflammatory is a great place to start.;

Eating foods that are known to possess natural anti-oxidants and plant-based nutrients is also a wise decision.;

You can also focus on improving your lifestyle.;

And guess what?

You don’t really need a doctor to tell you that eating fruits and vegetables is a good thing, right?

What Is Being Tested

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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What Are Thyroid Peroxidase Antibodies

An antibody is defined as a protective protein produced by the immune system in response to the presence of a foreign substance called an antigen. Antibodies detect and bind to the antigens with a mission to remove them from the body.

In some cases, antibodies attack the bodys own cells, tissues, and organs. This reaction is called autoimmune response. When thyroid antibodies attack healthy cells produced by the butterfly-shaped gland, an autoimmune thyroid disorder can occur.

Thyroid peroxidase functions as a catalyst to the organification and coupling reactions in the production of the T4 hormone. However, thyroid peroxidase antibodies prevent it from doing so. The presence of TPO antibodies indicates that the cause of thyroid disease is an autoimmune disorder such as Hashimotos thyroiditis and Graves disease.

Antibodies that attack thyroid gland induce inflammation and impair the function of this important gland.

Normal Thyroid Lab Tests But Still Have Hypothyroid Symptoms

Anti TPO Thyroid Antibody Guide: Symptoms + Optimal Ranges ...

This idea of “optimal” thyroid lab tests extends beyond just anti-TPO levels.

Unless you evaluate your thyroid lab tests entirely and with the “optimal” levels in mind, you will end up undertreated and may remain symptomatic.

Part of this problem is due to the reliance upon the TSH as the de-facto lab test to determine thyroid function.

The current treatment paradigm can be summed up in basically one sentence:

Give Levothyroxine or Synthroid to the patient and monitor the TSH to “normal” levels.;

It turns out that thyroid hormone management is not quite that simple and several studies have shown that treating based on the TSH ultimately leads to low levels of T3, reduced quality of life and weight gain due to a slower metabolism .

When you look at all the data out there and our current treatment paradigm it’s easy to see why many hypothyroid patients go under-treated and misdiagnosed.

Because of these reasons, it’s very important to have a basic understanding of what defines “optimal” thyroid lab tests and use these values to determine the need for further management .;

Complete thyroid lab panel + optimal ranges:

Part of the problem with diagnosing hypothyroidism is due to the body’s amazing ability to preserve serum thyroid levels;under situations of extreme stress.;

In addition, when it comes to hormones and serum levels, very small changes in blood levels can mean drastic changes in terms of function which results in symptoms in patients.;

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Connection To Thyroid Peroxidase Antibody

Thyroid peroxidase antibody is very similar to TgAb: it is also an antibody that mistakenly attacks the thyroid gland. While TgAb targets thyroglobulin, TPOAb targets an important thyroid enzyme called thyroid peroxidase. TPOAb can increase oxidative stress and may damage the thyroid .

The TBOAb test is also sometimes called the Antithyroid Microsomal Antibody Test .

The same conditions that cause TgAb to increase usually also raise TPOAb. In fact, TPOAb may be a better indicator of autoimmune thyroid disorders than TgAb .

About 90-95% of people with autoimmune thyroid disorders have detectable TPO antibodies, while only 70-80% of them have detectable thyroglobulin antibodies. Therefore, your test results may come back as normal TgAb and detectable TPOAb even if you have autoimmune thyroid issues .

TPOAb assays vary in sensitivity. Older assays may not detect TPO antibody levels more sensitive assays would. If your TPOAb came back normal and your TgAb high, you should probably repeat the TPO test with a more sensitive assay .

People without thyroid problems may also test positive for TPOAb. According to some estimates, about 10 to 15% of the general population produce TPOAb .

Another big difference between these two types of antibodies is that TPOAb does not interfere with thyroglobulin tests like TgAb does. This means a TPOAb test would not be helpful for determining thyroglobulin levels .

Factors Linked To Thyroid Autoimmunity

Autoimmune thyroid diseases are usually accompanied by the presence of anti-thyroid peroxidase , anti-thyroglobulin , and anti-thyroid-stimulating hormone receptor antibodies. Antibodies against thyroid antigens such as carbonic anhydrase 2, megalin, T3 and T4, sodium iodide symporter , and pendrin have also been detected, although rarely .

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Who Has Elevated Thyroid Antibodies

While high thyroid antibodies are one of the diagnostic criteria for Hashimotos disease surprisingly there are other health conditions associated with their presence. It means that there is a risk that eventually the person may develop Hashimotos and/or hypothyroidism later on.

1. Thyroid antibodies levels were found to be mild to moderately elevated;in associated diseases such as systemic lupus erythematosus , thyroid cancer, thyrotoxicosis, rheumatoid arthritis, fibromyalgia, pernicious anemia, autoimmune collagen vascular disease and type 1 diabetes.

2. According to different studies, high thyroid antibodies were reported in a range of 1229% in patients with chronic hives . There is an increased prevalence of thyroid autoimmune disease such as positivity of thyroid antibodies, Hashimotos disease with or without hypothyroidism in people with chronic urticaria. However, there are no cases of Graves disease described among patients with chronic hives.

Test for thyroid antibodies and thyroid function are especially recommended for those patients who experience chronic hives that cannot be attributed to an allergen or any other obvious cause.These tests can rule out involvement of thyroid autoimmunity or help to confirm it as being the cause of this condition.

One study estimated that up to 12.5% of women can have elevated TPO thyroid antibodies during the first two trimesters of pregnancy and it can negatively affect development of the fetus and child.

What Is Hashimoto Thyroiditis

Thyroid Anti TPO test. THYROID peroxidase antibodies test: why it is important.

Hashimoto thyroiditisÂ;also known as chronic lymphocytic thyroiditis, is a condition in which your immune system attacks your thyroid gland. The thyroid gland is part of your endocrine system, which produces hormones that coordinate many of your bodyâs functions. Hashimoto thyroiditis is the most common form of thyroid gland inflammation and the most frequent cause of decreased thyroid hormone production andÂ;underactive thyroid gland .

Hashimoto thyroiditis is the most common cause of hypothyroidism in the United States. Hashimoto thyroiditis can affect anyone at any age but occurs most commonly in women who are between 30 and 50 years of age.Â;Hashimoto thyroiditis can also occur in men and women of any age and in children. About 1 in 1,000 people are diagnosed annually with Hashimoto thyroiditis, and the number has been increasing over time due to improvements in diagnostic techniques. The ratio of women to men diagnosed with the disease is 20 to 1. People with a family history of thyroid diseases or with other autoimmune diseases, especially type 1 diabetes or adrenal insufficiency are at increased risk.

The thyroid gland is a butterfly-shaped organ that lies flat against the windpipe in the throat. It produces the hormones thyroxine and triiodothyronine and plays an important role in controlling the bodyâs metabolism.

Hashimoto thyroiditis symptoms

Signs and symptoms of hypothyroidism include:

  • Fatigue and sluggishness
  • Memory lapses

Causes of Hashimoto thyroiditis

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

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 Hashimoto’s 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:

  • Hashimoto’s thyroiditis/chronic autoimmune hypothyroidism

Stage 2: The Breakdown Of The Immune Tolerance

In the second stage, you start seeing the breakdown of the thyroids immune tolerance, and the person will start to have a white blood cell infiltration into the thyroid gland. Some of these immune cells are going to start grouping there. This;is when we will also start seeing elevated thyroid antibodies. This stage can go on for many years a decade or more before a person moves on to stage 3 or 4, when we start to actually see symptoms and changes in thyroid function.

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Symptoms Associated With High Thyroid Peroxidase Antibodies

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.;

What Are Thyroglobulin Antibodies

The Great Thyroid Slowdown: Hypothyroidism  The Golden ...

One of the primary ways the immune system protects the body is by producing antibodies. When a foreign invader is in the body, like bacteria, toxins, or viruses, the immune system sends out antibodies to fight it. This response is a sign of a healthy immune system.

Sometimes, the immune system goes rogue and creates antibodies that attack the healthy tissues in your body. Antibodies made to fight your own organs are a sign of autoimmune disease.Â;

Thyroglobulin antibodies are cells made by the immune system to attack thyroglobulin in the thyroid gland. Thyroglobulin is a protein that is created and stored in the thyroid gland to help make thyroid hormones.Â;

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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.

Stage 3: 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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Is There Anything Else I Should Know

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.

What Do The Results Of Tpo Antibodies Test Mean

Hashimoto’s Thyroid Antibodies (TPO & TGB) and Risk of Miscarriage, Premature Birth

The TPO antibodies test results may show one of the following options:

  • Negative as you can already conclude negative TPO antibodies test result indicates that no thyroid antibodies were found. This result also implies that thyroid problems and symptoms a patient experiences are not caused by an autoimmune condition
  • Positive antibodies to TPO and/or Tg this result indicate a patient may have Hashimotos thyroiditis
  • Positive antibodies to TPO and/or TSH may indicate the presence of Graves disease

The higher the level of antibodies, the more likely it is that a patient has an autoimmune disease of the thyroid e.g., Hashimoto’s or Graves’ disease. Blood test results for TPO antibodies are positive in 95% of patients with Hashimotos thyroiditis and in 50% to 80% of people with Graves disease.

When it comes to TPOAbs, the reference value is <9.0 IU/ml . Values above 9.0 are typically associated with autoimmune thyroid disease, but elevations are also observed in some other autoimmune conditions. The most commonly mentioned TPOAb reference range is less than 35 IU/ml.

The presence of TPOAbs in patients with subclinical hypothyroidism predicts an elevated risk of overt hypothyroidism. Moreover, this also shows that those patients could be at a higher risk of developing other autoimmune conditions like type 1 diabetes.

As mentioned above in the article, some people may be positive to TPO antibodies, but they do not have a thyroid condition.

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The Connection Between Thyroid Peroxidase Antibodies Hashimoto’s And Graves’ Disease

Does the presence of elevated thyroid peroxidase antibodies guarantee that you have Hashimoto’s?

Definitely not!

Elevated TPO antibodies are seen in 90-95% of patients with Hashimoto’s 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:

  • The presence of thyroid peroxidase antibodies with a LOW TSH and symptoms of hyperthyroidism point towards a diagnosis of Graves’ disease
  • The presence of thyroid peroxidase antibodies with a HIGH TSH and the symptoms of hypothyroidism point towards a diagnosis of Hashimoto’s thyroiditis
  • The presence of thyroid peroxidase antibodies with a normal TSH and no symptoms predicts an increased risk of developing a thyroid condition in the future
  • The absence of thyroid peroxidase antibodies does not rule out hyperthyroidism or hypothyroidism as both of these conditions can be caused by other conditions


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