What are considered raised TPO's?

[Lozzie611]

Hi Everyone, this is my first post but somehow I don't think it will be my last! My bloods are all in the 'normal' range and my TPOabs were < 33.4 kU/L .My doctor tells me this isn't high enough to cause me a problem but my throat is swollen and I feel a lump when I swallow and I now have a nodule on the swelling plus all the usual symptoms of hypothyroidism. I was low on Vit D, Potassium and iron and have been taking a Vit D supplement but still feel pretty awful. So if anyone can tell me whether the antibodies are at a normal circulating level of if they're higher than normal I'd be grateful - thanks!

[Heloise]

Hi Lozzie, I'll post a short video about TPO antibodies which will help you understand. Lymphocytes in autoimmunity can attack other parts of the thyroid system. They can accumulate. I'll add that Functional Medicine doctors try to find out exactly what is happening to cause symptoms.

youtube.com/watch?v=3_uaUXi...(Not working as expected?)

[Clutter]

Welcome to the forum, Lozzie611.

<33.4 means your antibodies are less than 33.4 which would be positive for autoimmune thyroid disease (Hashimoto's). It may be the nodule which you are feeling when you swallow. Has your GP palpated it or ordered an ultrasound scan?

Normal is a broad range. What are your thyroid results and ranges (the figures in brackets after results)?

[Lozzie611 in reply to Clutter]

Hi Clutter, thanks for your reply. My results are as follows;

T4 13 pmol/ll (10-22)

TSH 2.4miu/l (0.3-5.5)

T3 4.3 pmol/l (3.1-6.8)

TPOabs <33.4 kU/L (please note equivocal range for TPOabs=60-100 iu/ml) (I'm not sure what that last bit means!)

These are the only results I have in detail.

I'm waiting for an appointment for an ultrasound which may throw some light on what the problem is!

[Clutter in reply to Lozzie611]

Lozzie, 'equivocal range for TPOabs=60-100 iu/ml' means autoimmune disease (Hashimoto's) is possible. >100 would be confirmation.

TSH >2 indicates thyroid is beginning to struggle. Your FT4 is low in range but FT3 is currently not bad. NHS won't diagnose hypothyroidism until TSH is >5.5 or FT4 <10. You can support your thyroid by eating 3-5 Brazil nuts daily, supplementing 200mcg selenium or supplementing an over the counter thyroid support like NutriThyroid.

Nodules rarely impact on thyroid function but should be examined as suspicious looking nodules will require further examination. Although your thyroid antibodies are negative it is possible to have Hashimoto's nonetheless and the scan will show whether there is typical Hashimoto's damage.

Ask your GP to test ferritin, vitamin D, B12 and folate. Low/deficient levels can cause musculoskeletal pain, fatigue, breathlessness and low mood similar to hypothyroid symptoms.

[Lozzie611 in reply to Clutter]

Thanks Clutter, I was deficient in Vit D. Potassium and Iron and was given a large dose of Vit D to take for a month and a maintenance dose after that.I was very breathless but not now so that's an improvement. The rest of the symptoms including the fatigue are sadly still with me. I have now got an appointment for an ultrasound on Dec 1st so we'll see what that reveals. My GP didn't palate the nodule, just re referred me to the Endo for another ultrasound. At the time I last saw him my throat was only slightly swollen with no nodules so nothing showed up on the scan. In the three months since then it is more swollen, firmer and with the nodule so I'm hopeful they'll see something this time. As my T4 was 13 the Endo didn't order an antibody test but remarked that the patch of Vitiligo immediately over my thyroid gland was a classic sign of autoimmune disease, so I asked my GP to do one, which he did do with the <33.4 result. The mystery continues!

[Clutter in reply to Lozzie611]

Lozzie, Nodules aren't generally palpable until they're >1cm but smaller nodules usually show up on ultrasound scans. There doesn't seem to be consensus on whether vitiligo is an autoimmune disease itself or whether it is a symptom of other autoimmune disease.

[crimple]

Hi Lozzie when I was first diagnosed with hypo and given levothyroxine, my TPO reading was 15 (the range was 0-60) meaning anything under 60 was classed as not having sufficient antibodies to cause Hashimoto's disease. However with your reading being right in the middle of the range and your TSH also, there is definitley something going on and as Clutter suggests you need to support your thyroid. Taking brazil nuts or selenium supplemenst (I have done both) does help and also making sure that your VIT D, B12, ferritin, folate and Iron levels are all high in their ranges will also help.

After 5 years on levo and being OK I started to go "off the boil" again and then feeling really unwell. I asked for TPO test and the result cam back 120 (range 0-60) so that was a positive diagnosis for Hashimoto's. Both the GP and local endo said no treatment required, but I wasn't happy with that. I did my own research and went gluten and then lacto free. After a year my TPO was back down to 10 (range 0-60) and I felt a lot better. Do hope that things improve for you.

[Lozzie611 in reply to crimple]

Hi Crimple, thanks so much for your reply, how did you persuade the Doctor to give you levothyroxine, was your T4 below 10? Why are they not treating you now, are your bloods back in the normal range or did they just not want to increase the levothyroxine?

I was wondering if by taking selenium and Brazil nuts and therefore helping my thyroid would that delay actually getting a diagnosis and therefore levothyroxine if I need it? Or will it just make me feel better whilst not changing the blood results.Im still hopeful that the ultrasound appointment may indicate Hashimotos and prompt them to treat me (I can dream!).

Interestingly my identical twin who lives in Australia, visited her Endo and without even seeing the blood results said he would try her on a mixture of T3 and T4 to see if she felt any better, such a different experience!

Thanks so much for the advice, I need all the help I can get!

[crimple in reply to Lozzie611]

Lozzie I have dealt with different GP practices and there is a difference!! When first diagnosed hypo my TSH was about 5.8, not that high and I think the range then was up to 10, but the GP was a bit more of the old school, he listened to my symptoms and also noted that there is a strong family history of hypo, so I was put on 25mcg levo. This was gradually increased until I was on 125mcg. As the GP said my thyroid was obviously failing and therefore levo had to be increased to keep up with the "failure" I was OK (not 100%) for about 3/4 years and then started having problems again.

With hindsight I put that down to being on Teva levo which had its licence removed by MHRA after they found that the pills were not giving the correct dose of levo (less than 100mcg)!!!

I then moved house and had to join another surgery-less enlightened and the next 2 years were a roller coaster with dosage up and down. I think I was already suffering with antibodies then. Luckily I joined this site and learned soooo much!! That's why I decided to ask for a TPO test.

I have read a number of very informative books and together with advice from here I am now fairly happy that I have my treatment sorted. I will be moving again soon and will need to join a different practice so will see how I get on there. At least I can arrange my own private blood tests and interpret them and by keeping to GF and lacto free diet things are much better.

My local hospital lab, same for both GP practices never test anything other than TSH "which is the gold standard" according to the local Endo. They did test my T4 only once when mt TSH was 0.03. I just use Blue Horizon tests to monitor my thyroid and also B12 etc.

the attitude of most Endos seems to be you do not need to treat antibodies. What they mean is they don't know how the hell they will treat it! My current Gp knows I am on GF diet and I told him that was how I reduced my TPO, he seemed interested but whether he would apply that knowledge to any one else in a similar situation, who knows?!

It si clear to me from toher posts from folks abroad, that NHS has a lot to learn about thyroid issues!

Hope things soon improve for you

[Lozzie611 in reply to crimple]

Thanks Crimple I hope you lick the new GP into shape in short order!

[crimple in reply to Lozzie611]

I will do my very best, at least this time round I am much better informed.

Remember, the numbers (from thyroid tests) are useful but at the end of the day it is about how you feel. My TPO level was not that high compared to many on here, but I really would not want to get back to that level as I really felt awful.

I have even plotted my test results on a graph, that was very interesting and showed the roller coaster ride that antibodies bring!!

[HypoHim]

As a comparison, when I was diagnosed my anti-TPO antibodies were over 1500.

[Lozzie611 in reply to HypoHim]

Gawd! I've got a way to go then, You must have felt dreadful! I hope you're feeling much better now.