Hashimotos or No?

[JLR2019]

Hi friends,

I was sent for some thyroid testing after experiencing months of terrible symptoms like constipation, brain fog, exhaustion, muscle aches, rashes, night sweats, etc. My thyroid appeared to be inflamed on an ultrasound, with multiple nodules noted. However, my thyroid results came back as follow:

TSH: 1.43 mU/L (normal)

Free T4: 15.2 pool/L (normal)

Thyroid Peroxidase Antibodies: 56 iu/ml

Now, to me, those TPO antibodies are high. I was tested 3 months ago and they were at 54, now at 56. In my mind, if my thyroid is inflamed and my TPO antibodies are high, I'm concerned that I might be exhibiting early signs of Hashimotos.

I've been following a Hashimoto's protocol since just before my first test (AIP diet, stress relief, more sleep, etc.) and have seen HUGE relief in my symptoms, but am just wondering whether or not I should continue to push this with my doctor. He says that up to 60 iu/ml of TPO antibodies is considered normal... However, the literature that I'm reading from thyroid specialists dictates a number with a limit of 35 iu/ml, with optimal being under 9 iu/ml.

Any thoughts would be so appreciated!

[SeasideSusie Remembering]

What was the range (usually written like <XX for antibodies) that was with your test result.

On here, for TPO antibodies, we see <34 and <60, occasionally others.

If your level was above the <XX that came with your result then that confirms Hashi's. It doesn't matter what any other range from any other lab says, it must be the range from the lab that did your test.

If you want test results interpreted, please always include the reference range with the result. Your thyroid results say "normal", we know that the TSH is in range because the ranges vary so little, but we don't know where in range your FT4 is because they vary considerable, we often see 7-17, 9-19 and 12-22, so with one range you would be in the upper part, in another you would be middling, and the other you would be low.

[MaisieGray]

Your Dr is correct in so far as healthy euthyroid people can have those antibodies in their blood with no evidence of thyroid disease. You can't though, read anything that dictates an absolute upper limit of a blood test in isolation of the actual test protocol/assay method used because reference ranges can vary from laboratory to laboratory. Therefore you can judge your result only against the range provided by the laboratory that carried out the test, not another. Additionally, the level of below 9 is not an optimal result as you say. With the parameters you give ie 9 - 35, any where within that range can indicate that you are healthy and euthyroid for the reason given, in the absence of signs of illness; and there is no need to aim for a reduction below 9. Some people can continue to have high levels and yet when optimally medicated can be well. Equally if you had a succession of tests indicating your level was around say 10, and then the next test showed it to have risen suddenly to say, 34, accompanied by symptoms of thyroid dysfunction, you might reasonably assume that Hashimoto's is impacting your thyroid even though the level was still within range. Conversely, it is also possible that someone may have Hashimoto's yet be seronegative. It's important to look at the bigger picture. I also suspect although don't know, that a test result below 9 may not be scientifically accurate hence why the range doesn't start at 0. So we need to have the reference ranges for each of your blood tests provided, in order to comment accurately, because your result of 56 will look different if the upper range parameter is 34, than if it was 60 as you've mentioned for instance; and the same is true for your FT4 test. However remember that it is not those antibodies that damage the thyroid, but the autoimmune condition itself. There is no medical treatment for Hashimoto's, only for the resulting hypothyroidism, and not everyone with Hashimoto's will necessarily develop hypothyroidism.