Is There Anything Else I Need To Know About A Thyroid Antibodies Test
Thyroid disease can get worse during pregnancy. This can harm both the mother and her unborn baby. If you have ever had thyroid disease and are pregnant, you may be tested for thyroid antibodies along with tests that measure thyroid hormones. Medicines to treat thyroid disease are safe to take during pregnancy.
What Does The Test Measure
Thyroid antibody testing detects and measures thyroid antibodies in the blood. Normally, antibodies attack foreign substances in the body, like bacteria, viruses, parasites and toxins.
In patients with autoimmune disorders, antibodies mistakenly target the bodys own tissues. These antibodies that attack the patients own body are also known as autoantibodies or antithyroid antibodies. Thyroid antibody testing may look for several types of thyroid antibodies:
- Thyroid peroxidase antibodies : Thyroid peroxidase is an enzyme that is crucial to the production of thyroid hormones. TPOAb may interfere with the action of this enzyme. Almost all patients with Hashimotos thyroiditis have high levels of TPOAb.
- Thyroglobulin antibodies : Thyroglobulin is a protein made by the thyroid gland. TgAb may be present when the thyroid has been damaged. Thyroglobulin antibodies are often measured in addition to thyroglobulin tests after a patient completes treatment for thyroid cancer.
- Thyrotropin receptor antibodies : TRAb are antibodies that bind to the receptors on thyroid cells normally activated by thyroid-stimulating hormone . In Graves disease, an antibody called thyroid stimulating immunoglobulin binds to the TSH receptor and mimics the action of TSH. This causes constant stimulation of the thyroid gland, prompting it to release too much thyroid hormone into the bloodstream. Stimulation by TSI can also cause abnormal growth of the thyroid gland.
What Do The Results Mean
Your results may show one of the following:
- Negative: no thyroid antibodies were found. This means your thyroid symptoms are probably not caused by an autoimmune disease.
- Positive: antibodies to TPO and/or Tg were found. This may mean you have Hashimoto disease. Most people with Hashimoto disease have high levels of one or both of these types of antibodies.
- Positive: antibodies to TPO and/or TSH receptor were found. This may mean you have Grave’s disease.
The more thyroid antibodies you have, the more likely it is that you have an autoimmune disorder of the thyroid. If you are diagnosed with Hashimoto disease or Grave’s disease, there are medicines you can take to manage your condition.
Learn more about laboratory tests, reference ranges, and understanding results.
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Association Of Tai And Subfertility In Women
TAI identified by the existence of thyroid peroxidase antibodies or thyroglobulin antibodies is frequently stated in subfertile women. Specifically, TPOAb has been related to lower fertilization rates and unstable embryogenesis.13
TPOAb was likely to be positive in euthyroid women having female factor infertility in comparison with fertile, age-matched euthyroid women.6 In women with polycystic ovarian syndrome , the frequency of TAI may be higher in comparison with controls.14 In subfertile women with PCOS, the existence of TAI has been correlated with a lower probability of maturing ovarian follicles with the use of clomiphene citrate for ovulation induction.15 However, other studies have failed to prove such associations. Among infertile women with PCOS, a study conducted on 436 women undergoing 530 antral follicular count measurements, no correlation was found with regard to thyroid function or TPOAb positivity with AFC.16 Conversely, the same study reported that lower free T3 and TPOAb positivity were coupled with a lower AFC in females with diminished ovarian reserve or UE infertility.16
Gregory Kline MD, Hossein Sadrzadeh PhD, in, 2017
Thyroid Peroxidase Antibodies Test And Who Needs It
Thyroid peroxidase antibodies test measures the level of an antibody that is directed against TPO.
These antibodies are produced in the body by the immune system, as mentioned above.
The TPO antibodies test serves multiple purposes, such as:
- Helping doctors diagnose autoimmune thyroid disorders
- Aiding in differentiating autoimmune thyroid disorders from non-autoimmune hypothyroidism or goiter
- Serves as a diagnostic tool in deciding whether to treat a patient who has been diagnosed with subclinical hypothyroidism
Doctors may also order a TPO antibodies test if you are pregnant and have an autoimmune disease, particularly the condition that involves thyroid.
Thyroid peroxidase antibodies have been associated with reproductive difficulties such as miscarriage, preeclampsia, premature delivery, and in-vitro fertilization failure. In these instances, the doctor may also order TPOAbs test, but bear in mind its not a standard test for problems with fertility and pregnancy.
If a pregnant woman has an autoimmune thyroid condition or some other autoimmune disease with thyroid involvement, the doctor may order TPO antibodies test in order to determine whether the baby could be at risk of thyroid dysfunction.
Additionally, you might need a TPO antibodies test if other thyroid hormone levels are too low or too high. Your doctor will need results from TPO antibodies test to determine whether an autoimmune condition impaired the production and concentration of thyroid hormones.
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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.
Defects In The Enzymes Required For Iodide Organification
Defect in the Key Enzyme Catalyzing the Iodination and Coupling of Tyrosyl Moieties Gene: TPO
Thyroid peroxidase is a thyroid-specific heme peroxidase anchored via a C-terminal transmembrane domain at the apical membrane surface of follicular thyroid cells . Using hydrogen peroxide as oxidative equivalents, TPO catalyzes the iodination of tyrosyl residues in TG and the subsequent phenoxy ether bond formation between pairs of iodotyrosines to generate iodothyronines .
The first case of CH due to failure of iodide organification in the presence of hydrogen peroxide was reported in 1950 by Stanbury et al.32 Four decades later, the human TPO gene was cloned,33 followed shortly after by the description of a TPO mutation in a patient with CH.34 Inactivating biallelic defects in the TPO gene appear to be the most frequent cause of inherited dyshormonogenesis with permanent CH35,36 and the culprit in essentially all patients with permanent total iodide organification defects .37 Bakker et al. estimated the incidence of TIOD owing to biallelic TPO defects at 1:66,000 for a Dutch population.37
Finding of TPO mutations in a neonate with CH indicates that the patient will require lifelong treatment with thyroid hormone and that future pregnancies should be carefully monitored for the presence of fetal goiter. The latter can be detected by ultrasonography and treated by a single intraamniotic injection of L-T4 to prevent goiter-related dystocia and improve neurological development.41
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Treatment Options For Patients With High Anti
So what are you supposed to do if you have high anti-TPO antibody levels?
It turns out that there are several things you can do to lower these antibody levels.
The treatment is especially important because your physician may take the wait and see approach to treatment.
Basically many doctors may not even try to treat your antibody levels until they have caused glandular damage and thyroid hormone replacement is required.
Luckily there are several therapies that you can do to help reduce inflammation and autoimmunity.
Note: for best results, its wise to use a combination of these therapies and stack them together. If you take just 1-2 supplements, for instance, you will be limiting your progress.
#1. Supplements
Weve already discussed how certain nutrient deficiencies can predispose to developing autoimmune diseases.
This should give you an idea of the importance of nutrients and supplements in treating these conditions.
Now we need to discuss how certain nutrients can reduce inflammation and have even been shown to lower TPO antibody levels.
Supplements to reduce inflammation and autoimmunity:
Supplements to improve thyroid function:
You can also check out a more detailed guide on which supplements to take if you are hypothyroid here and which supplements to take if you have Hashimotos here.
#2. Medications
In addition to using supplements, there are some medications that can be used to help reduce inflammation.
#3. Hormones
#4. Diet
#5. Avoid endocrine disruptors
Grs Calculation And Statistical Analysis
The GRS for each individual was calculated across the associated SNPs as the weighted sum of all TPOAb positivity risk alleles carried by a person, with weights proportional to the effect estimates from the previously published meta-analysis . GRS quartiles were generated from the global distribution of the score. Supplemental Table 4 shows handling of participants with thyroid hormone measurements above the upper limit of detection and below the lower limit of detection before association analyses . We then estimated the age-, sex- and study centeradjusted associations between each of the SNPs and the natural logarithm of TPOAb concentrations as well as inverse normal transformations of TSH and FT4 concentrations. Associations with thyroid volume, goiter, and low echogenicity were examined using multiple linear and logistic regression as appropriate. The proportion of TPOAb variance explained was estimated from a linear regression model.
All GRS analyses were conducted using Stata/SE 13 or the R statistical framework .
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Certain Conditions Can Make Your Thyroglobulin Antibody High
Even though antithyroglobulin antibodies are not the best predictor of thyroid disorders, they should not necessarily be ignored. Unlike TPO antibodies, thyroglobulin antibodies are not able to stimulate an immune response in the thyroid, but they may be useful in diagnosing certain thyroid conditions .
Anti-TG antibody levels may show importance in the following:
- Patients diagnosed with thyroid carcinoma who have elevated TG antibodies may be at a higher risk of the cancer spreading to lymph nodes or surrounding organs. Elevated levels may also indicate a high risk of thyroid cancer recurrence after treatment [4
- Trusted SourcePubMedGo to source].
One study found that after successfully treating thyroid disease, thyroglobulin levels dropped back down into normal reference ranges . It is important to point out that this study tested the actual levels of thyroglobulin protein, not the TG-antibody levels.
However, this finding is consistent with another study that found elevated anti-TG antibodies to correlate with the severity of hypothyroid symptoms, including fragile hair, swelling of the face and eyes, and vocal hoarseness [3
Thyroglobulin autoantibodies may not be the best indicator of thyroid disease, but likely will continue to be useful in the screening and monitoring of select conditions.
What Is Thyroid Peroxidase Antibody
An antibody is a protective protein produced by the immune system against an antigen, a foreign substance. Antibodies help remove antigens from the body by binding to them. When antibodies attack the body cells, they produce an autoimmune response. Thyroid peroxidase antibodies prevent thyroid peroxidase from catalysing the production of thyroid hormones.
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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 [1
- 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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Thyroid Peroxidase Background Information
- McLachlan SM, et al. Autoimmune response to the thyroid in humans: thyroid peroxidase–the common autoantigenic denominator. Int Rev Immunol. 19:587-618.
- Nagasaka A, et al. Effect of antithyroid agents 6-propyl-2-thiouracil and 1-mehtyl-2-mercaptoimidazole on human thyroid iodine peroxidase. J Clin Endocrinol Metab. 43: 152-8.
- Kimura S, et al. Human thyroid peroxidase: complete cDNA and protein sequence, chromosome mapping, and identification of two alternately spliced mRNAs. Proc Natl Acad. 84:5555-9.
- Ruf J, et al. Structural and functional aspects of thyroid peroxidase. Arch Biochem Biophys. 445 :269-77.
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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.
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.
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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?
Symptoms Of Hashimotos Thyroiditis
At the very beginning, patients may not notice any particular symptom. This autoimmune condition tends to progress slowly over the years and causes thyroid damage and a decline in hormone production.
In fact, Hashimoto’s thyroiditis is the most common cause of hypothyroidism, which is why signs and symptoms of this autoimmune disease are similar to the underactive thyroid. Some of them include:
- Thick and red skin usually on top of feet or shins
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What Do The Results Of Tpo Antibodies Test Mean
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.