TPO antibodies

[ABro]

Just looking for an opinion- I acquired a copy of my original blood test form the GP from when i was diagnosed hypothyroid two years ago

TPO was 514IU/ml, range 0-59

My Tsh was 10.72 (0.35-5)

T4 was 13.2 pmol/L

I was put on 25mcg Levo immediately, raising to 50mcg some weeks later, which I remained on until recently before increase to 75.

Nothing was ever discussed about antibodies and the word hashimotos never memtioned. How do antibodies work - I havent been tested by GP for these since - can they fluctuate much? I am going to get a private test in 6 weeks to compare with my next gp one. Thanks

[Judithdalston]

Doctors , including endocrinologists from my experience, don't bother with thyroid autoimmune antibodies (tests being TPO or / and TgAb) because they think they can't do anything about them. However if you are a frequent reader here you will know it is suggested at least try a gluten free diet, for say 3 months ( some even go dairy free too), to limit the antibodies. Periodically the antibodies mistakenly believe the healthy thyroid gland is 'alien' and attack it, resulting in the dumping of dead cells, including their thyroid hormones, into the blood stream...consequently you have fluctuating peaks, or 'flares', of high hormones and comparative troughs of normal hormones. Unfortunately many doctors interpret peaks as hyperthyroidism, even though a retest the next week/ month might show as normal( initially) or hypothyroid. As the antibodies continue to attack the gland it is further depleted and you become permanently hypothyroid, needing replacement hormones like levothyroxin for life. In GB Hashimoto's disease is better known as autoimmune thyroidititis, so you might find a doctor who won't know the term Hashimoto's. You should have been put on 50 mcg of levothyroxin, unless you are an infant, very elderly or have a heart condition, and then retested 6-8 weeks later, and if appropriate have your dose raised...until TSH is about 1 or under, and your important active FT3( rarely tested in NHS) is over halfway thru the range. It is also important to check Vit D, B12, folate and ferritin as optimum, high in range, levels are needed for good thyroid health and conversion of T4 to T3. It is unlikely your doctor will test for all/ some of these, so many members go to labs with home testing kits like Medichecks or Blue Horizon for missing tests like Vit/ mins, FT3 ( with FT4, TSH and Total thyroxin) from the same blood draw. Good luck.

[ABro in reply to Judithdalston]

Thanks Judithdalston I think I have been neglected a bit but I am doing a lot of research, making changes and going by how I feel.Taking notes on everything posted here, many thanks

[greygoose]

Antibodies do fluctuate all the time, yes. Retesting to compare doesn't tell you much. They are highest just after the immune system has launched an attack on your thyroid, they come in to clean up the mess, so to speak. But, you'd have to test every day to know what they were at their highest and what at their lowest. Not exactly practical.

There is no cure for Hashi's, but you could try taking selenium, some people find that helps because it helps with conversion, and Hashi's people often convert badly. Another thing to try is a 100% gluten-free diet. Hashi's people are often gluten-sensitive, even if they don't have Coeliac.

But, how do you feel? Sounds as if your doctor is being a bit negligent. The protocol is that you are retested six weeks after starting levo, and your dose increased by 25 mcg. Then re-retested six weeks later and another 25 mcg increase. And this process should continue until you are well and the symptoms gone. Doesn't sound as if your doctor is retesting often enough!

[ABro in reply to greygoose]

I have generally felt ok and was told to leave it 6 months unless I had any other symptoms (left on 50mcg at that time) iIt’s only recently I felt I needed an increase but at the same time I changed gp practice and as I explained in another thread the new ine wants me to cut back again from 75 to 50 having only been on 75 for about 9 weeks. I agreed to cut back to alternating and to retest in 6 weeks and currently working on improving my vit levels thanks to advice received on here. I shall keep you posted, thank you for helping

[greygoose in reply to ABro]

You're welcome.

[jimh111]

Antibodies can attack the thyroid and cause primary hypothyroidism. It is most likely you have autoimmune hypothyroidism although the thyroid can fail without antibodies, so it's probable but not a certainty that your hypothyroidism is due to antibodies attacking the thyroid. Antibody levels fluctuate and decline in time, especially after the thyroid has packed in.

Gluten free generally has no effect on antibody levels, I have seen one study where gluten free seemed to have worked in patients who have gluten antibodies (not common). The antibodies fall in time and if you go gluten free this natural decline can be mistaken for the effects of avoiding gluten.

Generally I wouldn't worry about antibodies, they will decline when they want to. This is why doctors don't monitor them, there's very little that has been shown to affect them (experimentally demostrated as opposed to belief).

[ABro in reply to jimh111]

Thank you for your comments jimh111

[helvella Administrator in reply to jimh111]

Do antibodies actually attack anything at all?

Are they not just proteins that attach themselves to specific substances? And by so doing attract the attention of macrophages to do some devouring.

As such, the numbers are surely indicative of what the immune system is doing and how much of the target substance is present.

[Hidden in reply to helvella]

That's a thought. Looked it up (I always do - out of curiosity - not doubting your word for it). The Wikipedia article says:

"Using this binding mechanism, an antibody can tag a microbe or an infected cell for attack by other parts of the immune system, or can neutralize its target directly (for example, by inhibiting a part of a microbe that is essential for its invasion and survival)."

[Hidden in reply to jimh111]

I only had antibodies tested to establish which kind of hypothyroidism it was. the last test was for TSH only, so they could decide whether to increase the Levo. As they did increase it, I'm not complaining - hopefully won't need to, though I'm probably still undermedicated at 50 mcg.

[jimh111]

If you are feeling fine then just continue as you are. As you are running another blood tests I assume all is not well!

When referring to antibodies I was being very vague (sorry), just mean to say they somehow cause the thyroid to be attacked. When it comes to the mechanism I can only quote Manuel "I know nothing".