Anti-tg high, low TPO

[Noworries105]

Anti-tg high at 120.

Anti-tpo low <4

Hi guys, can anyone shed some light on why I might have these results? I’m being treated with Levothyroxine as my TSH was 3.5 and for fertility need around 1. But these immunes were a bit of a shock.

Thanks guys

[SlowDragon Administrator]

Vast majority of primary hypothyroidism is autoimmune thyroid disease also called Hashimoto’s diagnosed by EITHER or BOTH high TPO and/or high TG antibodies

Majority of Hashimoto’s patients have high TPO or both high TPO and high TG antibodies

However a significant minority of Hashimoto’s patients only have high TG antibodies

If based in U.K., NHS refuses to test TG antibodies unless TPO antibodies are high, so many patients with only high TG antibodies remain undiagnosed unless they test privately

20% of Hashimoto’s patients never have high thyroid antibodies at all, and ultrasound scan of thyroid can help diagnosis

Important to regularly retest vitamin D, folate, ferritin and B12 at least annually

How much levothyroxine are you currently taking

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

Always test as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

[Noworries105 in reply to SlowDragon]

Hi Slowdragon,

Thank you so much for your help. Literally even my Doctor doesn’t know!

So I am recently been given Levothyroxine and alternate days 25mg - 50mg.

Issue was I was testing with medichecks finger prick and it was all normal, then doctor decided on a full blood draw and sent off to a specialist immune lab in Chicago who confirmed very elevated Anti-TG.

Which at home test do you find works/is reliable?

I asked medichecks but they’re not really saying anything.

[SlowDragon Administrator in reply to Noworries105]

Approx how old are you and approx how much do you weigh in kilo

Standard starter dose of levothyroxine is 50mcg

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

ALWAYS test as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

What were most recent thyroid results, and have you had vitamin D, folate, ferritin and B12 last tested

What vitamin supplements are you currently taking

[buddy99 in reply to Noworries105]

I also have elevated Tgab and my doctor told me I did not have Hashimoto's (after having been diagnosed over 30 years ago) because my TPO was normal. Some doctors do, in deed, not know about Tgab at all (and some are confident enough to belief that the patient is always wrong and they are always right, so no need to verify or seek additional information). My doctor flipped a lid when I told her that my TPO always has been normal but my Tgab had usually been elevated. After that, disparaging me at every appointment seemed to be necessary. I found this publication which clearly states that Tgab is a thing and that it can influence quality of life independent of TSH. pubmed.ncbi.nlm.nih.gov/303... I used to get a full thyroid panel from Letsgetchecked but they don't service Canada anymore. If you live in the States or the UK that would be an option. In any case having elevated Tgab means having Hashimoto's, the most common cause of hypothyroidism.

[Noworries105]

Hi,

39 years, 57kg.

Vit D levels recently checked were good appx >100.

Don’t recall other levels but we’re all normal as take supplements.

I can recheck, do you suggest a particular one that seems reliable, medichecks etc?

Testing has been in the morning, but not 24 hours later as I have been taking my medication at night, not sure how to get round that, take my tablet in the am then test following morning?

The Anti-tg levels being so wrong with the at home finger prick test was a real concern.

Thanks again.

[SlowDragon Administrator in reply to Noworries105]

If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test

If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal

REMEMBER.....very important....stop taking any supplements that contain biotin a week before ALL BLOOD TESTS as biotin can falsely affect test results - eg vitamin B complex

Which brand of levothyroxine are you currently taking

Do you always get same brand levothyroxine at each prescription

Many people find different brands are not interchangeable