can anybody out there decipher this test result please?

[northsix]

This test was done at the beginning of last year. I was not aware that this test had been ordered and was never informed about the result as there was no comment from the health professional. I found it on my health record while I was trying to make sense of something else. It doesn’t look like a normal range for a Se thyroid peroxidase Ab test. I’ve experienced a few ‘flare-ups’ with various symptoms and I want to know if I’ve developed Hashi’s………

[helvella]

A positive TPOab test is usually regarded as indicative of autoimmune thyroid disease - of which Hashimoto's is the most common.

However, TPOab can also be positive in Graves, and after trauma (e.g. a thyroid operation or a seatbelt injury). (And Ord's which seems to be the same as Hashimoto's but without any goitre.)

And you could also have Thyroglobulin antibodies (TGab)! Some have TPOab and TGab, some just TPOab, and some just TGab.

The positive test alone does NOT necessarily mean that your have only just developed Hashimoto's. You could have had it for a long time.

[northsix in reply to helvella]

Thank you hellvella. So would the test show Graves after partial thyroidectomy? I am so confused. The flare-ups I been experiencing could be Ords or just thyroid levels dropping or something else then? I had Graves - or do I always have Graves? And could the Se thyroid peridoxase test mean I could have Ords but would have to ask for further tests. Sorry, I have brain fog this morning. Just getting my first coffee ……

[helvella in reply to northsix]

Ah!

TPOab are commonly elevated in Graves. But they really don't show Graves - more they are something that is often observed alongside Graves and seem to be part of the disease process. But there is no way of telling apart Graves and Hashimoto's/Ord's based on TPOab.

TPOab reference intervals (ranges) have changed over the years. At one point they seemed to vary wildly between labs. Some labs used arithmetic to make 0-100 negative, 101 to 200 indeterminate, over 200 positive. In other words, the numbers did not relate to anything physical/biological.

More recently, International Units have been used but I'm not sure how consistent labs are with each other.

I do not know how long after thyroid surgery TPOab would likely be raised - could be quite some time.

In other words, while something to keep an eye on, I don't think you can make much of this result on its own.

[northsix in reply to helvella]

Thanks again hellvella. Looks like I can ignore it but I need to find a way to feel better. I will keep digging …..

[tattybogle]

you had graves originally ....mildly raised TPOab are present in quite a lot of Graves patients but your graves was many yrs ago. .. I'm not sure about their significance in graves so many yrs later.

some very informative articles about the spectrum of antibodies found in thyroid autoimmune diseases : thyroidpatients.ca/home/sit... have a look under category 'thyroid autoimmunity'.

specifically this one thyroidpatients.ca/2020/04/...

so you may find more details in there.

your TPOab have previously been within range 4/5 yrs ago.... and have since come back down into range following that test last year .

posted feb 2023 ... TPOab 18 (<34) and posted 5 mths ago TPOab 12 (<34)

yes, it is an unusual range for a TPOab test. i've not seen it before. .... your result was positive , but even so , it looks like a pretty low result i think ? (TPOab levels can be in the hundreds/ thousands with hashimoto's / ords) .

yes ,it is possible to get hashimoto's/ Ords as well as having graves.....but pragmatically , does it make much difference in your case ? .. hashimoto's / ords slowly destroy thyroid tissue leading to the need for replacement thyroid hormone , but since your thyroid has already been 85% removed by surgery and i assume you are taking a more or less full dose of thyroid hormone replacement .... you're already 'there'.

i think if i was you i would have TPOab retested occasionally just out of interest .... but they wouldn't worry me much .. at the moment it's just a one off slightly high result that has since come back to normal .

[northsix in reply to tattybogle]

Thank you tattybogle. I will get tested again and thank you for the links, I will read them when later when my brain is in gear. I had a total knee replacement last July and I think it set off a reaction with my condition as I have been all over the place since then and definitely don’t feel well. I have finally been referred to endocrinology for the first time since my partial thyroidectomy in 1995. I am secretly hoping for a one-in-a-million informed endo who can really help me but I know it’s almost certainly a pipe dream. Still, I travel in hope. Many thanks again o you and hellvella for your very much appreciated help xx

[tattybogle in reply to northsix]

I really think you should try re-posting your latest thyroid results , (and vitamins if you have any) .... i notice you didn't get many replies a couple of months ago , everyone must have been asleep ... but your TSH was 2.7 .. which may well suggest you are still a bit undermedicated .. that could explain all sorts of symptoms.

I haven't had a look in detail ,and don't have the brain power at the mo. , but the highish TSH stands out as a bit of a red flag to me.

[northsix in reply to tattybogle]

Thank you tattybogle, I also thought that at the time. I will post again and see if anyone has any insights. I will get a full panel done once my endo appointment comes through and I’ll post that too….