TPO ab 1300, fluctuating TSH

TPO ab 1300, fluctuating TSH


I'm recently diagnosed with hypothyroidism. Dr wanted me to start levothyroxine 25mg and do further tests. We decided to wait for next results before starting (me being a bit floored by it and hoping it would go away!)

First results were

TSH 5.98

Free T4 10.7

Next results two weeks later

TSH 3.44 so in range

No T4 back yet

TPO ab 1300

Why would my TSH now be normal and I know my TPO is out of range (0-60) but is it quite significant? What does it mean? Can I reduce it?

My Dr app is Tuesday so I'd like to get prepped for questions to ask.

She's pretty switched on, felt my thyroid and said very enlarged. Mentioned referral to endo for scan and possible biopsy which is a bit scary.

Any advice?

13 Replies

  • Welcome to our forum misslissa

    If you have thyroid antibodies it means you have an Autoimmune Thyroid Disease called Hashimoto's. It is the commonest thyroid hormone disease. I shall give you some links for info. What recommends as does Dr Toft of the BTA, if antobodies are present to begin levothyroxine to 'nip things' in the bud Dr T. says.

    The TSH is variable throughout the 24 hours. Higher early a.m. dropping throughout the day. The Thyroid Stimulating Hormone is from the Pituitary Gland.

    Two helpful sites as well:

    When you get blood tests for thyroid hormones, it should be the earliest possible and don't eat before but you can drink water. If on hormones allow 24 hours between last dose and test. Always get a print-out of the results with the ranges.

  • Thank you, I'll make sure I get tested at the earliest time in future.

    Would you know if it makes a difference where you are in your menstrual cycle too?

  • I don't think there's any affect due to menstrual cycle.

  • That's good, just wanted to check

  • As well as the post by shaws above explaining about the circadian rhythm of TSH throughout the day etc, your high TPO antibodies will have a big impact on your TSH as well, and your thyroid hormone levels will fluctuate as your antibody levels fluctuate.

    The antibodies attack the cells of the thyroid. When the cells get destroyed they release the thyroid hormone they contain. In a heavy attack that "extra" thyroid hormone will noticeably increase your thyroid hormone levels and thus reduce your TSH. When the antibodies decrease you will have less thyroid hormone overall and your TSH will get higher.

    Dampening down the antibody levels (which will wax and wane when left to their own devices) helps to prolong the life of your thyroid. It also improves the stability of your thyroid hormone levels and you would feel better.

    There are a few things you can do. The first requires a change of diet. Many people have found that antibody levels are reduced if they stick to a 100% gluten-free diet. It isn't necessary to test positive for coeliac disease to benefit. You could try that for 3 or 4 months and see if it helps you to feel better. It would also help if you had a test for antibody levels as well after that time. Whether you go back to eating gluten is up to you, but if your antibody levels have dropped it wouldn't be a good idea.

    If you still have high antibody levels after the gluten-free experiment then you could try going dairy-free as well.

    And another thing you could try is going sugar free - in my personal opinion the worst torture of all. :(

    Some people find antibody levels will drop when they get adequately treated for hypothyroidism. If you get offered the chance to be treated I would grab it with both hands if I was you.

    There are no certainties, sadly. Just a lot of experimentation to see what works for you.

  • Thank you, I go back to Dr on Tuesday so it will be interesting to see what's said. Do most people get referred to an endo?

    I'm unsure about cutting gluten yet, think I'd like to see how I react to medication first. Otherwise I'd never know what works, or do you think that's not the way to do it?

  • Don't expect your GP to be wise about anti-bodies - they usually say - nothing to worry about - the treatment is the same. Am afraid that is not the case. When you have one auto-immune illness it is possible to have others in the future.

    I have Hashimotos and Crohns. I am now Gluten Free and have reduced my anti-bodies greatly for the first time since 2005 when I was diagnosed.

    You also need to have your B12 - Ferritin - Folate - VitD tested as these will be LOW with the Hashimotos. B12 needs to be around 1000 - Ferritin 80/90 - Folate halfway through range and VitD towards the top too.

    The Levo does not work on the anti-bodies - it supports the thyroid whilst under attack from the anti-bodies.

    If you click onto the heading - Hashimotos - top right of this page - you will see over 1700 posts discussing Hashimotos. Am afraid it is all about reading and learning as much as possible.

    I am not a medical person - just a fellow sufferer :-)

  • I've never seen an endo and there are quite a lot of people on the forum who haven't. They vary enormously in how much use they are. The good ones are rare.

    There are a whole load of things we can do to try and help ourselves, as I mentioned above, and as Marz mentioned in her post. What order we do things in is really up to us. For example :

    I've had a problem with iron deficiency all my life. Good iron levels are essential if someone has a thyroid problem, and my iron levels were dire. I started supplementing with prescription-strength iron and after nearly 2 years of supplementing my ferritin levels were still below mid-range. I then, very reluctantly, gave up gluten as an experiment. I had had a negative test for coeliac disease so thought I was wasting my time and making my own life difficult. Within a few months my ferritin levels had shot up higher than I had ever seen. I was less tired, and was less breathless. My gut didn't feel much better, but obviously something good had happened.

    So, I have had to stay gluten free for my own good, and I still hate it. Whether you decide to experiment or not is up to you.

    There is a book you might want to buy which has had good reviews. The author has autoimmune thyroid disease herself.

    The author also has a website and a facebook page :

  • Do many GP's offer the T3 testing?

  • The labs rarely test if the TSH is in range. You can have tests done privately through Thyroid UK....

    The above website will also give you lots of information about the thyroid and hashimotos.

  • Well I'm totally confused, Dr wants to monitor, sent me away with print outs about hypo but told me I have Graves' disease not Hashimotos?? Isn't Graves Hyper not Hypo??

  • Bump

  • Misslissa,

    Updates and 'bumps' are easily missed.  It's better to post a new question, perhaps linking to your previous post, if you need a response.

    High Thyroid Peroxidase Antibodies (TPOab) means you have autoimmune hypothyroid disease (Hashimoto's).  Thyroid Stimulating Immunoglobin (TSI) or Thyroid Receptor Antibodies (TRab) are the tests for Graves Disease which is the autoimmune hyperthyroid disease.

    You are most definitely not hyperthyroid with TSH 3.44 and the indication is that you will eventually become hypothyroid.


    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.

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