TPO ANTIBODIES, what does it mean? : Hi all... - Thyroid UK

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TPO ANTIBODIES, what does it mean?

Elmo218
Elmo218

Hi all,

Got another round of results back after being diagnosed hypo in April and beginning meds in May.

I was a bit shocked to see my TPO was 543 (0.00-24.00) should I be expecting this to come down?

T3- 4.9 (3.90-6.80)

T4- 23.2 (11.00-23.00)

TSH- 3.15 (0.35-5.00)

27 Replies
oldestnewest

It means you have Autoimmune Thyroiditis - aka Hashi's. That is what is causing your hypo, because your immune system is slowly destroying your thyroid. And, there's probably nothing you can do about it.

It doesn't matter if your antibodies go up or down, it won't change anything. The antibodies aren't the disease, they're the result of it - and they don't do the attacking, as some people think. They just come along to clean up traces of TPO and Tg that leaked into the blood during an attack. So, they are highest just after an attack.

How much levo are you taking? Because you're still very hypo. TSH should come down to 1 or under on levo. And, you probably have a conversion problem, too - your T4 isn't converting to T3 very well. This is common with Hashi's. But, how do you feel?

SlowDragon
SlowDragonAdministrator

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

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

Low vitamin levels affect Thyroid hormone working

Your previous post shows your B12 dropping

You need folate, ferritin and vitamin D tested too

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

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

If not already strictly gluten free ......Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies

While still eating high gluten diet ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first

Assuming test is negative you can immediately go on strictly gluten free diet

(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially)

Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse

Many people find TPO antibodies slowly reduce on strictly gluten free diet

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

thyroidpharmacist.com/artic...

scdlifestyle.com/2014/08/th...

drknews.com/changing-your-d...

restartmed.com/hashimotos-g...

Important to regularly retest vitamin levels and many/majority of Hashimoto's patients find they need to supplement some or all of these to maintain optimal levels

Optimal vitamin levels help improve conversion of FT4 to FT3

How much Levothyroxine are you currently taking?

Are these TSH, FT3 and FT4 results from before starting on Levothyroxine or on current dose?

The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many need TSH significantly under one) and most important is that FT4 in top third of range and FT3 at least half way in range

How much thyroxin do you take ?

TPO are autoimmune proteins that attack your own thyroid, the presence of anti-tpo indicate that you have an autoimmune hypothyroidism.

If you want to reduce these antibodies, you must start taking selenium (200 mcg) per day, be on strictly gluten-free diet, avoid pro-inflammatory foods and beverage.

You also need to check your vitamins level such as D3, ferritin and folate and eventually optimize them

greygoose
greygoose in reply to Blueskyyy

TPO is not a protein, it's an enzyme. And it doesn't attack the thyroid, it is essential for the production of thyroid hormones. TPO antibodies are the antibodies that clean up traces of TPO leaked into the blood - where it shouldn't be - during an immune system attack on the thyroid. TPO antibodies don't attack the thyroid, either. And reducing them serves no useful purpose. :)

Blueskyyy
Blueskyyy in reply to greygoose

Anti-tpo !!!! Do attack the thyroid !

Read about it !

greygoose
greygoose in reply to Blueskyyy

Anti-tpo is still not a protein. And it still doesn't attack the thyroid. Anti-TPO is just another way of saying TPO antibodies. And please don't shout at me.

DIYqueen
DIYqueen in reply to greygoose

Hi, here's my 5 peneth worth, with degree in biochemistry.

Most, though not all enzymes are proteins. They all facilitate a biological process that would otherwise need higher temps/be too slow etc etc.

TPO is a protein enzyme. All antibodies are proteins.

Hashimotos destroys thyroid gland cells by antithyroid antibodies attacking them, the gland inflames, it can, with time then slowly atrophy leaving progressive fibrosis:

ncbi.nlm.nih.gov/books/NBK4...

With regard to TPO antibodies and TgAb they attack the TPO and Tg INSIDE the thyroid gland cells themselves (and small storage spaces or vesicles) as this is where they operate.

TPO alters the arriving iodide into iodine inside the cells so they can attach to parts of the thyroglobulin protein ready for the next step which it is also involved in. [This is then 'chopped up' by other enzymes to make T4 and T3 for export]. So TPOAb's interfere with this step. TPO is a membrane-bound protein so can't leak (but can get exposed by the Ab infiltration due to several mechanisms) and their attack damages the cell membranes, the cells die (and therefore the gland) in the process.

en.m.wikipedia.org/wiki/Thy...

Thyroglobulin is the 'matrix' to which these iodines attach and are held in 'storage' inside the gland (in small vesicles). (see ref above).

Tg is produced in the thyroid and is used there exclusively. Once used some is recycled by the thyroid and some travels to the liver in the blood for recycling. This is normal, not leaked, but any TgAb will attack Tg in thyroid and also attack this circulating Tg.

Thyroblobulin which is used in the thyroid to make T4 and T3 is not the same as thyroxine binding globulin made in the liver which carries finished T4 and T3 around the body.

greygoose
greygoose in reply to DIYqueen

Granted. But it is still not the TPO/Tg antibodies that destroy the thyroid cells.

Did you read the link I gave?

DIYqueen
DIYqueen in reply to greygoose

TPOAb's do, TgAb's don't. Read my message above. It got delayed as I needed to edit a reference then got called away

greygoose
greygoose in reply to DIYqueen

Well, that's not what it says in the link I gave.

DIYqueen
DIYqueen in reply to greygoose

Actually it does. He just then places more emphasis on the Th1 and Th2 'warrior' systems that follow. This is actually a lot more complicated than he makes it out to be and can't be simplified to CIA and soldiers because of interactions with many other factors.

ncbi.nlm.nih.gov/pmc/articl...

This is a very technical paper but it basically explains that the former hypothesis of a Th1/Th2 dichotomy, as he describes, has been abandoned (ie outmoded) as new subsets have been discovered Th10 and Th17 being just two.

T-cells of the immune system first misidentify the thyroid as foreign and infiltrate it causing inflammation, exposing TPO (in the membranes) and TgAb (in the vesicles). Antibodies then form and the destruction begins. This is why most sources on here refer to getting inflammation under control.

I looked up the references at the end of the article you referenced and whilst they are scientific papers, not directly linked to the points he raises. I was not convinced by him and his reasoning or in being up to date. Sorry

greygoose
greygoose in reply to DIYqueen

OK, haven't read that yet - and I agree that likening antibodies to the CIA etc is a little childish and I didn't like that - I've only just got up and my eyes aren't open yet.

So, if what you're saying is true - and it goes against all I've read - getting rid of TPO antibodies should get rid of Hashi's, yes? So, is it possible to get rid of antibodies? Not asking for myself, it's way too late for that, but just out of general interest.

Or on the other hand, is it as he says and the number of antibodies does not the reflect any sort of degree of seriousness of Hashi's?

DIYqueen
DIYqueen in reply to greygoose

This the part where my understanding gets a little fuzzy. There is a lot of conflicting info - both anecdotal and scientific about whether you CAN lower TPOAb's if you have them, whether it makes any difference once damage has been done/started etc etc.

My own particular concern is that I have been on levo for 19 years (T3 as well for first 10), FT4 at top of range most of time (with some odd wild fluctuations) and TSH always at <0.05. 19 years ago I was tested for TgAb (NOT TPO surprisingly) and was positive. Different Dr only now has requested TPO for 6 weeks time and I am concerned that after so many years with these results and, I suspect' little thyroid left that she will discount the Hshi dx. Trying not to be anxious so I have ordered test for both from medichecks, waiting for it to arrive. Not sure if it would make any difference anyway.

greygoose
greygoose in reply to DIYqueen

I don't see how you could prove that antibodies had reduced due to your own efforts, anyway, given that they fluctuate so much and that the diminish as the thyroid gets smaller - less to attack.

For myself, I had both TPO and Tg antibodies tested for my diagnosis. Tg were sky high, but TPO only just over-range. Yet, my thyroid has been eaten away (perhaps not a very scientific term) until there's hardly anything left. But, I realise that you cannot draw any conclusions from just one test.

As I said before, I have read a lot on the subject, and the consensus seemed to be that it is not the TPO antibodies that attack the thyroid, it is lymphocytes produced by the immune system. And, our resident researcher, diogenes, said the same. So, it is rather hard for me to now accept that people are now thinking that it is the TPO antibodies that do the attacking.

Why did you stop the T3? And, after all these years, does it matter if your doctor discounts the Hashi's diagnosis? After all, you know, and most doctors discount it no matter what. It was about five years after my diagnosis that a doctor finally mentioned my antibodies and told me what they meant.

DIYqueen
DIYqueen in reply to greygoose

I moved house - and GP surgery and they refused to prescribe T3. I couldn't afford to buy it privately. Thankfully a high dose of T4 seemed to help, but am keen to see my FT3 result.

I have been suffering (new) symptoms over recent months; symmetrical multiple joint and muscle pains, stiff. Bad, all-over, constant headache. Fatigue - again. Itching. Left sided (kidney area) significant but intermittent pain.

FT4 is in upper 1/4 of range and suppressed TSH is normal for me so, although I know these can be linked to Hashi's, their appearance after all this time is concerning. Got a recent positive ANA test, so am concerned about a new autoimmune condition starting eg a connective tissue one (like lupus - especially with kidney pain) so for me it matters she sees I have Hashi's to make link and get the right tests done.

Don't want to start the whole 'it's in your head, you're depressed, get more sleep etc' whirl I went on 20 years ago. She has already been making 'you are overmedicated' noises. She is the best GP I have had but admits she is not an autoimmune specialist and sticks strictly to guidelines as a result.

I am interested in AIP, supplements etc but have decided to change nothing until all my blood tests are done and I see her in 8 weeks. Taking paracetamol when I can't stand it (don't tolerate NSAIDS)

greygoose
greygoose in reply to DIYqueen

The FT3 result is key. But, none of them understand that. I'm fortunate in that I didn't have any trouble getting diagnosed, but after that, I could find anyone who knew how to treat me, and have had to go it alone. I've seen so many GPs and endos! None of them had the first idea what they were doing. So sad.

Blueskyyy
Blueskyyy in reply to greygoose

What’s wrong with you ? Your medicine knowledge seems not good

greygoose
greygoose in reply to Blueskyyy

Just like your manners. You must be the rudest person on here at the moment.

Blueskyyy
Blueskyyy in reply to greygoose

You are ! your are spreading inaccurate information!

greygoose
greygoose in reply to Blueskyyy

Not me. Read the link I gave you.

Blueskyyy
Blueskyyy in reply to greygoose

No need, but I repeat what I

Already said : Anti-tpo are proteins!

greygoose
greygoose in reply to Blueskyyy

OK, it appears you're right on that one. But so what? If you won't even listen to someone else's point of view, and read the links you're given, there's no further point in talking to you.

greygoose
greygoose in reply to Blueskyyy

Removing one exclamation mark doesn't make your response any more polite. And I have read about it. Maybe you should read about it:

hashimotoshealing.com/under...

Marz
Marz in reply to greygoose

Great link 😊

greygoose
greygoose in reply to Marz

Thank you. :)

DIYqueen
DIYqueen in reply to greygoose

Is this for me or bluesky as I didn't use any exclamation marks?

greygoose
greygoose in reply to DIYqueen

Blueskyy :)

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