What Is Thyroid Peroxidase
As a thyroid patient, you should probably know a little bit about the protein known as thyroid peroxidase.
For starters, its one of, if not, the most important enzymes in your thyroid.
It is responsible for ensuring that your body can actually produce thyroid hormone.
If there is ANYTHING wrong with this enzyme then there is a good chance you will not be able to produce enough thyroid hormone and you may end up with the symptoms of hypothyroidism.
The good news is that most people dont have any issues with thyroid peroxidase so they dont have issues with thyroid function.
But many people, including those with Hashimotos thyroiditis, can develop antibodies to this very important enzyme.
And guess what happens if this occurs?
The enzyme is disrupted, you wont be able to produce thyroid hormone, and you will become hypothyroid .
We are going to spend a lot of time talking about this enzyme, how it becomes disrupted, what it means if you have antibodies to it, how to determine if your levels are normal, what symptoms are associated with high antibodies, and much more.
Before we do, though, let me explain a little more about thyroid peroxidase.
Thyroid peroxidase, when it is functioning normally, helps your body use iodine to create thyroid hormone .
It does this by oxidizing iodide into iodine, a process that is actually fairly dangerous for your thyroid cells.
This oxidation results in the formation of reactive compounds that can damage your thyroid gland!
Stage : 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.
Final Thoughts On Thyroid Antibodies
In summary, high thyroglobulin antibody levels likely hold little clinical relevance to the presence and severity of thyroid disease. TPO antibodies are a greater indicator of thyroid health and can be used to monitor the progression of thyroid dysfunction.
However, even TPO antibodies come with their own limitations. Unless your TPO antibodies are very high, its not necessary to be hyper-focused on reducing your thyroid antibodies to the lab reference range. Reducing elevated TPO thyroid antibodies to below 500 IU/mL, and improving your thyroid function with diet and lifestyle changes significantly reduces your risk of developing hypothyroidism.
If you want help with reducing thyroglobulin antibody high levels or reducing thyroid symptoms, schedule an appointment at our center for functional medicine.
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Thyroid Stimulating Hormone Receptor Antibodies
TSH initiates the production of T3 and T4 by binding to molecules on the thyroid gland called TSH receptors. TSH receptor antibodies imitate the action of TSH and, by targeting these receptors, can trigger hyperthyroidism.
TSHR-Abs are present in over 85% of people with Graves’ disease and less commonly with Hashimoto’s disease. As such, high levels of TSHR antibodies are strongly suggestive of Graves’ disease.
The TSHR-Ab test is also sometimes referred to as the thyroid-stimulating immunoglobulin test.
What Does It Mean If Your Thyroid Peroxidase Antibodies Result Is Too Low
The thyroglobulin antibody level cannot be too low.
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What Do Tpo Antibodies Mean To You
TPO antibodies test informs the doctor whether symptoms you experience are associated with an autoimmune condition. But, if you already have some thyroid disease, its treatment is not really based on antibody levels.
After all, the treatment of thyroid condition is based on thyroid hormone levels and the severity of symptoms a patient experiences. Doctors order TPO antibodies tests to assess the potential cause of thyroid condition and identify the subclinical disease of the butterfly-shaped gland.
The doctor is less likely to treat the thyroid disease if a patient has high TPO antibodies without symptoms and with normal thyroid hormone levels. On the other hand, if a patient has mild symptoms or borderline abnormal thyroid hormone levels along with higher TPO antibodies, the doctor may recommend treatment. Again, the treatment will work to manage symptoms and normalize levels of thyroid hormones.
How Does The Thyroid Gland Function
The major thyroid hormone secreted by the thyroid gland is thyroxine, also called T4 because it contains four iodine atoms. To exert its effects, T4 is converted to triiodothyronine by the removal of an iodine atom. This occurs mainly in the liver and in certain tissues where T3 acts, such as in the brain. The amount of T4 produced by the thyroid gland is controlled by another hormone, which is made in the pituitary gland located at the base of the brain, called thyroid stimulating hormone . The amount of TSH that the pituitary sends into the bloodstream depends on the amount of T4 that the pituitary sees. If the pituitary sees very little T4, then it produces more TSH to tell the thyroid gland to produce more T4. Once the T4 in the bloodstream goes above a certain level, the pituitarys production of TSH is shut off. In fact, the thyroid and pituitary act in many ways like a heater and a thermostat. When the heater is off and it becomes cold, the thermostat reads the temperature and turns on the heater. When the heat rises to an appropriate level, the thermostat senses this and turns off the heater. Thus, the thyroid and the pituitary, like a heater and thermostat, turn on and off. This is illustrated in the figure below.
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How To Lower Thyroid Antibodies
However, using thyroid medication has its limitations and practice shows that most patients get their antibodies lowered only partially. There is a holistic nutritional approach to Hashimotos disease that has demonstrated great results in lowering thyroid antibodies because it looks for factors that cause them initially.
Hashimotos disease occurs as a result of complex interactions between genetic and environmental factors. According to the recent research conducted and published by Prof. Fasano, there is a new factor that plays the key role in the initiation of the autoimmunity.
Increased intestinal permeability or leaky gut syndrome is a condition when intestinal gut walls lose their protective effect and let through the antigens that cause the overreaction of the immune system. Leaky gut is a reversiblecondition and is one of the factors that should be addressed first.
There are many scientific publications that support this treatment approach and the idea that
Hypothyroidism caused by Hashimotos disease is reversible in some cases
Since most environmental triggers of autoimmune overreaction are dietary, identifying and removing these factors should be the next step. This strategy has not only has promising results in dampening the autoimmune reaction but also in lowering thyroid antibodies levels.
There are many other dietary factors that can trigger Hashimotos disease. But we are all different and what works for some people may not work for you and vice versa.
I Found Out My Thyroglobulin Antibody Is High Now What
Despite thyroglobulin antibody levels showing a correlation with thyroid health, research supports that they are not a strong predictor of thyroid disease. There are much more reliable tests for diagnosing Hashimotos thyroiditis, such as TPO-antibodies, TSH levels, and thyroxine levels.
Hashimotos thyroiditis is a common autoimmune condition that causes the immune system to attack the thyroid gland. In some cases, this leads to hypothyroidism, however this is much less common than many people assume .
Hashimotos is diagnosed by several thyroid function tests, such as :
- Elevated thyroid stimulating hormone levels.
- Low thyroid hormone levels, reported as free or total T3 and T4
- Elevated thyroid peroxidase antibodies
- Elevated thyroglobulin antibodies
- Elevated TSH antibodies
While TPO-antibodies are more indicative of Hashimotos thyroiditis, elevated anti-TG antibodies are often reported on lab results, creating concern for patients.
A 2019 study found that anti-TG antibodies are elevated in 60-80% of patients with Hashimotos thyroiditis and in 40-60% of those with Graves disease. However, the presence of thyroglobulin antibodies showed only a low-to-moderate sensitivity in diagnosing autoimmune thyroiditis. Additionally, they were not useful in identifying when a patient has transitioned from subclinical to overt hypothyroidism .
It is no wonder that these elusive antibodies cause so much confusion to health care providers and patients.
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Autoimmune Antibodies And Thyroid Disease
The thyroid is a gland located in the front of your neck. It produces important hormones that help control your metabolism and other body functions.
Your thyroid gets its instructions from the pituitary gland, a small structure in your brain. The pituitary gland releases thyroid stimulating hormone , which tells the thyroid gland to make thyroid hormone.
Antibodies are proteins your immune system makes to help protect you against infections. Sometimes antibodies can mistakenly attack your own tissues.
Some thyroid conditions happen because antibodies attack the gland and interfere with its normal hormone-making process. These conditions are called autoimmune diseases of the thyroid.
There are several types of thyroid antibodies. Each one attacks a different target in the thyroid hormone production process.
The most common thyroid antibodies are:
- Anti-thyroperoxidase antibodies
- Thyroid stimulating hormone receptor antibodies
- Anti-thyroglobulin antibodies
How To Heal Your Thyroid
Based on the results of the TPOAbs test, the doctor will recommend certain treatment measures if necessary.
However, there are many things you can do on your own in order to prevent or lower the levels of antibodies. These measures can help delay progression or aid management of autoimmune thyroid conditions. Below, you can see some useful suggestions:
- Modify your diet the first and most important thing you can do to lower levels of TPO antibodies is to modify your diet. Make sure to lower or avoid intake of heavily processed and refined foods, GMO foods, and foods laden with thickening agents, artificial sweeteners, thickening agents, food dyes, among others. Instead, try to include organic fruits and vegetables into your diet and other foods that are rich in nutrients and with amazing anti-inflammatory activity. You also need to consume fiber-rich foods which are beneficial for the digestive system i.e., your gut. Additionally, your diet also needs protein which assists in the repair of tissues in the body, participates in the transport of thyroid hormones throughout the body
Very High Thyroid Antibodies
All that said, if your TPO antibodies are very high, reducing your antibody count is definitely a worthwhile goal. The higher the TPO antibodies, the more likely you are to develop hypothyroidism.
The farther you reduce your TPO antibodies, even if you cant get them down to 500 IU/mL, the less damage to your thyroid gland. Just dont feel discouraged by failing to get them down to the normal reference range.
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.
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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 youve 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 a 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 own 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.
Verification Of The Manufacturers Suggested Normal Ri
We prepared a histogram to evaluate the distribution pattern of TPO Ab values among reference individuals . Next, we generated a box plot for outlier detection. In accordance with the criterion proposed by Dixon, we used an absolute difference to range ratio greater than 1:3 to pinpoint outliers. We considered the suggested RI to be acceptable only if 2 or fewer of the 20 tested samples tested as being beyond the manufacturers reported reference limits, as recommended by CLSI.
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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.
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.
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Hypothyroidism Triiodothyronine And Thyroxin
Hypothyroidism can be a cause of infertility and, if untreated, may lead to increased complications during pregnancy, e.g. to more spontaneous abortions, hypertension of pregnancy, placenta previa or placenta abruptio . In populations with a sufficient iodine supply, chronic thyroiditis is the most common cause of thyroid hypoactivity. Also thyroid antibodies, without manifest hypothyroidism, increase the risk of spontaneous abortions and premature births . This was also confirmed by the results of a meta-analysis . Levothyroxine seems to lower this risk. Depending on the severity and duration of hypothyroidism during pregnancy, there may be impairment of neuropsychological development of the child. This is known, in particular in connection with iodine deficiency . Pop studied the developmental outcome of 63 children born to mothers with low free thyroxin during pregnancy compared to 62 children born to euthyroid mothers and found on the Bayley developmental scales an average reduction of 10 points on the mental scales, and of 8 points on the motor scales in the first and second year of life. Similarly, Li found delayed development at 2530 months of age in offspring of women with subclinical hypothyroidism, hypothyroxinemia or elevated levels of thyroid peroxidase antibodies. In a study from The Netherlands maternal hypothyroxinemia was found to be a significant risk factor in the offspring for language and cognitive delay at 30 months.