Can anyone give any advice on TPO levels?

[Jive15]

recently diagnosed with underactive thyroid and feeling much better since taking meds.

Now been sent for more bloods and TPO has come back at 52.1 out of normal range. Can't get gp appt for ages can anyone explain what this means? Many thanks

[SlowDragon Administrator]

see my replies in previous posts

high TPO antibodies confirms autoimmune thyroid disease also called Hashimoto’s

You need vitamin D, folate, ferritin and B12 levels tested and coeliac blood test done

Has GP started you on levothyroxine yet?

Standard starter dose of levothyroxine is 50mcg

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

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

[Jive15 in reply to SlowDragon]

Thank you for replying! Yes I am on Levothyroxine, TSH level is back within range. I will check out your previous posts thank you again!

[SlowDragon Administrator in reply to Jive15]

how much levothyroxine are you currently taking

How long on this dose and which brand of levothyroxine is it

Always test thyroid levels early morning, ideally just before 9am and last dose levothyroxine 24 hours before test

pathlabs.rlbuht.nhs.uk/tft_...

Guiding Treatment with Thyroxine: 

In the majority of patients 50-100 μg thyroxine can be used as the starting dose. Alterations in dose are achieved by using 25-50 μg increments and adequacy of the new dose can be confirmed by repeat measurement of TSH after 2-3 months. 

The majority of patients will be clinically euthyroid with a ‘normal’ TSH and having thyroxine replacement in the range 75-150 μg/day (1.6ug/Kg on average).

The recommended approach is to titrate thyroxine therapy against the TSH concentration whilst assessing clinical well-being. The target is a serum TSH within the reference range. 

……The primary target of thyroxine replacement therapy is to make the patient feel well and to achieve a serum TSH that is within the reference range. The corresponding FT4 will be within or slightly above its reference range.

The minimum period to achieve stable concentrations after a change in dose of thyroxine is two months and thyroid function tests should not normally be requested before this period has elapsed.

Approx how much do you weigh in kilo

[PurpleNails Administrator]

Antibodies usually have a 0 - 34 or <34.  Ranges do vary, but a value above the expected lab reference limit is a positive results. 

 Some results run into 100s even 1000s, but the level of antibodies doesn’t always correlate with severity of hypothyroidism. 

 Thyroid peroxidase enzyme is usually contained in thyroid.  If the immune system is attacking & causing damage to thyroid the debris released into body is being cleaned up by these antibodies.

So a positive “Thyroid Peroxidase Antibodies (TPO Ab)” signify “autoimmune thyroiditis”  which is the most common cause of under active thyroid.

  Most places in world calls this Hashimoto’s but in uk it’s called autoimmune thyroiditis.  

Often doctors just refer to “under active thyroid” As the autoimmune aspect can’t be addressed.  

Hypothyroidism what ever the cause is treated by replacing the missing thyroid hormone. 

 Doctors test to confirm diagnosis but because results fluctuate greatly it’s not a test which is repeated.