Hashimoto - how to bring persistently high Anti-TPO level down?

[Tracyyyy]

Hi everyone,

I'm new to this group and need your advise on persistently high Anti-TPO levels.

I have a diagnosed Hashimoto since many years. Under L-thyroxine my thyroid hormones, which I have tested regularly, show normal. I also feel fine.

Last year I got pregnant and it unfortunately ended in a miscarriage. This was the fist time I had my Anti-TPO checked, assuming that there might be a connection between high Antibodies and the miscarriage (there seems to be some evidence for this, which I wasn't aware of before... e.g. bmj.com/content/342/bmj.d2616).

It indeed came out that while my hormones (TSH, fT3, fT4) all showed normal my Anti-TPO was very high (1712 IU/ml at that time, normal range < 5.61). I tried all kind of things to bring it down, including increase in L-thyroxine intake, Selenium and Zinc, strictly gluten and dairy free diet, stress reduction etc. Name it, I did it. When I had everything tested again earlier this week my Anti-TPO was higher than ever before at 1828 IU/ml (normal range < 5.61)!!! Total bummer after all those efforts... My TSH is fine at 0,68 uLU/ml (reference range: 0.350 - 4.940) and also fT3 and fT4 are within normal range (fT3 at 2,2 pg/ml - reference range 1.71 - 3.71; fT4 at 0,99 ng/dl - reference Range 0.70 - 1.48).

I actually feel fine, no real symptoms it is just that the Anti-TPO remains very high for such a long period of time (for about 10 months now) and of course I'm quite concerned that the rest of my Thyroid tissue is getting destroyed bit by bit and that the autoimmune process might affect other parts of my body in the long run.

I live abroad at the moment and there are basically no doctors here that are knowledgeable about Hashimoto and respective treatment options.

Is there anything I could do to bring these Anti-TPO levels down? Happy to hear about your experiences with similar situations.

Thanks so much for your advise!

[greygoose]

Well, you know, it's not the TPO antibodies destroying your thyroid. Even if you got rid of TPO antibodies completely, you would still have Hashi's. And, the TPOab certainly won't affect other parts of your body. They are very specific in their action. All they do is mop up the traces of TPO found in the blood after an immune system attack on the thyroid.

As for antibodies and pregnancy, the situation doesn't seem very clear. Are the antibodies the actual problem, or just the indication of a problem? I haven't been able to work that out from what I've read.

In any case, is it actually possible to reduce antibodies? I don't know that it is. People claim to have reduced them with gluten-free diets, but given that antibodies fluctuate anyway, I don't see the proof. Besides, they reduce naturally as you age, and as the thyroid is reduced in size. So, I really don't have an answer to that question.

[Missmina in reply to greygoose]

Dear Greygoose

Just like always I really appreciate your answers and i found they are very informative and helpful. For this answer to Tracyyyy's question, do you mean that we cannot do anything to reduce the high TPO and we can live with it until our thyroid wont work anymore? Or do we have to take the hormone in order to stop our own thyroid to wotk which is the case that everyone with high TPO is doing i guess? Anyway, could you please explain to me what do ou mean by " ..All they do is mop up the traces of TPO found in the blood after an immune system attack on the thyroid."? Thanks so much n have a great day, Warmest ragards

[greygoose in reply to Missmina]

I honestly do not know if you can reduce antibodies, I'm just saying I've never seen any proof that convinces me. I think you would have to test your TPOab very frequently to know - it might come down, because antibodies fluctuate, but will they go up again? That is the question.

We don't take thyroid hormone with aim of stopping our thyroids working, we take it to replace the hormone the thyroid can no-longer make enough of. Although, in some cases, taking thyroid hormone replacement will stop thyroid hormone production. However, suppressing the TSH could reduce autoimmune attacks on the thyroid - although there's no guarantee that it will. And, certainly, not everyone with high TPOab is doing that because doctors are terrified of a suppressed TSH, and do their best to raise them.

TPO is an enzyme in the thyroid gland that is necessary for conversion, I believe. When there is an immune system on the thyroid, traces of TPO leak into the blood stream, where it isn't supposed to be. Therefore, the TPO antibodies come along and envelop the TPO and take it away to be destroyed. That's what antibodies do. They don't attack.

[Tracyyyy in reply to greygoose]

Thanks for your detailed reply. Of course the antibodies are not the problem in itself and are merely an indicator of the autoimmune reaction. Core issue is to balance/normalize the autoimmune process. But it seems that there is little that can be done. Even though many people here seem to have made improvements under this Autoimmune Protocol (AIP). It just sounds like a massive endeavor and I can imagine that it will make life rather difficult. I just followed a gluten and dairy free diet over the past few months and that was already very challenging. And it had obviously no impact in my case. Anyhow, thanks for sharing your thoughts!

[greygoose in reply to Tracyyyy]

You're welcome.

[Missmina in reply to greygoose]

Again thanks so much for your explanation. : )

[Hidden]

Hi, I'm sorry to hear of your miscarriage. Have you looked into infections or gut infections? Or parasites? These can all be causes of the high antibodies and if you remove the trigger the immune attack will stop 😊 have a look at izabella Wentz work. Good luck x

[Hidden in reply to Hidden]

I should have also said that antibodies can go up when you start to implement things to make you feel better, as your immune system is often too weak to produce the antibodies that it would if it were stronger. This is why many people with hashimotos have antibodies within the normal range. After a while the antibodies will stabilise and may drop 😊

[Tracyyyy in reply to Hidden]

Thanks for your reply! I had a few test done and so far there is no indication of infections/gut infections. Will have a deeper look at Izabella Wentz work. Do you implement the diet she suggests?

[Hashi-hacker in reply to Tracyyyy]

Hi Tracyyyy, sorry also for your miscarriage and I wish you well for the future. It sounds like you are all over the AIP diet so you may not find too much more with Dr Wentz, however her site is well written, and there may be things for you to consider e.g. SIBO that you haven't explored. My go to resources are Dr Wentz, Dr Ruscio, Chris Kresser and The Paleo Mom (who is AIP)

General articles...drruscio.com/thyroid-disord...

Specific article about thyroid antibodies....drruscio.com/tips-for-hashi...

Quote...

'What are healthy levels of Thyroid antibodies?

Thyroperoxidase antibodies (aka TPO ab)

Between 100-300 (roughly) is considered a clinical win

Normal reference range is < 35 UI

The higher the levels the greater the risk of developing true hypothyroidism in the future

Thyroglobulin antibodies (aka TG ab)

Less than 10 times the reference range

Normal reference range is equal/below 1 IU/mL'

Hope that helps x