What Your Tpo Antibodies Test Results Mean
The normal range for TPO Antibodies is less than 35 IU/mL.
A null to minimal TPO Antibody test means that your blood does not contain TPO antibodies. This normally insinuates that the causes of your thyroid symptoms are not due to an auto-immune disease. However, if these conditions are suspected then, a recurring test may be recommended.
When the levels are mildly elevated, this can be caused by many thyroid conditions like thyroid cancer, type-1 diabetes, rheumatoid arthritis, as well as auto-immune collagen vascular disease.
High levels of TPO Antibodies are usually caused by an autoimmune disease like the Hashimoto Thyroiditis, Graves Disease, pernicious anemia, lupus and rheumatoid arthritis. It has been reported that almost 3% of people who have a positive TPO test result do not show any symptom.
If levels are high in a pregnant woman, this may lead to higher risks of developing hypothyroidism or hyperthyroidism in the newborn baby.
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.
What Thyroid Antibody Tests Are There
There are several different kinds of thyroid antibody tests. The BTF lists some of them as follows:
- Thyroid peroxidase antibody test. People with Hashimotos thyroiditis have higher levels of TPOAb, and some people with Graves disease also have raised TPOAb levels.
- Thyroglobulin antibody test. A doctor may monitor Tg Ab levels in people who have had thyroid cancer. Some people with Hashimotos thyroiditis also have elevated Tg Ab levels.
- Thyroid-stimulating hormone receptor antibody test. People with Graves disease have higher levels of TSHR Ab.
- Thyroid-stimulating immunoglobulin test. A person with Graves disease may have raised thyroid-stimulating immunoglobulin levels.
Doctors do not always use all these tests if they suspect that someone has a thyroid condition.
Below are some of the most common questions and answers about thyroid antibodies:
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Conflict Of Interest Statement
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
The reviewer JC and handling Editor declared their shared affiliation, and the handling Editor states that the process nevertheless met the standards of a fair and objective review.
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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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References
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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
What Does Your Thea Score Mean
Ideally, we want a THEA score of 0. That is only possible without any genetic predispositions. With a genetic predisposition, the lowest score will always be a 2.
Low risk is considered in the 0-7 range. This means they are at a low risk of developing Hashimotos, or that their Hashimotos is not super aggressive at this point. Nonetheless, they are at risk. For a person with a genetic predisposition, with no other points lets say they score a 2 they still have a 1.6 percent chance of being hypothyroid within 5 years. Keep in mind that if this same individual experiences more triggers, that will contribute to the disease progression.
The higher the score, the higher the aggressiveness rating, and the higher the chance of a person becoming hypothyroid within 5 years.
If we look at a score from 16-21, we know that the aggressiveness of the condition is very high and that they have about a 86 percent chance of becoming hypothyroid within 5 years. As we know that hypothyroidism is Stage 4 of Hashimotos, while other autoimmune conditions occur in Stage 5, higher thyroid antibodies may also predict a faster progression to other types of autoimmune conditions.
What I hope for with my clients is that they can reduce their risk and eliminate their symptoms. And the best way to reduce the THEA score early-on is to reduce thyroid antibodies.
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What Is A Normal Range For Thyroid Antibodies
It depends on the type of thyroid antibody, alongside a variety of factors.
According to Thyroid UK, the reference range for Tg Ab should be less than 200 milli-international units per milliliter or an antibody index of no higher than 0.9. The reference range for TPOAb should be less than 150 mUI/ml or an antibody index of no higher than 0.9.
However, it is also important to note that different laboratories may have different reference ranges.
Autoantibodies As Potential Immunological Markers
TG and TPO antibodies provide readily available evidence for Graves disease although not specific, their presence in a patient with hyperthyroidism strongly suggests the diagnosis. These antibodies are present in 20%30% of the cases 57 years before diagnosis . Although TSAb are not generally measured because present bioassays are laborious, TBII estimation is a cheap, commercially available surrogate which is very useful in confirming the diagnosis of Graves disease in the absence of clinical evidence such as ophthalmopathy. TSAb or TBII levels have been investigated as predictive markers for the success of antithyroid drug treatment in Graves disease. Although patients with the highest levels tend to relapse the most, the results are insufficiently accurate for clinical use . The most important indication for TBII assay in Graves disease is in women with known Graves disease during pregnancy, when a level more than threefold higher than normal predicts the risk of neonatal thyrotoxicosis .
Wilmar M. Wiersinga, in, 2004
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Improve Your Gut Health
Preliminary evidence suggests that gut health is closely linked to thyroid health and that improving gut health can decrease thyroid antibodies and balance your thyroid hormones. Here are several ways you can work on improving your gut health.
- Anti-Inflammatory Diet: A low-quality diet is typically the single biggest source of inflammation that can impair your thyroid and immune function. But encouragingly, early evidence shows that changing your diet can lower thyroid antibodies.A low-carbohydrate diet was shown in one study to reduce thyroid antibodies by 44% in people with Hashimotos thyroiditis, but not celiac disease , while a gluten-free diet was shown to reduce thyroid antibodies in a group of women with Hashimotos thyroiditis . Other studies have shown that eliminating dairy or gluten may help improve thyroid function [14
- For more on supplements to support thyroid function, see How Should I Use Thyroid Supplements?
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.
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Why Arent Thyroid Antibodies The Initial Screening Test Used For Thyroid Disease
You might wonder why TSH is still the standard screening test for thyroid disease given that thyroid antibodies can be elevated for decades before any change in TSH may even be seen.
Thats a good observation and an even better question. Unfortunately, many traditional doctors ONLY test for antibodies after they see an elevation in TSH. Its backwards from what it needs to be. That is why you need to be your own advocate and insist on thyroid antibodies testing. You can discuss this testing with your physician or you can also self-test, as the tests are not overly expensive. Ill talk more about that below.
At some point, the medical community will pick up on the importance of antibodies as an early warning for Hashimotos. I also believe labs will start to incorporate newer findings. For example, the reference range for TSH itself has already been redefined by the American College of Clinical Endocrinologists. The reference range was lowered , but most labs you get still use the old higher ranges as normal. That will hopefully change in the future.
On top of the reference ranges changing, we also know that a person with Hashimotos may fluctuate between high and low TSH readings. Reference ranges are also only average values, so even if your TSH reads as normal, you may not be. Remember, I was told my thyroid was normal when my TSH was 5.5 IU/mL, and I was sleeping for 12 hours each night! TSH is not the screening tool we should be solely using.
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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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.
Symptoms Of A Thyroid Issue
What are the symptoms of a thyroid problem? The symptoms of a thyroid problem comes from hyperthyroidism or hypothyroidism, both caused by unbalanced thyroid levels. Thyroid disease symptoms include:
- Enlarged thyroid
Graves disease or Hashimotos thyroiditis can lead to dangerously high or dangerously low thyroid hormone levels, respectively. There are many triggers for Graves or Hashimotos.
Its crucial to know if a patients thyroid imbalance is due to Hashimotos or Graves disease these are autoimmune conditions with a significantly different root cause and treatment strategy than thyroid disease which is not autoimmune in nature.
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What Are Thyroid Antibodies
Antibodies are not inherently bad and are actually a very important part of our immune system. When the body detects foreign pathogens, such as bacterial or viral infections, it produces proteins called antibodies. These proteins help recruit other immune cells and fight off intruders.
However, in some people, the immune system goes awry and starts to produce antibodies against normal body tissue. In the case of thyroid autoimmune disorders, like Hashimotos hypothyroidism and Graves disease, the immune system mistakenly produces antibodies that attack the thyroid cells.
When they go unchecked, these antibodies can lead to inflammation in the thyroid known as thyroiditis. This destruction to the gland may eventually cause the person to enter a hypothyroid or hyperthyroid state.
Not everyone who has antithyroid antibodies is hypothyroid, but some people with elevated TPO, TSH, or TG antibodies will eventually become hypothyroid. Furthermore, some patients with thyroid disease may never show elevated levels of any thyroid antibodies .
Stage : The Genetic Predisposition
The first stage is when the person does not have any manifestations of Hashimotos. So, they are going to have a normal TSH and will have normal thyroid function. They will not have any elevated thyroid antibodies. If you were to biopsy their thyroid gland, it would be perfectly normal. They just have the genes at this point. Again, there are 3 requirements for the disease to progress: genetics, intestinal permeability, and one or more triggers.
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What More Should I Know About Thyroid Tests
Thyroid hormone levels change during pregnancy and due to certain medical conditions. They also differ concerning the age and gender of an individual. Your healthcare provider will help monitor and assess thyroid levels. They will guide you on ways to balance these hormones and help maintain normal ranges.
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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 .
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Thyroglobulin And Iodine Levels
Thyroglobulin is a protein secreted by the thyroid gland that aids in the production and storage of thyroid hormones. TG fluctuates with iodine levels, and high thyroglobulin levels may be an indicator of iodine deficiency or excess .
Iodine is a nutrient that is essential for the proper functioning of our thyroid gland. Iodine deficiency is an independent risk factor for underactive thyroid and can even lead to the development of a goiter and thyroid nodules [7
Excess iodine blood levels can create toxicity symptoms, such as stomach pain, nausea and vomiting, and neurological dysfunction. Therefore, screening thyroglobulin levels may be useful in detecting abnormal iodine levels, as iodine is not routinely run on blood tests.