Many people have asked what the significance of Thyroid Peroxidase antibodies is in those who currently have no obvious thyroid hormone issues.
This paper looks at that and comes up with some answers.
Considering that few get tested for TPOab before diagnosis, and many don't even after diagnosis of hyper- or hypothyroidism, this paper probably has little direct relevance. But it might serve to encourage testing and, if elevated TPOab are found, further encourage repeated testing.
Autoimmune Dis. 2019; 2019: 1684074.
Published online 2019 Jul 28. doi: 10.1155/2019/1684074
PMCID: PMC6699358
Significance of Anti-TPO as an Early Predictive Marker in Thyroid Disease
Thushani Siriwardhane, 1 Karthik Krishna, 2 Vinodh Ranganathan, 2 Vasanth Jayaraman, 2 Tianhao Wang, 2 Kang Bei, 2 Sarah Ashman, 1 Karenah Rajasekaran, 2 John J. Rajasekaran, 2 and Hari Krishnamurthy
Abstract
Even though most thyroid subjects are undiagnosed due to nonspecific symptoms, universal screening for thyroid disease is not recommended for the general population. In this study, our motive is to showcase the early appearance of thyroid autoantibody, anti-TPO, prior to the onset of thyroid hormone disruption; hence the addition of anti-TPO in conjunction with traditional thyroid markers TSH and FT4 would aid to reduce the long-term morbidity and associated health concerns. Here, a total of 4581 subjects were tested multiple times for TSH, FT4, anti-TPO, and anti-Tg and followed up for 2 years. We streamlined our subjects into two groups, A1 (euthyroid at first visit, but converted to subclinical/overt hypothyroidism in follow-up visits) and A2 (euthyroid at first visit, but converted to hyperthyroidism in follow-up visits). According to our results, 73% of hypothyroid subjects (from group A1) and 68.6% of hyperthyroid subjects (from group A2) had anti-TPO 252 (±33) and 277 (±151) days prior to the onset of the thyroid dysfunction, respectively. Both subclinical/overt hypothyroidism and hyperthyroidism showed a significantly higher percentage of subjects who had anti-TPO prior to the onset of thyroid dysfunction compared to the combined control group. However, there was no significant difference in the subjects who had anti-Tg earlier than the control group. Further assessment showed that only anti-TPO could be used as a standalone marker but not anti-Tg. Our results showcase that anti-TPO appear prior to the onset of thyroid hormone dysfunction; hence testing anti-TPO in conjunction with TSH would greatly aid to identify potentially risk individuals and prevent long-term morbidity.
Full paper available here:
ncbi.nlm.nih.gov/pmc/articl...
Do be aware that the paper includes this:
Conflicts of Interest
Siriwardhane and Ashman are employees of Vibrant America LLC. Krishna, Ranganathan, Jayaraman, Wang, Bei, Rajasekaran (K), Rajasekaran (J), and Krishnamurthy are employees of Vibrant Sciences LLC.