Thyroid UK
82,824 members97,853 posts

Elevated TPO


I have elevated TPO= 49, range 0-9. thyroglobulin antibody= 3.9 My TSH=2.210 and FT4= 1.15 seem to be normal. I'm wondering what this means? My calcium was 10.3 and wbc= 3.52 rbc= 4.18- my wbc has been dropping since 2012, in 2005 it was 5.

I have type 1 diabetes diagnosed about 3 years ago. I have all the thyroid symptoms:brain fog, palpitations, shortness of breath, irritability, sweating, hunger, fatigue, hair shedding, itching and more. I was diagnosed 3.3 years ago with type 1 diabetes while in dka. I had complications including blood clots. Since being on insulin I feel ill a lot of the time with these symptoms and I recently started having moderate vertigo starting January. It started out when I went on an insulin pump and after with treating a low bg right before that. An hour after treating a mild low I was suddenly violently dizzy while I was reading- I drank a ton of oj thinking my bg was low again but my bg was normal 2 minutes afterwards. Fortunately the vertigo has improved quite a bit- it still gets worse in the shower and when my bg fluctuates. I had testing done to rule out and nothing was resolved except it may have been a vestibular migraine syndrome. I've had chronic migraines on and off for years.

My grandfather had Graves disease which I was told was why I developed type 1. I also went into early menopause around the time some of these symptoms started. I have seen two cardiologists, the last one thinks my palpitations are an endocrine issue.

Does this level of TPO mean I could be developing Graves Disease or Hashimotos? I would like to do something to prevent this if possible. My gp is testing me for parathyroid hormone, ionized calcium, vitamin d 25. I'm not sure what other tests I may need other than T3.

I'm so sick of all of this and feeling lousy a lot of the time.

Thanks for your input.

17 Replies

Welcome to the forum, 000ggg.

Elevated TPOab means you have autoimmune thyroid disease (Hashimoto's) which will eventually destroy your thyroid gland and make you hypothyroid. 100% gluten-free diet helps many people manage Hashimoto's and reduce antibodies and may delay progression.

TSH 2.2 is slightly elevated within normal range and indicates your thyroid is beginning to struggle to produce T4 hormone. Unfortunately, symptoms can precede abnormal bloods by months/years but NHS does not diagnose until TSH is over range or FT4 &/or FT3 below range. Do you have the lab ref range for FT4 1.15 (the figures in brackets after the result)? It isn't possible to determine whether 1.15 is good or bad without the range. Supplementing 3-5 Brazil nuts daily or 200mcg selenium will help support your thyroid.

In addition to the other tests your GP is doing ask for ferritin, B12 and folate. Low/deficient levels are common in thyroid patients and optimising levels can really improve wellbeing. Ask for printouts of all blood tests with the lab ref ranges and post them in a new question for comment and advice.


Thanks Clutter,

The range for Free Thyroxine: FT4 was .93- 1.7 ng/dl.

I will ask about those tests, maybe she can add them on or give me another rx- I haven't had the other tests done yet. I have blood work done with my endo 3x per year at least, but he has been difficult about doing thyroid testing(although he did do the antibody testing last time when I asked) and seems to think my palpitations are anxiety/ psychological which I know is a bunch of rubbish. Some of the numerous doctors I saw before my type 1 diagnosis thought that too I'm sure and then I ended up nearly dead in the hospital with serious complications even with obvious diabetes symptoms and screaming lab work & symptoms which showed I was already in dka. I just don't want another disaster because who knows if I will even survive another one.

I'm in the US but as I said my endo I feel isn't really taking this seriously yet anyway which I'm not happy about. I don't understand why most doctors seem to have no interest in trying to prevent something from happening. On top of that he was nasty to me at my last visit so I may eventually change docs. I plan to go in to nyc for another opinion on what is going on and if it is Hashimotos etc.

I supplement 4000 mcg methylcobalamin since May and I was taking cyanacobalmin before that as well as 1-2000 mcg folic acid for neuropathy pain so I don't know if these tests will be accurate for what my true levels are. I noticed I do feel a little more energy since starting the methylcobalamin and the higher dose. I will add some selenium in too.

I always get printouts of everything and read them myself now and I did it a lot in the past too.

I started doing gluten free at some point after the type 1 diagnosis due to always having had symptoms with wheat, however I have ibs and it was never really clear until then that maybe that was affecting all my ibs symptoms. I don't follow a strict gluten free diet though so I may be getting some. I have gluten free soy sauce and I don't eat grains/wheat for the most part but I do cheat rarely and have some bread, usually with a high bg result and some mild gas stomach upset etc. I just hope I don't have to give up my Green & Black chocolate because that is literally the only time I feel happy anymore, that with my green tea, lol. I'm not sure if it's gluten free or not. I also eat a low carb high fat diet to help manage BG. I just read that the GB toffee flavor which I love is the only gluten free one, however it says that it is made with glucose made from wheat? I'm not sure how this could be gluten free. I was using some gluten free whole psyllium husks as fiber for bread a while back and had bad stomach cramps from them so I stopped using them and give them to my cats with constipation- they seem ok with them.

Btw, I contacted an expert at a UK thyroid site and he said I'm at risk for Hashimotos and Graves, but the antibody as you said suggests Hashimotos, however he feels I don't have it yet and my symptoms are not caused by my thyroid blood panel. I'm not sure what to think because everyone seems to have a differing opinion.

Here are my lipid results in case this will help:

ldl direct= 132

triglycerides= 32

cholesterol = 247

hdl = 103

ldl= 138

vldl = 6

I have had advanced lipid testing which shows I'm not at risk for cvd but due to the diabetes I tried provastatin for a week- I have chronic pain and fybromyalgia and I had an immediate reaction- I had to take a pain killer everyday so I stopped it. I also had severe headache and felt very dopey.

I will post more results when I get my tests done.


000ggg, Your FT4 is low, just over 25% through range which confirms your thyroid is struggling. I don't understand why doctors don't prescribe thyroxine until symptoms are crippling and bloods abnormal. It's not like your thyroid is going to improve when you have Hashimoto's. Another thing doctors won't acknowledge is that Hashi's does cause symptoms even when bloods are euthyroid. I had very bad palpitations which you could see pulsing away through a sweatshirt. Doctors were insistent all symptoms were non-thyroidal because bloods were normal. All improved after thyroidectomy and starting Liothyronine (T3) though.

Unfortunately, just as you can't be a little bit pregnant, nor can you be a little bit gluten-free. If it's to work it needs to be 100% gluten-free. It sounds as though you have some sensitivity at least to gluten. Not sure whether chocolate has gluten, doubt it somehow, but green tea won't for sure :-D

To get a B12 and folate baseline result you'd have to stop supplementing for 4 months while red blood cells die off and renew. B12 should be high when supplementing but you can't OD on B12 so it's nothing to worry about. B12 levels decrease with age so it's reasonable to assume they'll be lower than before you supplemented.


Thanks Clutter,

I will start looking for an endo who specializes in thyroid and who will help me figure this out hopefully. My symptoms are bad enough as it is. I would be scared to do any surgery so if this is the case, I have Hashimotos, hopefully meds will help. I'm glad you got relief with surgery and T3, that is great!

I'm still kind of wondering if these symptoms could be something else like parathyroid or from the diabetes and insulin but the antibodies suggest otherwise, I had gad antibodies also for type 1 and had symptoms on and off for years with extreme symptoms in the last 3-4 years.

I think the chocolate is ok :-) I have another I eat with is stamped gluten free but G&B is my fav. Almost everything I eat is gluten free it's just hard sometimes if you eat out etc and my family isn't gluten free.

I will discuss what to do for the vitamin testing with my gp if I can. I think my last vitamin d was normal, I will have to look to see what it was. But I have been supplementing that too for quite a while with calcium. I lowered it recently because I had added in an only vitamin D after the type 1 diagnosis which I've stopped now, but the calcium still has some and I take fish oil and flax seed oil.


000ggg, I didn't mean to imply that surgery is an option for Hashimoto's, it isn't, Hashimoto's eventually destroys the thyoid but it can take years.

Thyroid symptoms can overlap with a lot of illnesses so it is necessary to make sure your diabetes and any other illnesses are optimally treated. A vitD, calcium and parathyroid hormone test will indicate whether there is parathyroid dysfunction.

1 like

Why did you have yours removed? I'm glad to hear pills will be enough if I need treatment. Someone at another site had hyper and then hypo thyroid and treats hers, but she didn't have thyroid antibodies- she has type1 antibodies. She also thinks my TF4 is not optimal and I will feel better on meds. I see what you mean now that it's at the low end of normal just about. Now I have to find a doctor who won't dismiss my symptoms and who will help me figure this out.

Has anyone here ever tried digestacure? I'm wondering if this may help prevent it or slow it down since it seems to have helped a lot of people with crohn's and thyroid issues.

I do the best I can with the diabetes and keep my bg in a good range but it's very difficult and exhausting.


000ggg, I had a large nodule which was compressing my trachea removed. It was found to be malignaant so I had completion surgery 3 months later.

I've not heard of digestacure but people do use enzymes, Betaine Pepsin and raw apple cider vinegar to aid digestion.


Hi Clutter, I'm so sorry about that- I'm glad they caught that in time. I'm going research BP. I often have raw apple cider vinegar in my salad dressing although I haven't had it lately. I will try adding some into my water. Just google Digestacure and let me know what you think. It's very expensive but I guess I could try a bottle and see if it helps me at all.


000ggg, add the ACV to orange juice or honey sweetened water. It's vile otherwise.

Why not try ACV or Betaine Pepsin for a while to see if they improve your digestion. If they don't help you can always try the Digestacure later.


Thanks, I only drink juice etc. for lows because it spikes my bg rapidly and I would have to take insulin for it- I have added it to water with olive oil and it's fine for me, lol. If I drink it plain with water or even the oil it can irritate my reflux which is bad.

Digestacure isn't specifically for digestion although it can help people with crohns and other gastrointestinal issues- it is supposed to help fight the autoimmune attack. I have IBS too so who knows it may help that. One thing I don't have is weight gain, which seems to be typical of hashimotos.. I have gained back the weight loss from dka but I'm thin overall. I do have fat pads under my arms and chin now- I read somewhere the other day that is also a symptom of thyroid issues.


hi, sorry didn't reply, thought your username meant it was a scam or spam! I had to get it checked out, so sorry, think paranoia follows me everywhere! :-) too much going on with my health at present. glad clutter helped you out!


Hi Sambs, I'm sorry you have so much going on. No my user name isn't a scam, nor am I. I still haven't done my testing. I'm now dealing with other things, my father fell and has multiple rib fractures. I will post more later when I get my testing done. I will be seeing my endo in October so I will also ask him about all of this and t3 testing, for some reason my gp didn't add that on to the other tests, I have to call her.


Hello 000ggg,

Gosh....sorry to hear about your father..

I have been reading your posts and replies and wanted to add:

Low thyroid hormone can put a strain on the adrenal glands which secrete cortisol.

Normally the body responds to low blood sugar by producing cortisol to increase blood sugar levels but if cortisol is already disrupted, adrenaline will be used instead...hence we get shakey and light headed when hungry.. Good blood sugar levels are achieved with low GI foods and regular meals.

Low thyroid hormones interfere with the secretion of stomach acid causing IBS, malabsorption and gut dybolsis. The Betaine with Pepsin as suggested by Clutter is excellent and has been extremely beneficial in helping with my gut issues. I also take digestive enzymes with every meal.

It is imperative to be totally gluten free if you have positive thyroid antibodies and are experiencing an immune response.I am gluten free and also supplement therapeutic doses of Curcumin which has reduced inflammation in my body.

This link below explains the importance of vitamins and where they may be obtained.

Eating soy is controversial in Hashimoto sufferers.

This link gives advice on a healthy duet for Hashimoto sufferers

I hope you feel better soon



Thanks Flower!

I'm so worried about him. He seems a bit better today.

Managing bg when you're on insulin and when your body doesn't produce insulin is very different than when you don't have those issues. Lows are very dangerous and I have to use my diet to help everything. It's all about managing the bg as best as possible. I eat a low carb high fat diet and I've already eliminated tons of foods, for me I eventually had to add more carbs in because I was having too many lows and I felt like I was starving.

I personally don't believe in "leaky gut" and I doubt I would be able to follow that diet, there seem to be several different versions of it, for any length of time and manage my bg well, if at all. I am gluten free now as I said but not in the strict sense of how someone with celiac might be- because my family eats wheat and bread etc. and I use the same dishes, I do very rarely eat some bread and when you eat out, rare for me, you never know for sure what is in the food, even when you ask unless you tell them you have a life threatening food allergy. There are many things in a gluten free diet also, which I would never eat, they're way too high carb for me.

I also don't believe any more for various reasons that diet is everything or that it "cures". I was eating a vegetarian and then a vegan diet for 2 years before I went into dka and it was making me even worse.

I have too much stomach acid and have had pretty bad gerds for a long time now. I'm going to look into those supplements and try them out. A lot of supplements and most probiotics make me worse. I also have to be careful that they don't cause lows when combined with insulin too. I have stopped calcium, vitamin d & b12 for now until I get my levels tested. I'm unable to take vitamin c except for in veggies/fruits and same for b6, it irritates me.

Thanks for all this information :-)


On poor you. This all sounds a nightmare.

My husband has been an insulin dependant diabetic for over 50 years. He is extremely well and fit and has not seen any of the usual detioriation in eyes, kidneys, extremities that diabetics usually suffer.

We eat mainly gluten free ( me totally) and follow a Hashi diet but with probably more protein. Protein is slow digesting and keeps blood sugars level. If you have grapes, have cheese or nuts to prevent sugar spikes and lows, if you have berries, have them with plain yogurt, etc, etc.

A good read is Protein Power by Dr Michael Reades. It is a really old book but explains all the principles of preventing sugar spikes.

I still encourage you to support adrenals to prevent unbalanced cortisol levels which as explained above will cause blood glucose inbalance.

Good luck OOOggg & hope your Dad gets better.



Thanks Flower,

It is a nightmare, truly, I would do anything to go back to just having ibs and chronic pain etc. Anything! Your husband is very lucky. Some people seem to stay more stable and have an easier time. I've already had serious compications(dvt) and damage to my vision in dka and I have mild neuropathy and some digestive issues which could be gastroparesis. I agree in my case the thyroid issues could be affecting some of this and I'm hoping to get cortisol levels tested too. I had hypoglycemia years before the D started coming out I think, that was the beginning.

I do always eat protein and fat with carbs, I have always done that long before D too because I knew that was the best thing to do for your system/body and it helped manage my hypoglycemia- I usually ate several small meals, but now due to managing my basal and mealtime insulin and the way my bg can swing rapidly I had to change that. I usually have to leave 4-5 hours between meals so as not to stack insulin. Fortunately on a pump I can shut the insulin off when needed.

I read about hcl betaine pepsin again, I had investigated that years ago when my reflux got really bad, and unfortunately I'm not going to be able to do that due to my gerds and also having chronic pain from injuries which I need to take anti- inflammatory drugs for on and off. I will look into adrenal issues/support, and check out this book too. Too much protein can also cause a bg spike several hours after so I try to eat smaller portions now.

I think he is a little better now although he told me today he hadn't taken a pain killer for 5 days now and he felt much better taking one today. I'm not sure how he could stand that pain but the narcotic drugs are very constipating so he's trying to avoid that.


You have many health complications OOOggg but I wish you well on your journey.



You may also like...