TPO antibodies.. plus other questions

[OudMood]

I was looking through old BT results and I’ve seen I was tested for TPO a few years back and the level was <33iu/mL.

The reference range is 0-60.

At the time TSH was 0.99 but has since risen consistently since. (Was 5.63 in March).

I was unaware that I had TPO antibodies..

I was also reading the following:

“ TPO antibody: The measured serum level should be less than 9 IU/mL.” […] “It can take time for the destructive effect on your thyroid gland to be reflected in your thyroid-stimulating hormone (TSH) level. It's not uncommon to have positive TPO antibodies for months or years before your TSH level rises to a point where you are diagnosed with hypothyroidism.”

The above seems to be the case for me as TSH was good at that time and it started rising since, but no one checked TPO since.

I am getting all test done this week including TSH, FT3, FT4, TPO &TG, but I’m driving myself mad in the mean time 😅😅😅.

Am I correct in suspecting a likelihood that my “sub-clinical” Hypothyroidism is likely to be Hashimotos?

Also, can they diagnose Hashimoto is there’s antibodies but TSH is not over 10 and technically still subclinical?

Is there difference between Subclinical and full Hypothyroidism treatment wise? (As in will they wait to treat me till my levels are over 10?)

(I know you can’t really tell until we have the new tests, but I’m driving myself insane as I can’t stop thinking about it and I’ll need to wait 10+ days from today to see the results 😥.)

Thank you all again! 🙏

Once my knowledge is up, I’ll make sure I’ll pay it forward by helping other new members! As you’ve been so so helpful ❤️

[SlowDragon Administrator]

TPO a few years back and the level was <33iu/mL.

The reference range is 0-60.

This shows your TPO antibodies were less than 33

And need to be over 60 to be positive

However antibodies levels change

Also need to test TPO and TG antibodies

Significant minority of people with Hashimoto’s only have high TG antibodies

20% of Hashimoto’s patients never have high thyroid antibodies at all

If antibodies are both negative, an ultrasound scan of thyroid can be helpful

healthunlocked.com/thyroidu...

Paul Robson on atrophied thyroid - especially if no TPO antibodies

paulrobinsonthyroid.com/cou...

[OudMood in reply to SlowDragon]

Thank you!

I replied below to susie why the 33 of antibodies is still concerning to me.. 😬

As I was trying to find a baseline, but I couldn’t find anything leading me to believe that the baseline for normal population is usually 0ish..

I know you could have some antibodies but no Thyroid issues..

But since the TSH DID rise I’m making all of these connections.. 🥸🔍

If I’m being silly… please DO TELL ME 🤣

Also thank you for the links!

I can only open the first one as many links on the site tell me error 400 bad request! 😵‍💫 not sure what’s wrong with my phone! 🤦🏼‍♀️ do you have a title to the second article please?

[SeasideSusie Remembering]

OudMood

“ TPO antibody: The measured serum level should be less than 9 IU/mL.” […] “It can take time for the destructive effect on your thyroid gland to be reflected in your thyroid-stimulating hormone (TSH) level. It's not uncommon to have positive TPO antibodies for months or years before your TSH level rises to a point where you are diagnosed with hypothyroidism.”

Where did you read that?

Because antibody ranges vary, there's no way of knowing what range they used in that example. Most common range we see here is <34, but we also see <60 and we have occasionally seen a very low range (can't remember the number but we don't see it often).

When articles quote a specific level like that, we can't take it that it applies to us because our lab's range may be different from the one used in the example. Your result was <33 with a range of 0-60 so that showed a negative result.

So I would ignore what you have read and wait and see what your new results come back like and take it from there.

Also, can they diagnose Hashimoto is there’s antibodies but TSH is not over 10 and technically still subclinical?

Hashi's is not a term UK doctors tend to use, they refer to it as autoimmune thyroid disease. An enlightened doctor, who knows about it and doesn't dismiss antibodies, may diagnose and start treatment when TSH goes over range (but doesn't necessarily reach 10) when antibodies are raised.

Is there difference between Subclinical and full Hypothyroidism treatment wise? (As in will they wait to treat me till my levels are over 10?)

No, treatment is the same -Levothyroxine but whether your GP would start treatment if TSH hasn't reached 10 is hard to predict, some doctors will, some wont. If antibodies are raised the guidelines suggest a trial so it's worth pointing that out if no treatment is offered if TSH is over range with raised antibodies.

I’ll need to wait 10+ days from today to see the results

Why 10 days? Who are you doing the test with? If your GP then thyroid tests are usually back within 2 days, often the next day. And if it is a GP test I have my doubts that FT3 and Tg antibodies will be done.

[OudMood in reply to SeasideSusie]

Thank you @seasideSusie!

The TPO antibody I’ve read it on a site while doing research..

It’s not a medical journal or anything.

I do know that based on my range it’s technically “negative” or in “range”.

But I associate the word negative with “0” or so.

I think my logic is that those antibodies ARE present and are a little over halfway through and that test is from 3yrs ago.

It’s more the next sentence that resonates with me.. that you start to have antibodies (even little) and then things progress from there, which is exactly what happened with me. At that time the tests were:

TSH: 0.99

TPO: <33 (0-60)

FT4: 14 (12-22)

Even FT4 was barely above lower limit.

I know, I’m building castles on sand in my mind 😂

I just can’t stop myself..

The logic is that if I can narrow down my possibilities, I can research things before I speak to the nurse/doctor. (As usually they call me on the same day if they see something that worries them, or sometimes even if it doesn’t worry them!)

So I want to be prepared in advance of the possibilities.

Re the 10+days:

My test Is on Thursday which is still 3 days away.. 😬 and whenever I do my tests they always take a week.. 😔

Hence the 10 days..

[OudMood in reply to OudMood]

Just for context..

The TSH values I can see (there are more records from the hospital which I don’t have unfortunately 😑 which could give a better pic..

But her it goes:

Dec 2018/Jan 2019

TSH: 0.99 (0.27 - 4.2)

Nov 2019

TSH: 2.68 (0.27 - 4.2)

Nov 2020

TSH: 4.41 (0.27 - 4.2)

March 2021:

TSH: 5.63 (0.27 - 4.2)

Sep 2021:

? Will test soon