Advice about my thyroid results

[Anxiousjojo]

Hi everyone,

I recently had a thyroid test and found out I have subclinical hypothyroidism.

I have recieved the results but can't get an appointment for another 2 weeks to discuss this with my gp.

I would like some advice about the results and specifically whether the presence of tpo antibodies means I have an autoimmune condition (hashimotos) .

These are my results and the reference ranges given:

Tsh: 5.5 (0.2-4)

T4: 13.2 (11-22.6)

Tpo antibodies: 42 kU/L (0-60)

Any advice about my results and what the presence of antibodies means. Does it generally mean this will progress into hypothyroidism?

Thank you so much 🤍

[SlowDragon Administrator]

Welcome to the forum

Was this test done early morning as this gives highest TSH

Your TPO antibodies are under 60….so result is negative

Do you have hypothyroid symptoms

Symptoms of hypothyroidism tick list

thyroiduk.org/wp-content/up...

You will need a second thyroid test in another 2-3 months before GP will consider starting you on levothyroxine

See flow chart here

Starting levothyroxine - flow chart 

gps.northcentrallondonccg.n...

For full Thyroid evaluation you need TSH, FT4 and FT3 tested 

Also both TPO and TG thyroid antibodies tested at least once 

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

About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high thyroid antibodies 

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.

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

NHS won’t test TG antibodies as your TPO antibodies are negative

If both antibodies are negative

20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis 

In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)

Recommended on here that all thyroid blood tests early morning, ideally just before 9am

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

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

List of private testing options and money off codes

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

bluehorizonbloodtests.co.uk...

Only do private testing early Monday or Tuesday morning. 

Watch out for postal strikes

Link about thyroid blood tests

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

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

[Anxiousjojo in reply to SlowDragon]

Thank you for your in depth reply, I'm beginning to understand more about thyroids!

I will ask gp to check vit levels too. My test was done at 9.30am and I hadn't eaten anything before the test.

Do you know anything about why we have these tpo antibodies and why it is considered 'normal' to have them under 60?

Just wondering if this might be an early indication of autoimmune and the levels might continue to rise over time.

Otherwise, I'm not sure what could be causing my thyroid to be dysfunctional. I have the following symptoms which may or may not be thyroid related: tiredness, feeling cold, horizontal ridges in nails, heart palpitations and general feeling of anxiety all the damn time.

Thanks again,

Jo

[SlowDragon Administrator]

Suggest you ask GP at appointment to test vitamin D, folate, B12 and ferritin levels

[tattybogle]

Hi welcome .

just to explain about the lab range for your TPOab (Thyroid Peroxidase antibodies) test .

[0-60] is the amount of thyroid peroxidase antibodies that are found in healthy people.

You don't have a 'positive' result for Thyroid Peroxidase antibodies as 42 is well within the level expected for humans .

a positive result for TPOab (on this test) would be "anything over 60" .

Hashimoto's patients often have hundreds (or even thousands) of TPOab .

However .. having a negative TPOab result does not completely rule out hashimoto's ( autoimmune thyroid disease)

There is another thyroid antibody (that the NHS do not usually test for in hypothyroidism ) called TGab (Thyroglobulin antibodies).. these can sometimes be raised in Hashimoto's even though TPOab are normal ... but NHS will not accept them as diagnostic of hashimoto's because they can be raised for other reasons .

(and occasionally ,people have been found to have hashimoto's damage to their thyroid without having evidence that either TPOab or TGab were raised)

But to put your mind at rest about your TPOab of 42 ~nobody has" 0" TPOab ~ Thyroid {Peroxidase antibodies are part of the normal healthy function of the body

They are there to help clean things up .

it is only when there are "lots more than expected" that it indicates a problem .

A Raised (positive) TPOab result shows that there is "more thyroid Peroxidase to clean up than is normal", and this is usually because the thyroid has been damaged by the immune system ,

Thyroid Peroxidase is within the thyroid , but when the immune system ( lymphocytes ) damage the thyroid , then thyroid peroxidase gets 'spilled' and the TPOab fasten to the stuff that is spilled ~(like marker labels) ~ saying "clean this up , it shouldn't be here "

Thyroid Peroxidase antibodies are not what attacks/ damages the thyroid in autoimmune thyroid disease( hashimoto's )...... the immune system does that .... they come along afterwards and help clean up the mess .

[Anxiousjojo in reply to tattybogle]

Oh my goodness thank you for this explanation! I've been so confused about the antibodies and couldn't find anything online about it🤔. I do have a tendency to worry excessively about my health, but this helps to explain things.

[SlowDragon Administrator]

come back with new post once you get vitamin levels tested

make sure you get actual results and ranges

If GP won’t test get tested privately along with BOTH thyroid antibodies

Are there any close family members who have any autoimmune diseases

[Anxiousjojo in reply to SlowDragon]

I will do that. I don't think there are any close fam members with autoimmune, I have an aunt who is coeliac. I will say that I have a very stressful life and struggle with mental health so maybe that's causing some of my thyroid issues.

[Singwell in reply to Anxiousjojo]

Just to add as a fellow newbie. It looks like stress, shocks such as bone breaks, accidents or family loss can all kick off the autoimmune response. I track my hypothyroidism to a nasty bout of shingles. Take your time to read informative posts here and try not to frighten yourself. There's lots of knowledgeable folk plus shared experiences and advice.