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Can someone help me with results of a Thyroid Peroxidase Antibodies tes...
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Can someone help me with results of a Thyroid Peroxidase Antibodies test result?

I received my test results on my Thyroid Peroxidase Antibodies test and it was 810.4.  I have been leaving messages for my Endocrinologist and he has not returned my calls.  I only saw him once so I don't think he is that responsive  I went to see him for insomnia, weight gain, always being cold, depression, difficulty swallowing, mood swings, etc.  I cannot find any information on what a normal range is for this test.  Does any know?  Or can anyone tell me where to find this information?  
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Avatar_f_tn
Ranges vary lab to lab on TPOab, but we often see the normal range on it as "less than 20" or "less than 40".

810.4 is clearly a positive on TPOab.  It indicates that you have autoimmune thyroid disease, probably Hashimoto's thyroiditis (hypo, except in early stages.  However, TPOab is sometimes elevated with Graves' (hyper) as well.  

Did your doctor test any other thyroid functions?  FREE T3, FREE T4 or TSH?

Hashi's is one of the most prevalent causes of hypo in the developed world, so you have lots of company...I was diagnosed a few years ago.
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Avatar_n_tn
He did another test that came back as abnormal but it is difficult for me to understand exactly which test it is.  I can just see that the results were 110.  It looks like it is my "CL" which I believe is my chloride???
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1756321_tn?1377771734
TPO antibodies are measured in either IU (international units) or U (units). I've had my TPO antibodies measured in both IU and U.  My lab work lists normal range is <6IU or <60U.
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Avatar_n_tn
I just accidentally posted my test results on someone else's question...oops!  Not used to this site....Look at the question by Mrstarz and you can see my test results.  My physician just called me and said he never rec'd my results....right...In any case, when I told him what the results were and asked him what it meant, he just blew it off and said he was going to have to see the results from the lab first.  Which, I guess is probably appropriate.
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Avatar_n_tn
The lab results list 0.0-9.0 IU as normal and show my results as abnormal. However, it does not say HOW abnormal 810.4 acutally is.  So I guess I need to sit and wait for the doctor to call and let me know.
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Avatar_f_tn
I copied your results from the other thread just to make it easier for eeryone:

                          Normal           Abnormal
K Serum             4.5
CL                                              110
CO2                   25
Glucose             85
BUN                   13
Est. GFR             62
Creat.                 1.0
T3 Uptake           35.0
TSH                    1.78
TSI                       97
T3 Total Serum   88
T4, Free            0.94
Thy,Peroxid, AB                        810.4

When you post labs, you have to post reference ranges as well since those vary lab to lab and have to come from your own lab report.  The best way to do that is usually to list test, result and range in parentheses, e.g.:

TSH 1.78 (0.3-3.0)

As far as your TPOab is concerned, you can see that reference range is 0.0 to 9.0, and your result is 810.4, clearly way above range.  However, antibody counts are basically either positive or negative, and raw numbers don't mean a lot, i.e. someone with an antibody count of 100 can feel worse than someone with a count of 800.  We often see antibody counts in the hundreds or even thousands.  Just to give you some perspective, my TPOab on diagnosis was 900+, and my TGab was 3,000+.  

If you post your other ranges, we can comment further.
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Avatar_m_tn
Your other symptoms are consistent with being Hypo.

Ans you have Hashi's.

While this may all sound scary. What this really means is that you will need medication to help add Thyroid.  Hashi's is progressive which means that your dosage of medication will likely increase over time.

The trick or art of all of this is getting and keeping the correct dosage of medication to keep you feeling well.

One important if not critical step in this process is to ensure and demand that you ALWAYS get tested for as a minimum your FREE T3 and FREE T4 levels.

Do NOT fall into the trap that TSH is all that you need.  FUrther do NOT fall into the trap that if you are somewhere within the reference range that is "good enough". NOTHING could be further from the truth for a lot if not most people.

Most people feel well and symptom relief occurs when their FT4 is in the MIDDLE of the range if not even slightly higher. AND (that means in addition to) their FT3 is in the UPPER 1/3 of the range.

This is just a rule of thumb but seems MUCH more appropriate target to shoot for to get symptom relief than the broad reference range.  You may find the Dr will only treat/medicate you until you fall on the bottom end of the ranges.  This will keep the DR safe from being sued but it may also keep you feeling like crap.

If you have a Dr who only believes in TSH, find another Dr. You will almost assuredly not ever be treated to optimum as TSH is 100% totally unreliable to adjust medication levels to any degree of accuracy required to feel well.

Understand that Free T4 and Free T3 are the ONLY hormones your body uses.  So on that basis alone doesn't it make sense to always test for them!
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649848_tn?1424570775
My lab lists range for TPOab as < 35 IU/mL, so as you can see, these do vary lab to lab, since yours lists normal as 0 - 9 and Red Star's is < 6; however, as goolara pointed out, your 810 is clearly over range.  

You may or may not have Hashi's, since TPOab can be present in other autoimmune diseases, as well.  A final diagnosis will depend on what other thyroid tests your doctor ran.
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Avatar_n_tn
You have been most helpful. I could not believe the answer I rec'd from the Endocrinologist when he contacted me last night.  I failed to mention that I have been on 50mcg. of levothyroxine for the past year from my PCP. She put me on it because I kept complaining of my afore mentioned symptoms...and because my TSH came back "borderline". But last night took the cake....Before I tell you what the Dr. said, I will tell you that the flag reference range on my results are as folllows:

T3 Uptake: 30.0-39.0%
TSH: 0.35-4.50uIU/mL
TSI: <=110%
T3 TOTAL, SERUM: 80-200 ng/dL
T4 FREE: 0.60-1.38 ng/dL
THY.PEROXID AB: 0.0-9.0 IU/ml

So the Dr. tells me the 810.4 is "very high" but I should do nothing. I ask if that is why I feel lousy all the time and why I can't seem to lose any weight (I go to the gym 5-6 days a week and work out for 1-2 hours and don't lose any weight). I only sleep 2-3 hours a night, I am ALWAYS freezing...I am constipated all the time regardless of what I eat, etc...he told me that is why I am taking the medication and that is what it is for.  I then asked him if I could have the Hashi's disease and he said "no" where would I get that idea??? and told me he needed to take another call. I asked when I needed to come in to be seen again so that we could make sure my meds were the right dose and he said maybe six months...has anyone EVER been treated like this? Is this normal?? I have never been to an Endocrinologist before.  Maybe 810.4 is really nothing???? Help?
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Avatar_m_tn
Unfortunately many people have been equally ill treated.

Try to find another Dr.  You never got tested for FREE T3 only Total which is outdated and not much value.  But it shows that it is at the very bottom end of the range.

Your FT4 is a bit low but not horrible.

In your case I might suggest you lobby your Dr to try natural dissected thyroid (Armour, Nature Thyroid or Efra) which would give you a bit of a T3 boost.
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Avatar_f_tn
"...has anyone EVER been treated like this? Is this normal??"  Well, I guess if by "normal" you mean the way most doctors treat thyroid patients, on my bad days, I'd have to say 'yes, it is normal'"!  LOL  Is it right?  He//, no.

I agree that you have to lose this doctor.  Your TPOab definitely indicates Hashi's.  

Another concern is your TSI level.  While it is within range at 97 with a reference range of less-than 110%, this is also an indication of Graves'  disease.  "Normal" people don't produce TSI and have levels less-than 2%.   The upper limit of the TSI range is set where most people usually begin to show symptoms of Graves'.

It sounds like a contratiction that you can have both Hashi's (hypo mostly) and Graves' (hyper), but, although rare, it does happen.  Basically, at any one time, one is more active, and that is the one treated.  The Graves' antibodies may never be a factor for you if the Hashi's antibodies "kill" off your thyroid first since TSI can't do any damage once your thyroid is dead.  However, it does bear being aware of and watching.

You might PM one of our members, gimel, who maintains a list of thyroid doctors recommended by patients.  He may know of someone in your area.    

Let me assure you that a TPOab of 810 is "something".  This doctor wants to ignore your symptoms and let you suffer for the next six months...don't let him do that.    
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Avatar_m_tn
I have a TSH of 0.419 and a TPO of 5.0, I have undergone thyroid ultrasounds showing that I have multiple nodules on both sides of my thyroid noting that it is consistent with Hashimoto's Thyroiditis. My TSH goes up and down. My last throid uptake (2years ago) showed 85%. I am scheduled for a repeat next week. My thyroid biopsy was canceled for this test. I am confused that my TPO is within normal range! Can anyone explain this to me?
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Avatar_f_tn
Some people with Hashi's are TPOab positive, some TGab (thyroglobulin antibodies) and some both.  Apparently, a very small percentage of people with Hashi's test negative to both antibodies.

The next step would be to test TGab.  
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Avatar_m_tn
I have been diagonosed with an enlarged thyroid (goiter).  In January 2013 my TSH was...

1/13....2.2

4/8...3.0

4/19...2.9

Here are the results of my other labs from 4/19

sodium  145 (range of 135-145)
Potassium 3.9 (range 3.5 - 5.0)
Chloride 106 (range 980-0107)
CO2 26 (range 22 - 30)
Urea Nitrogen 17 (range 7-21)
Creatinine .61 (range .60-1.0)
EST. GFR (MDRD) 60 (range 60)
anion gap 13 (range 90-015)
Bun/Creat Ratio 28 (range undefined)
Glucose, Random 80 (range 65 - 179)
Calcium 9.2 (range 8.5-10.2)
magnesium 2.0 (range 1.6-2.2)
phosphorus 3.5 (range 2.4-4.5)
uric acid 4.2 (range 3.0 - 6.5)
Protein, Total 6.9 (range 6.6-8.0)
Albumin 4.1 (range 3.50-05.0)
AST 25 (range 14-38)
ALT 25 (range 15 - 48)
PRO-BNP 86 (range 0-178)

T4 Total...6.7 (range 5.5 - 11.0)
TSH.....2.9 (range .60-3.3)
T3 Total....1.3 (range 1.0-1.7)
T3 Free...3.65 (range 2.71-6.16)
T4 Free .93....(range .71 - 1.4)

Thyroperos AB .36 (range 0.0-5.6)

Can anyone help decifer these results....I have the following symptoms...

Carpal Tunnel both wrists (surgery in left wrist in February)
Psoriasis
Extreme Fatigue
Muscle aches in my arms
major depression
Panic Disorder
Heart Palpitations
Very difficult to loose weight with diet and exercise
Brain Fog, poor memory, poor concentration
Constipation
Calloused heels


All comments appreciated!

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Avatar_f_tn
I'd just like to clarify that your TPOab result was 0.36 (not 36), with a range of 0.0-5.6.  Is that correct?
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Avatar_f_tn
Wow!  I have all your symptoms!  My Thyroid Peroxidase AB was 259 iu/ml (<35).  My TSH 8.92 mIU/L (0.40-4.50); my RDW in CBC 15.2% (11-15%); Vitamin D, 25-OH, Total 35 ng/ml (30-100).  I feel terrible!  I'm taking Synthroid 125 mcg; 50,000 IU/wk Vitamin D and I will soon start to take Progesterone SR 25mg daily.  Lupus, RA and Sjogren's antibodies tests came back within normal range.
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Avatar_f_tn
I just got my thyroid test results and the figures look as follows
FT4 - 7.9
TSH - 35.44
FT3 - 4.2

Throglobulin Antibodies - 865
Thyroid Peroxidase Antibodies - 649
Anti Nuclear Antibody Titre - 1280

What does it mean for me? Since the acceptable limits are far less, I am concerned for what it means for me? We are also trying for a baby, and my doctor suggested against it, for concerns with the brain development of the foetus.

Can you please suggest what this may mean for me?

Thanks, Diya  
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Avatar_m_tn
Since thyroid test results and associated reference ranges vary from lab to lab, it is important to always compare results to the ranges from that specific lab.  Please post the reference ranges for the tests you listed above.  
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11094179_tn?1415242067
Yes. Some years ago, not too awful long after I had some benign nodules removed  (not an endocrinologist ), I was finally referred to a just awful endocrinologist. All he could talk about was how fat I was (I weighed about 160) and that my test results were fine and I didn't need to come back. Over about the last 25 or so years my PCP would test my TSH and say I was fine. As time went on, I began to feel bad and then worse and worse. The PCP, unknown to me tried to refer me to this jerk again. He said he would never see me again as I was noncompliant. I have no clue to what he was talking about. But I didn't want to see him anyway. I had to go to another city for the endocrinologist I now have. She is wonderful! She got right on the ball with testing, ultrasound and needle aspiration of my new nodules. I was terribly hyperthyroid with huge nodules and extremely large thyroid. In no time I was getting a thyroid ablation as I elected not to have surgery. I am slowly getting better but will eventually go into permanent hypothyroidism as the ablation kills the thyroid. But that's ok. She closely monitors me and there's meds for that. My humble advice to you is, run as far as you can from your current doctor. You can look online for endocrinologist's ratings and patient satisfaction ratings. Do research on different doctors and if you don't like the next one, try another one. We're taking about your health here and you deserve the best and brightest there is. I wish you God speed in your search. God bless
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Avatar_f_tn
I have all the same exact symptoms. Where u ever given a diagnosis?
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Avatar_f_tn
My thyroid test result
T4 free 1.35
Tsh 3.030
Tyroid Peroxidase(tpo)17
Thyroid antibody  <1.0
Triiodothyronime,free serum 2.4
I'm conocer about this result, are there normal,
because I dont feel good.
Thank you in advance for you help.
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Avatar_m_tn
Please post the reference ranges for those tests, as shown on the lab report.  Since test results and calculated ranges can vary somewhat from one lab to another it is important to always compare the two from the same lab.  

Also please tell us about symptoms you have.  
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Avatar_m_tn
My thyroid test results.  I need some help reading my results and what they mean, since my doctor wouldn't take to the time to tell me.

T3 TOTAL  68
THYROGLOBULIN ANTIBODIES 17
THYROID PEROXIDASE ANTIBODIES 176
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Avatar_m_tn
That is a strange combination of tests.  Obviously the doctor was checking for the possibility of Hashimoto's Thyroiditis, since TG ab and TPO ab were done.  The TPO result is indicative of Hashi's.  Usually I would expect tests for TSH and Free T4.  It is also better to test for Free T3 rather than Total T3.  So in the future you should make sure they always test for the biologically active thyroid hormones, which are Free T4 and Free T3 each time you go for tests.  

With Hashi's the autoimmune system erroneously identifies the thyroid gland as foreign to the body and produces antibodies to attack and eventually destroy the gland.  As this progresses over an extended period of time, output of natural thyroid hormone is diminished and has to be replaced by thyroid medication to prevent hypothyroid symptoms.  

So please tell us about any symptoms you are having now.
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Avatar_f_tn
always post the test reference range as (esp TPA tests change over time)  it looks like Hashi's but make sure you check with the doc.  also make sure the doc checks Free T3 and 4 -not total and works with you on diet. (S)he should also take the time to explain the ramifications of having Hashi's and what to be looking out for- if those things aren't happening (at a minimum) then find a different doctor!
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16531991_tn?1448868077
so happy I found this website.  my doctor told me I have Hashimoto based on blood results and thyroid scan.  When I start reading about this disease, I get really scared.  could someone please assist me in interpretation of my results? Because I am not sure how bad my results are?

TSH:  2.77  uIU/ml  (range  0.490 - 4.670)
Free T3: 4.10 pmol/L (range 3.1 - 6.8)
Free T4: 16.72 pmol/L (range 12.0 - 22.0)
Anti TPO (microsomal) antibodies: 239.0 IU/ml (range negative: 0-34 equivocal: 34-38 and positive: >38)
Thyroglobulin Antibody: 647.7 IU/ml (range negative:  225)

many thanks for your feedback!
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Avatar_m_tn
No need to be scared about having Hashimoto's Thyroiditis.  With Hashi's the autoimmune system erroneously identifies the thyroid gland as foreign to the body and produces antibodies to attack and eventually destroy the gland.  As this proceeds, the output of natural thyroid hormone is diminished and must be replaced by adequate thyroid medication.  

If your doctor told you that even though you have Hashi's your test results are within the "normal" range and nothing further is needed at present, then that is wrong, if you are already experiencing hypo symptoms.  So before going further, please tell us about any symptoms you have.
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16531991_tn?1448868077
thanks for your response gimel.  Symptoms: I am very tired a lot!  moody, anxiety, restless, and heavy menstruation
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Avatar_m_tn
Looking at the rest of your test results, I am somewhat surprised that your TSH has not risen farther; however, TSH is a pituitary hormone that is affected by so many things that at best it is only an indicator, not a diagnostic.  The most important diagnostics are symptoms, followed by tests for Free T4 and Free T3, which are the biologically active thyroid hormones.  

In addition it is important to understand that the range for TSH is based on large numbers of people.  Also, there is huge variation from one person to another in their TSH levels.  Studies have shown that a reference range for an individual would be 1/2 of the range for a group, for all of the thyroid tests.  So trying to use group test data and associated reference ranges, to diagnose an individual is not logical and does not work for many people.  Also, in establishing the upper limit for the TSH range, it is purposely set high enough to avoid false positive diagnoses.  As a result patients receive a lot of false negative diagnoses and erroneously end up having to live with their hypo symptoms.  

The errors in setting the TSH reference ranges have also corrupted the ranges for FT4 and FT3.  Those ranges are not based on test results from large groups of healthy adults with no known thyroid problems.  Instead the ranges are based on all the test data at a given lab, excluding only the data from those patients whose TSH exceeds its erroneously high upper range limit.  So the data base includes patients with central hypothyroidism and also patients who are already being treated for thyroid problems.  Accordingly test results that fall in the lower half of the ranges for FT4 and FT3 should be further evidence of possible hypothyroidism, not cause for denial of treatment.

Sorry if I belabored that, but I think it is important for you to know why you  reactions like you got from your doctor are wrong.  Instead, you should be started on thyroid medication and then gradually increased as needed to get your Free T4 up to the middle of its range, at least, and your Free T3 in the upper end of its range, or as needed to relieve symptoms.  That is what a good thyroid doctor will do:  treat a hypo patient clinically by testing and adjusting FT4 and FT3 as needed to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important, not just test results. You can get some good information from this link written by a good thyroid doctor.

http://www.hormonerestoration.com/Thyroid.html

One other thing I should mention is that hypo patients are frequently too low in the ranges for Vitamin D, B12 and ferritin.  If not tested for those, you should get that done.  D should be about 55-60, B12 in the very upper end of its range, and ferritin should be 70 minimum.  Low levels can cause symptoms.  Low D or low ferritin can adversely affect metabolism of thyroid hormone.  Since your FT4 is near the middle of its range, but your FT3 is only at 27 % of its range, it appears that your body is not adequately converting T4 to T3.  Low ferritin can be a contributor to that.  

In summary you need to get your doctor to recognize the above problems and realize that you are already hypothyroid with those symptoms and test results, and start you on thyroid meds and raise the dosage gradually as needed to relieve symptoms.  You also need to test the Vitamin D, B12 and ferritin and supplement as needed to optimize.  If your doctor does not want to do those things, then you need to get aggressive and push him to change his approach, or you will need to find a good thyroid doctor that will do what is needed.  


  
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16531991_tn?1448868077
thanks soooo much, this is extremely helpful!  I will go to my doctor and have a long list of questions for her :).  SHe is actually my gynaecologist and tested my blood based on my complaints.  so she does look at the complete picture and suggested thyroid scan.  However, I am not sure how far her knowledge is in terms of thyroid.  She did say, for now, no need to go to endocrinologist.  She suggest taking the 25 mg Levo for 3 months and then doing another thyroid scan and blood test.

Thanks a lot! I appreciate your response.  one more question, I am on FB on the Hashimoto 411 group, where everyone suggests at least gluten free diet but also AIP (auto-immune protocol) to heal leaky gut, what is your opinion on that?  AIP seems very overwhelming for now to me, but I am trying to eat mostly gluten free now (I would say I am eating 90 percent gluten free).
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Avatar_m_tn
Be aware that Endos are not necessarily good thyroid doctors.  Many specialize in diabetes, not thyroid.  Also, many have the "Immaculate TSH Belief" and only pay attention to that. That is very wrong If they go beyond TSH they will test Free T4 and tell you that a test result that falls anywhere within the range is adequate.  That is also wrong.  I explained above what a good thyroid doctor will do for you.  That is what you need.

There is no conclusive, scientific proof that Hashi's is caused by a leaky gut.  Everything seems to be based on anecdotal information.  So going gluten free is really questionable.  Also, any damage to the thyroid gland that has already occurred would not go away anyway.  So thyroid med is required.  Also, even if you needed to go gluten free, I don't think just 90% really works.
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16531991_tn?1448868077
thanks a lot for your advise really helpful!
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16531991_tn?1448868077
If I can ask one more question, so the key is to find out first whether you have leaky gut or not?  ANd if you do, then heal the leaky gut (through diet or detox)?
A
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Avatar_f_tn
35 is what normal should be. Just got mine back a little over 1500 with the same symptoms. Good luck gal!
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Avatar_n_tn
I have Hoshis. My latest results are
TPO >900. Range is <9 IU/ml
Is this considered very high?
I also have fibromyalgia and carpal tunnel
I stay exhausted and have constant joint pain
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