Can TSH be in range but be positive for TPO ant... - Thyroid UK

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Can TSH be in range but be positive for TPO antibodies?


Following advice from my first Endo appointment where I've been diagnosed with Hashimoto's, the consultant suggested as there's a genetic link, that any sisters should be tested too. My 3 sisters have been tested. 2 were only sent for TSH readings. They rang for results today. One has 3.5 and the other didn't get a reading but was told is fine. The 3rd sister has been tested for TSH, T4 and TPO. Her results are due next week. My question is, for the 2 that had TSH only and the 3.5 and ok readings, are they clear for TPO by those results, or do they need the T4 and TPO too, due to my diagnosis?

8 Replies

Gill-56, antibodies can be elevated months/years before TSH rises and patients become hypothyroid. TPOab needs to be tested to confirm or rule out autoimmune thyroid disease (Hashimoto's). Normal thyroid results don't rule out Hashimoto's. I had TPOab 230 with TSH 1.7, FT4 14.4 and FT3 4.8 which are unequivocally euthyroid.

The sister who was told her results were fine should ask for the result. 'Fine' is an opinion and usually means result is within range but doesn't indicate whether it is low or high in range. TSH 3.5 means your sister's thyroid is struggling but she won't get a diagnosis and treatment until TSH is over range.

TSH is a pituitary hormone which rises in response to low thyroid hormones T4 and T3. Many GPs won't test FT4 and TPOab until TSH is abnormal (over range).


I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

I was diagnosed with Hashimotos in 2005. All the TFT's were in range and Anti-bodies well over range. I was treated with 25mcg of T4 increasing slowly - having been told by my Doc here in Crete that my thyroid needed support whilst under attack.

Wishing you and your sisters well - and stick to your guns :-)

in reply to Marz

I love your comments it's very educational! Some of the posts I was reading in the forum fas saying that coffee consumption bad it is messing up the adrenals . I did not get its coffe itself or coffein in general?? I can't leave without coffe. Again I have dilemma . If you know anything ,please educate me.

Thank you for your time.

in reply to Esya47

I have read for and against ! I do believe there are good ingredients in coffee that are beneficial ! I think like most things - everything in moderation. I really enjoy my one strong coffee a day - sitting outside in the sun - after eating breakfast !

Coffee can be acidic so best not to drink on an empty stomach :-)

Betty Dowdell - is hilarious - her website is Too Pooped to Participate I think ! She wrote about coffee being good. I have her Newsletters and they are very amusing too !

in reply to Esya47

Definitely give up coffee and any caffeine. If your body 'needs' something that bad it's defo bad for you. Even if I drink one coffee it sends me into massive hyper! 😞

Thank you for respond! I really want to know how coffe can mess up the adrenals???

What mechanism? Really, I don't know anymore what studies to trust... It's many studies was done in the pass about holesterol is bad , salt is bad... Cabbage is good, Cale is good. Now I now that all this BS! I am biochemist by my profession. And I know that we need cholesterol due to our sell walls consist of this substance, and 94% of holesterol produced by our liver so only 6% we get consuming food, salt we need also

Cabbage and ,Cale now proved to be suppressing thyroid production,20 yrs ago tomatoes was not recommended by doctors,now every doctor recommends tomatoes

Because of benefits of licopene in tomatoes!

I gave up coffe for couple of weeks and

I feel terrible . I had only in the morning 1 cap a day.

Any doctor who is doing their job properly would test all of you for anti TPO, surely. 3.5, although within the reference range, is a bit high and I wouldn't be surprised if your sister was positive for antibodies. Also, if you can, ask for thyroglobulin to be tested as well, as it is high in over 80% of hashi patients. My tsh has varied from 2 to over 5 and my tpo is 237.

Thanks ada11. I've not replied here for a while as was hoping for some more info from sisters results. The sister who was tested for TSH, T4 and TPO rang for results and was told by the receptionist that her TST's (whatever they are!) are normal. I asked her to get them to elaborate and give her readings because she needs to know that her TPO was normal. How frustrating!

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