Thyroid UK
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TPO antibody positive

Not sure what this means but I have positive thyroid peroxidase antibodies?

Anti TPO antibodies *875 (<34)

Symptoms - sluggish gut, weight gain, dry skin, hair and eyelash loss, pins and needles, joint pain, goitre, cold intolerance

Advice appreciated thanks

10 Replies
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Oh my dear , are you On thyroid medications already or is

This part of ongoing checks . Having TPO antibodies generally means that you

Have an autoimmune type of thyroid disease . It

May be that this is a condition that has just started and the antibodies have switched on . It usually is the cause of Hashimotos however Gp’s do not

Differentiate the autoimmune conditions of hypo/hyperthyroid and just treat the thyroid function texts . It helps to take selenium and vitamins to support your immune system .

I truly wish you the best and please feel free to message more if we can help

At all .

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Hi I was wondering how often Levo gets increased? Still on 25mcg after 4 years thanks

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Then you are likely very under medicated.

Can you see a different GP.

50mcgs is a standard starter dose.

Bloods retested 6-8 weeks after each dose change and increased by 25mcgs steps until TSH is around one and FT4 towards top of range and FT3 at least half way in range

Your vitamin levels are likely extremely low

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,

"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.

Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."

You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor

please email Dionne:
tukadmin@thyroiduk.org

You will see if you read posts regularly on here, very sadly your situation if far from rare.

The current guidelines on treatment are terrible and many GP's seem to have no idea on how to treat

Reply

Your antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).

About 90% of all hypothyroidism in Uk is due to Hashimoto's

Have you also had TSH, FT4 and FT3 tested?

Post results and ranges if you have them, members can advise

Are you on Levothyroxine, if so how much and how long have you been on it

Essential to also test vitamin D, folate, ferritin and B12. Always get actual results and ranges.

Post results when you have them, members can advise

Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels

Low vitamin levels affect Thyroid hormone working

Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten

According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

But don't be surprised that GP or endo never mention gut, gluten or low vitamins. Hashimoto's is very poorly understood

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies

Ask GP for coeliac blood test first

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thyroidpharmacist.com/artic...

amymyersmd.com/2017/02/3-im...

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Reply

TSH 10.9 (0.2 - 4.2)

FT4 13.7 (12 - 22)

FT3 3.1 (3.1 - 6.8)

25mcg Levothyroxine, been on it since diagnosis 4 years ago

Reply

Make an urgent appointment tomorrow with a different GP.

Insist on 25mcg dose increase and testing of vitamin D, folate, ferritin and B12

You should also ask for Coeliac blood test

You can say you have taken advice from NHS recommended thyroid support group (don't mention internet or forums)

All thyroid tests should be done as early as possible in morning and fasting and don't take Levo in the 24 hours prior to test, delay and take straight after. This gives highest TSH, lowest FT4 and most consistent results

Link about antibodies

thyroiduk.org.uk/tuk/about_...

Link about thyroid blood tests

thyroiduk.org/tuk/testing/t...

Print this list of symptoms off, tick all that apply and take to GP

thyroiduk.org/tuk/about_the...

See Box 1. Towards end of article

Some possible causes of persistent symptoms in euthyroid patients on L-T4

You will see low vitamin D, folate, ferritin and B12 listed

onlinelibrary.wiley.com/doi...

Reply

Vitamin D 26.9 (25 - 50 deficiency. Supplementation is indicated) taking 800iu

Ferritin 21 (15 - 150) diagnosed with anaemia

Folate 1.9 (2.5 - 19.5) GP said a little low

Vit B12 207 (180 - 900)

Reply

All are terrible due to being very under treated for Hashimoto's

Vitamin D - you need loading dose

oxfordshireccg.nhs.uk/profe...

Ferritin, you need full iron panel and ferrous fumerate supplements 3 x daily

B12 full testing for Pernicious Anaemia before starting B12 injections

Folic acid supplements should not be started until after first B12 injection

All these are direct result of poor management of your Hashimoto's

Ask for coeliac blood test too

You need 25mcg dose increase in Levothyroxine

Retesting in 6-8 weeks

Dose increased in 25mcg steps until TSH is around one and FT4 towards top of range and FT3 at least half way in range

All thyroid tests should be done as early as possible in morning and fasting and don't take Levo in the 24 hours prior to test, delay and take straight after. This gives highest TSH, lowest FT4 and most consistent results

Link about antibodies

thyroiduk.org.uk/tuk/about_...

Link about thyroid blood tests

thyroiduk.org/tuk/testing/t...

Print this list of symptoms off, tick all that apply and take to GP

thyroiduk.org/tuk/about_the...

Typical posts with Low vitamins due to under medication

Detailed supplements advice from SeasideSusie our vitamin guru

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Thyroid UK are collecting evidence of malpractice due inadequate medication

Please consider sending a brief outline of this. I would include the dire vitamin levels

thyroiduk.org.uk/tuk/get_in...

Reply

Iron 5.1 (6 - 26)

Transferrin saturation 12 (12 - 45)

Only things flagged up from complete blood test were

MCV 80.2 (83 - 98)

MCHC 387 (310 - 350)

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These confirm you need iron supplements

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