What is TPO for and what does it mean for your thyroid?

[rjerome812]

Hello I wanted to know what it means if you have TPO anibodies . I recently had my routine blood work done and my TSH went from Hypo to Hyper , so now they are testing TPO and TSI. My TPO antibodies came back at 2, which I guess is good because its less than <9. I wonder if im just too medicated. I take a grain and half of nature throid and have been on it for over a year. Just trying to figure out why it went from low to high. Doctor says its hyperthroidism. My results for tests are below.

TSH ULTRA SENSITIVE TSH 0.03 High

T4, FREE 7528 Free T4 1.1 ( 0.8-1.8 )

Range Normal

T3, FREE (FT3) 1430 T3, FREE 5.6 mine ( 2.3-4.2)Range High

[greygoose]

Those results are not hyper. The Frees are not nearly high enough. You might be slightly over-medicated but you're not hyper. Besides, if you are hypo, you cannot suddenly 'go hyper', the thyroid cannot regenerate itself and start over-producing thyroid hormone.

As to antibodies, here's an interesting article on them:

hashimotoshealing.com/under...

[Nanaedake in reply to greygoose]

I can't judge if the author is reliable on Hashimotos but he says TgAb is used to measure thyroid cancer after thyroid removal. However, it's thyroglobulin levels, not the antibodies that are measured to assess for thyroid cancer. As I understand it, if a person has antibodies, it may interfere with measurement and make it impossible to monitor by that means.

[greygoose in reply to Nanaedake]

Well, then, they'd have to measure the antibodies to see if a person does have them.

uhn.ca/PatientsFamilies/Hea...

[Nanaedake in reply to greygoose]

Yes, that's right, it's done routinely before thyroidectomy.

[greygoose in reply to Nanaedake]

According to the link I've added above - unless I've misunderstood - they are also tested afterward where thyroid cancer is concerned.

[Nanaedake in reply to greygoose]

Thyroglubulin levels are tested after thyroidectomy to monitor progress of thyroid cancer treatment. Thyroglobulin antibodies are measured before thyroidectomy because if present they interfere with monitoring thyroglobulin after thyroidectomy for cancer. Once it's known whether antibodies are present or not then the monitoring of thyroglobulin is adapted accordingly.

Normally, there are two distinct tests, a one time test for Thyroglobulin antibodies before thyroidectomy and then a continual monitoring for Thyroglobulin levels after thyroidectomy and/or RAI.

The test for Thyroglobulin antibodies and the test for Thyroglobulin are two separate things.

There is often confusion around this, both in the literature and for patients undergoing treatment.

The item below that Maisie Gray has posted says that if antibodies are present then TgAb can serve as a surrogate Thyroglobulin marker. In that more unusual instance then it seems that it may serve as an adapted means of monitoring. That makes sense. It is a more unusual situation.

[greygoose in reply to Nanaedake]

OK, so that's cleared that up. But, I really don't think that casts any shadow of doubt over the author of that article - or his article.

[Nanaedake in reply to greygoose]

OK, it sounded confused and seemed to contradict my experience of thyroid cancer treatment and made me wonder if he knew what he was talking about. It's probably just me, not understanding the article, don't worry.

[greygoose in reply to Nanaedake]

No problem.

[rjerome812 in reply to greygoose]

So my tsh would be considered in detectable. ? What's that mean ?

[rjerome812 in reply to rjerome812]

Undectable

[greygoose in reply to rjerome812]

By itself, it means nothing at all. You have to take all the readings into consideration at the same time.

So, if we look at your FT3 - the most important number - it is slightly over-range. And that is why your TSH is now suppressed.

So, the over-range FT3 could mean that you are slightly over-dosed on NDT. But, then, we have to take how you feel into consideration. Do you feel well? If so, then those readings are fine. If not, try reducing the NDT by 1/4 grain.

Those labs were designed for people on levo only, so if you're taking T3 or NDT, the interpretation has to be flexible. NDT contains T3, and when taking T3, the TSH is bound to be low, as is the FT4, so you can only really go by the FT3 as a rough guide, and how you feel.

[MaisieGray in reply to Nanaedake]

I think what he says is correct though - it's explained elsewhere thus: the main clinical utility of the Tg-Ab test is to ensure the reliability of the serum Tg test in the follow-up of patients with differentiated thyroid carcinoma. For patients with elevated Tg-Ab (which renders serum Tg unreliable as a tumor marker), Tg-Ab itself can serve as a surrogate tumor marker for DTC.

[rjerome812]

So what if anything does my results say ? I went from a 5.20 to 0.03 tsh. Does the Tpo result matter . ?

[Nanaedake in reply to rjerome812]

If TPO is elevated above the laboratory range then it shows a person has an autoimmune thyroid condition which is also known as Hashimotos thyroiditis.

According to what you've said, your TPO is not elevated. It is worth testing a couple of times as I've known people who's TPO has tested normal and then tested as elevated 6 months later.

There is a lot of information on the Thyroid UK website you could read.