anti-tpo how high is high?

[Victoria27]

hi I’ve posted before about my tsh coming back as <0.001 with slightly low free t4 and normal free t3 and was told I should get antibodies tested. Gp seems to think I have Subclinical hyperthyroidism and is only paying attention to the odd tsh result and wants to repeat it in 2 months. I’ve had them redone privately and these were the results. My question is my anti-tpo is above the normal range but seen people with it in the 100’s. I have most the symptoms of hypothyroidism but don’t know where to go next.

Tsh <0.001 (0.35-5.5)

Free t4 11.4 (11.5-21.2)

Free t3 4.4 (3.1-6.8)

Anti-tpo 54 (0-34)

Anti-tg 26.4 (0-115)

Thanks in advance

[joey82]

My results for TPO & TG ab and TSH have been very similar for the last year, it's probably because your TSH is heavily suppressed that you have low anti body readings. Better than being in the hundreds...

[Victoria27 in reply to joey82]

Oh I see. I don’t know why my tsh would be suppressed anyway it has been for the past few weeks and I’m not taking anything

[joey82 in reply to Victoria27]

I couldn't say, my knowledge is very limited!

[Jaydee1507 Administrator]

Your FT4 is below range which suggests hypo, yet your TSH is suppressed. This is a confusing picture which really an Endocrinologist should be looking at. Could you ask your GP for a referral to an Endo?

You can email [e-mail] for a list of Endocrinologists. If you then want a recommendation for one you can name one or twso and make a post asking for feedback by private message to narrow down your choices.

Although your TPO antibodies are positive they are really only just out of range. TPO numbers can go up into the hundreds and low thousands sometimes. Positive antibodies at any level indicate an autoimmune thyroid condition regardless of how high they are.

[Victoria27 in reply to Jaydee1507]

Thanks for replying that makes more sense

[Idalmis]

I am exactly in the same situation. Seeing the endocrinologist Wednesday. I have lots of questions. I will come back here to tell you what he said.

[Victoria27 in reply to Idalmis]

Thank you I appreciate it

[Idalmis in reply to Victoria27]

Hi. I’ve just come back from the endocrinologist. I have a small goiter with nodules. I am to stay on carbimazole for the time being every other day and have the radioactive capsule eventually to shrink the thyroid. Long waiting list I am afraid.

[Victoria27 in reply to Idalmis]

Ah that’s annoying. Thanks for coming back to reply

[radd]

Victoria,

You are not hyperthyroid as although you have a low TSH, your thyroid hormone levels are also low.

Thyroid antibodies fluctuate and each persons tolerance level is individual. Some people live healthy lives with elevated thyroid antibody levels, whilst another will be quite symptomatic with just over-range results. Any level of positive TPOAb accompanied with symptoms indicates Hashimotos.

The antibodies are produced as a part of the autoimmune response creating an unnatural and chronic inflammation, and if you feel symptomatic it might be prudent to assume the antibodies are contributing to making you feel unwell.

This is because thy can send out further inflammatory messages which disrupt the production and regulatory mechanisms of thyroid hormones by suppressing the HPT axis (hypothalamus-pituitary-thyroid signals). It can also decrease the amount and sensitivity of thyroid hormone receptors, and decrease conversion from T4 to T3, hence the low thyroid hormone levels which decrease further as the gland is destroyed.

Are you medicating any thyroid hormone replacement meds?

[Victoria27 in reply to radd]

I’m not taking any thyroid meds. Dr just wants to repeat them in 6-8 weeks. But I don’t know what extra that’s going to show. I had them done 3 weeks ago and pretty much showed the same

[radd in reply to Victoria27]

Victoria,

That’s because a GP requires more than one test evidencing hypothyroid results in order to act. If I were you I would ask for a referral to an endocrinologist asap as endocrinology departments have long waiting lists and your results as they stand are indicative of ‘central hypothyroidism’.

This means the TSH & thyroid hormone levels will never correspond, and a GP could struggle interpretating these results. To complicate matters further you have just out-of-range thyroid antibodies.

[Victoria27 in reply to radd]

Thank you I’ll see if they’ll refer me but I’m not hopeful and May have to take into my own hands

[greygoose]

The anti-TPO being high means that you have autoimmune thyroiditis - aka Hashi's. Having Hashi's means that your Free levels can jump around as the immune system slowly destroys the thyroid, releasing stocks of hormone into the blood. The TSH cannot move as fast as the Free levels, it lags behind. Could be that you've recently come down from a Hashi's 'hyper' swing and the TSH just hasn't caught up yet.

Either that or you have a problem with your pituitary. But you are definitely hypo despite the low TSH.

[Victoria27 in reply to greygoose]

Thanks I’m going to try and get a gp appointment asap as I’m not getting anywhere and don’t feel great. Don’t want to wait 2 months for them to be repeated and show the same thing most probably

[SlowDragon Administrator]

Get GP to test vitamin D, folate, ferritin and B12 levels

You need referral to endocrinologist for central hypothyroidism

[Victoria27 in reply to SlowDragon]

Thanks I’ll mention both of these tomorrow if I get an appointment