Thyroid UK
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Why would Antibodies rise on levothyroxine?

Sorry if you've already seen this. I'm struggling to get to grips with this forum.

I can't work out why my antibodies have shot up. I've been on 175 thyroxine for a couple of months.

These were my original results before taking any thyroxine MY LEVELS RANGES Total thyroxine (T4) 105nmol / L 59-154 TSH6.77 Miu / L 0.27 – 4.2 Free Thyroxine14.8 pmol / l 12 – 22 Free T34.1 pmol /L3.1 – 6.8 Thyroglobulin antibodies 188.1 IU/Ml0-115(negative) Method used for Anti –tg: Rouche Modular Thyroid Peroxidase Antibodies 373.9 IU/mL0-34 Method used for Anti –tpo: Rouche Modular Thyroid Microsomal AB: (conf) Positive – Titre of 1 in 102,400

 Most recent test by gpTsh - 0.01 t4-24.7 (range 9-19.1) t3- 5.56 (range 3.6-6.5) antibodies shot up from 394 to 1000It doesn't look how id have expected it too? Im on 175 thyroxine. You guys are much cleverer than me. Also I was feeling great but I've hit a bit of a wall again the last month or so. I was diagnosed with fibromyalgia originally.

10 Replies

This is highly speculative - but hypothyroidism and/or high cortisol mess with gut function - and the resulting inflammation might heighten any auto immune response. (not sure if it can do so so quickly)

Stress can make us less able to use the hormone/convert T3. Is the second T3 number free or total T3? Could your free T3 be down a bit, or is more reverse T3 possible?

There may be the possibility of some sort of short term reaction to the T4 too (there are scenarios where hormone delivers benefit initially, but then fades - can't remember the details), but somebody else may be able to answer that one...



Hi there!

There’s a lot of confusion around this… Autoimmune thyroiditis or Hashimoto is an autoimmune condition which results in a damaged thyroid gland incapable of producing thyroid hormones at a level that the body needs them (or in fact at all if it gets to the point that it shuts down completely). The standard medical treatment for this involves taking thyroid hormones in the form of medication (whether it be T4 or T3 or combination, synthetic or natural desiccated). This medication is necessary and helpful in that it helps us cope with the fact that our body is not producing the hormones we need. But it does absolutely nothing to address the root cause of the problem, which is the autoimmune attack on the thyroid gland, ie, the presence of thyroid antibodies. Think of it as a hearing aid: it does nothing to address the fact that one’s hearing is deteriorating, but it is helpful to “function” a bit better in that situation. Or a walking stick: again it does nothing to improve the sight of whoever is carrying it, but it helps them get around. Sadly doctors don’t tend to explain this.

It is completely normal and to be expected that your thyroid antibodies would continue to rise on levothyroxine or any other kind of thyroid medication, as this medication does not address the autoimmune condition at all.

This doctor explains it well:

I was diagnosed with hashimoto over a year ago with high antibody levels and have done a lot of my own reading on the subject.

The immune system resides in the gut, so that is the place to start. I have managed to reduce my antibody levels substantially, through very strict dietary modifications. My last antibody test came back with negative results on all antibodies tested, which was very good news. Going 100% gluten free is key (a little bit gluten free does not work, it has to be strict). It is not easy to do… I have also had to eliminate other foods I am allergic too and had no idea (things like onions, black pepper, blueberries) None of these things have ever given me digestive symptoms… so I had no way of telling I’m allergic to them until I was tested. I have been concentrating on healing my digestive system with probiotics, prebiotics and digestive enzymes…

There are quite a lot of good resources out there. I have found the following helpful:

“Why Do I Still Have Thyroid Symptoms? When My Lab Tests Are Normal: A revolutionary breakthrough in understanding Hashimoto's disease and hypothyroidism” (Dhatis Kharrazian)

“Hashimoto's Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause” (Izabella Wentz) and the author’s web page

Web page such as

All the very best!

1 like

Hello - thank you so much for this, I think this is a few months old. I hope your health is on the up-up.

Have a question for you with regard to your diet, where did you get your food testing done? and what were the tests called. (I have head bowel issues for last couple of yrs brought on by mis diag, giving pump inhibitors i didn't need) now rise in anti TPO. I just have to get my health back. 3 years down the line.

I now have fruct map - so gluten free but now keen to rule anything else out. Also considering a leaky gut test if there is one.

Bye for now, I would really appreciate you replying as I can tell you are well informed and have been on the same journey as me sadly.


Could something like overdosing of levothyroxine speed the process up? I think I need to look at t3 as well. X


I am not a doctor, but based on all the many books I've read on the subject I'd say no, whatever amount of levothyrocine you are taking has no connection whatsoever with your thyroid antibody levels and does not influence them one way or another.

It is really important to address the autoimmune process per se as, once it has begun, it's not necessarily going to limit itself to attacking the thyroid gland... Sadly those of us who suffer from an autoimmune condition are more likely to develop others if we don't focus on stopping the chronic friendly fire that is going on inside us. It is just the way it is. Unfortunately traditional doctors don't normally explain this, they just prescribe levothyroxine and leave patients to it. It's not right...

Rethinking one's diet and accepting restrictions is not easy, but it pays off in the long run.

All the best!


I think Chiquitita has hit the nail on the head. The immune system will continue to attack until something is done to stop it. If this type of diet change works it's very much worth trying it too. A lot of our health issues come about from the foods we consume. I thought I had irritable bowel syndrome for many years and was also suffering from adult acne, until I discovered I was reacting to cows milk, which was causing severe inflammation. I stopped drinking the stuff and within a week my acne cleared and the pain in my bowel went. I also believe this was what may have caused the massive amounts of antibodies on my thyroid at the time, although have never gone back and asked for another test, mainly because I think I would know what the result would be. I've not had thyroid symptoms since to need to discuss this with my doctor.

It's very much worth trying!! Medication isn't always the answer. Medication, in my view, is often required for the side-effects of either other medication or the foods we put into our bodies.


I agree with what I've been learning from a functional medicine doctor who says Hashimoto is an auto immune disorder that needs to be treated.

Even Stop The Thyroid Now website says that antibodies may rise with treatment of thyroid hormone:

AVOIDING NDT BECAUSE YOU HAVE HASHIMOTO’S Sadly, some doctors will state that those with Hashimoto’s should avoid NDT because it can increase the attack. It’s true that at first, antibodies raise, say patients. But the higher they raise, the lower antibodies become, as reported by many, probably due to a better immune system due to the T3! A large body of Hashi’s patients need to avoid gluten to get those antibodies down. Others use 200 – 400 mcg selenium to lower antibodies, while more difficult cases may need Low Dose Naltrexone. Many even report that their iodine use lowered their antibodies.Overall, Hashi’s patients have soared with NDT if they do it right,


I've been gluten free before and I think im very limited in the gluten I intake now as I follow the slimming world plan (make everything from scratch no bread etc) if hashimotos can mean you get other autoimmune disorders is it possible there is also something else going on? What sort of autoimmune disorders. Ive been ill for four years now and told I have fibromyalgia but I don't think I believe it as wasn't properly examined when given this label. My symptoms are muscle pain fatigue headache and parathesias (constant restless leg sensation but all over my body) sorry for all the questions. Im just learning X


Also wondering whether to push NDT with Dr S. He wasn't keen as felt I could get well on levo (being only 27 I think he felt it was better if I could get something free and not difficult to obtain) although my gp still refuses to prescribe levo x


I have found that on T4 alone or high levels of T4 with T3 cause my thyroid antibodies to rise drastically. I had a doctor put me on T3 only for several months and my Thyroid antibodies came down drastically. Recently a new doctor had me on a higher ratio of T4 to T3 and my antibodies remained high even though I maintained a gluten free diet. At my suggestion of lowering the T4 dosage to see its affect my antibodies decreased by 50%. I don't why but I know that T4 does increase my antibodies for sure.


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