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What Is Thyroid Peroxidase Tpo Ab

Thyroid Antibody Test Results

Thyroid Peroxidase Antibody Test | Anti TPO Test

Antibody levels can be tested with a blood sample. The antibody test measures the amount of antibody per milliliter or liter of blood in international units.

Normal values are:

  • TPO antibody: Less than 9 IU/mL
  • Thyroid-stimulating immunoglobulin antibody : Less than 1.75 IU/L
  • Anti-Tg antibody: Less than 4 IU/mL

Note that different laboratories may have different normal range values.

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.

Everything To Know About Thyroid Peroxidase Antibodies

    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.

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Causes Of Hashimotos Thyroiditis

Doctors aren’t entirely sure why the immune system, which is supposed to defend the body from harmful viruses and bacteria, sometimes turns against the body’s healthy tissues.

Some scientists think a virus or bacterium might trigger the response, while others believe it may involve a genetic flaw. A combination of factorsâincluding heredity, sex, and ageâmay determine your likelihood of developing the disorder.

Genetic predisposition

Researchers estimate that 70%â80% of autoimmune thyroid disease susceptibility is from a family history of autoimmune disease.


Pregnancy puts metabolic stress on a woman. The thyroid undergoes noticeable modifications to cope. These changes are typically reversible after birth, though pregnancy can sometimes be a trigger for postpartum thyroiditis. Postpartum thyroiditis is a condition in which the thyroid becomes inflamed within the first year after birth. In most cases, postpartum thyroiditis is limiting to weeks or months after delivery but occasionally develops into Hashimoto’s disease.

Other hormonal events

Hashimoto’s is seven times more likely to occur in women than men. Hormonal events like puberty, pregnancy, or menopause may contribute to the development of Hashimoto’s.


It is not uncommon for someone with one autoimmune condition to have another like celiac disease, type one diabetes, rheumatoid arthritis, or lupus. This condition of have two or more autoimmune disorders is polyautoimmunity.

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A Note From Paloma Health

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.

Thyroid Peroxidase Antibodies And Thyroid Dysfunction

TPO Abs may be involved in autoimmune thyroid cell death via two mechanisms: antibody-dependent cytotoxicity involving natural killer cells and C3 complement-mediated cytotoxicity . They also influence the diversity of the pathogenic T-cell epitope repertoire. Some TPO Abs have been reported to bind to TPO and inhibit its enzymatic activity. This effect was observed in vitro and most likely does not occur in vivo due to the inability of Abs to penetrate the follicles and reach TPO on the apical pole. Furthermore, this finding was not reproduced using human monoclonal antibodies. It has recently been suggested that the effects of TPO Abs may require the involvement of FcRn, an Ig receptor expressed on thyrocytes, which is implicated in transcytosis of IgG across epithelia .

Krista M.D. La Perle, Sissy M. Jhiang, in, 2003

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Other Thyroid Antibodies Like Tpo May Be More Useful

Thyroid peroxidase antibody levels are a much stronger indicator of an increased risk for thyroid disease. TPO antibodies are 90% sensitive in detecting thyroiditis, and are effective in monitoring the progression and severity of thyroid conditions [2

Trusted SourcePubMedGo to source]. However, monitoring anti-TPO antibodies come with their own limitations.

The normal reference range for TPO antibodies is less than 35 IU/mL. But a 2016 study published in the Journal of Hormone and Metabolic Research [9

  • Those who had TPO antibodies below 500 IU/mL had a low risk of future progression to hypothyroidism.
  • Those who were above 500 IU/mL still only had a moderate risk.

The Tehran Thyroid Study, which followed the course of thyroid disease in a large cohort of people over nine years, showed similar results: those with elevated TPO antibodies only had a 9-19% chance of becoming hypothyroid after 6 years of follow up .

If we consider this, elevated thyroid antibodies are not as consequential as many thyroid experts would suggest.

Ive commonly seen people with Hashimotos disease or elevated thyroid antibodies become hyper-focused on reducing their antibody test results to the normal reference range, and becoming unnecessarily stressed. The research suggests this isnt necessary.

Grs Calculation And Statistical Analysis

Thyroid Peroxidase | TPO | Anti TPO Antibodies | Thyroid Antibodies |

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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What Is The Treatment For High Thyroid Antibodies

Hyperthyroidism due to Graves disease is caused by antibodies attacking the thyroid and turning it on . Antithyroid medication, radioactive iodine, and surgery are all effective treatments and can restore thyroid function to normal.

What are the symptoms of high TPO antibodies?


  • Enlargement of the tongue.

What does a Hashimotos flare feel like?

You may feel fatigue, gain weight, be perpetually cold, experience constipation, have fertility issues, brain fog, or have aching joints and muscles, all of which are symptoms of Hashimotos.

Why are my thyroid antibodies high?

Significantly increased concentrations most frequently indicate thyroid autoimmune diseases such as Hashimoto thyroiditis and Graves disease. In general, the presence of thyroid antibodies suggests the presence of an autoimmune thyroid disorder and the higher the level, the more likely that is.

Why is Dairy bad for Hashimotos?

More specifically, people with Hashimotos disease tend to be more sensitive to specific proteins found in dairy products. They also tend to have a higher incidence of lactose intolerance.

Can you live a normal life with Hashimotos disease?

However, even though Hashimotos disease and the hypothyroidism it causes can have widespread effects on your mind and body, it doesnt need to control your life. With good treatment, a healthy lifestyle, and a strong support system, you can still live a full and happy life even with chronic disease.

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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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.

Thyroid Peroxidase And Thyroid Peroxidase Antibody

Thyroid Peroxidase Antibody (PA5

Thyroid peroxidase is a 100-kDa poorly glycosylated membrane-bound enzyme containing a heme prosthetic group. The enzyme is expressed on the apical membrane of thyrocytes, facing the colloid, where it is responsible for catalyzing iodine oxidation, iodination of tyrosine residues and coupling of iodotyrosines to generate thyroid hormones . TPO is identical with the previously defined thyroid microsomal antigen , and measurement of TPO-Ab has replaced measurements of antibodies against the microsomal antigen .

TPO, together with Tg, is the main autoantigen in AITD. Like Tg-Ab, TPO-Ab is found in the majority of patients with autoimmune thyroid diseases, and is also commonly measurable in apparently healthy subjects without symptoms or signs of thyroid disease . However, in the population, there is a considerably stronger association between elevated serum TSH, as a sign of impending thyroid failure, and the presence of TPO-Ab, than between TSH and Tg-Ab .

Figure 60.2. Prevalence rates of elevated serum TSH at different concentrations of TPO-Ab and Tg-Ab . The prevalence of elevated TSH increased with increasing level of TPO-Ab . A less prominent but significant TPO-Ab-independent association between TSH and Tg-Ab was observed. The trend was statistically significant both in participants with Tg-Ab measured alone and in participants with TPO-Ab present , . Data from Bülow Pedersen et al. with permission.

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When Should I Get A Thyroid Antibody Test

It is not always necessary to test for thyroid antibodies to establish a diagnosis of an autoimmune disorder affecting the thyroid. Yet doctors may find thyroid antibody testing helpful in the following situations:

  • Subclinical hypothyroidism: If you have a high TSH and a normal FT4, testing for TPO antibodies may help predict whether the hypothyroidism will progress from being subclinical in which it may not cause significant or observable symptoms to more severe and permanent dysfunction.
  • Goiter: This is the abnormal enlargement of the thyroid gland. Some experts recommend testing for TPOAb if you have a goiter, even if your thyroid hormone levels are normal.
  • Hyperthyroidism, if the cause is not obvious: If you have an overactive thyroid, sometimes it is clear from your physical examination and thyroid hormone tests that you have Graves disease. In less obvious cases, TRAb testing or imaging tests, such as ultrasound or radionuclide thyroid scan, may help diagnose or rule out Graves disease.
  • Monitoring after thyroid cancer treatment: If you are monitored with thyroglobulin testing after treatment, you may also have your TgAb levels tested, as they can interfere with some thyroglobulin tests.

Although thyroglobulin antibodies may be elevated in both Hashimotos thyroiditisand Graves disease, it is not typically tested during diagnosis.

Common symptoms for Hashimotos thyroiditis:

Common symptoms for Graves disease:

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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What Does It Mean When Thyroid Peroxidase Antibodies Are High

The presence of TPO antibodies in your blood suggests that the cause of thyroid disease is an autoimmune disorder, such as Hashimotos disease or Graves disease. In autoimmune disorders, your immune system makes antibodies that mistakenly attack normal tissue.

What is considered high for thyroid antibodies?

Normal values are as follows: TPO antibody: The measured serum level should be less than 9 IU/mL. Anti-Tg antibody: The measured serum level should be less than 4 IU/mL. Thyroid-stimulating immunoglobulin antibody : This value should be less than 1.75 IU/L.

How can I lower my thyroid peroxidase antibody?

Beneficial supplements include: Selenium. Studies show that taking 200 mcg of selenium per day may help reduce antithyroid peroxidase antibodies and improve well-being in people with Hashimotos disease . Zinc.

What Are Thyroid Antibodies

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

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 .

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Can I Take The Test At Home

Test kits allow you to test for certain thyroid antibodies at home. These kits provide the supplies needed for obtaining a blood sample and returning it to the company for analysis.

Some kits include one or more thyroid antibody tests as part of a panel of thyroid tests, while others test only for TPOAb or TgAb. At-home tests for TRAb may not be commercially available at this time.

Thyroid antibody tests are difficult to interpret and may be unnecessary if other thyroid tests are normal. If an abnormal level of thyroid antibodies is detected on an at-home thyroid test, an endocrinologist will likely want the test to be repeated.

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