TSH 0.88 but TPO Ab is 271.68. What does it mean?

[islwyn]

I had hyperthyroid 3years ago and stopped meds since TSH is back into normal range and stayed at 0.88. But my TPO hasn’t been able to come down at all. Endo doc said it’s fine but fertility doc says no. Any thoughts on how to bring it down is much appreciated. I m already on gluten free... not 100% tho. More like 98%

[SlowDragon Administrator]

Just testing TSH is completely inadequate

High thyroid antibodies confirms autoimmune thyroid disease also called Hashimoto’s

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested.

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

Low vitamin levels are extremely common, especially with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis. Both are autoimmune and generally called Hashimoto’s.

In U.K. medics never call it Hashimoto’s, just autoimmune thyroid disease (and they usually ignore the autoimmune aspect)

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Are you in U.K.?

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

List of private testing options

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test

bluehorizonbloodtests.co.uk...

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

If TPO or TG thyroid antibodies are high this is usually due to Hashimoto’s (commonly known in UK as autoimmune thyroid disease). Ord’s is autoimmune without goitre.

About 90% of all primary hypothyroidism in Uk is due to Hashimoto’s. Low vitamin levels are particularly common with Hashimoto’s.

Gluten intolerance is often a hidden issue too.

To be effective it does need to be strictly gluten free

Link about thyroid blood tests

thyroiduk.org/getting-a-dia...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

List of hypothyroid symptoms

thyroiduk.org/if-you-are-un...

[islwyn in reply to SlowDragon]

Sorry for not sharing the full picture... i have tested FT3/4 too regularly for the last 3 years and they also came back to normal after taking PTU for 18months. My vitD is at 30ng, ferritin at 114ng. On 1mg folate a day and also a b complex pill. So really, it’s just my TPO that wont come down.

[islwyn in reply to islwyn]

I heard TPO can be postive for both Graves/ Hashi, right? I hope i m not turning into hypo... 😫

[greygoose in reply to islwyn]

Yes, it can. But high TPOab cannot prove Grave's. Did you have the Grave's antibodies tested: TRAB or TSI?

[SlowDragon Administrator in reply to islwyn]

You need TSI or Trab antibodies tested to prove Graves’ disease

Graves and hashimoto’s patients often benefit from strictly gluten free diet

[tattybogle in reply to islwyn]

Yes TPOab are sometimes present with graves, and equally, a form of TRab are sometimes present in hashimoto's:

Tania .S.Smith from thyroidpatients.canada has written several interesting articles exploring which antibodies occur in which disease and what they do. Below are a couple of them , but there are lots more listed on the site map (it's in the drop down resources section of the webpage) :

thyroidpatients.ca/2020/04/... the-spectrum-of-thyroid-autoimmunity

thyroidpatients.ca/2020/04/... remissions-and-fluctuations-trab