Thyroid Peroxidase Antibodies test results?

[Allison90]

I just got results back on a blood test that I took a couple weeks ago. My doctor thought that my thyroid looked a little enlarged so she sent me to get some blood work done. Apparently something is abnormal, because she recommended a follow-up with a primary care doc.

Here are the results:
THYROID PEROXIDASE ANTIBODIES - 722 - Flag(s) H - Reference Range <9 IU/mL

T4, FREE - 1.0 - Reference Range 0.8-1.8 ng/dL
TSH W/REFLEX TO FT4 - 6.70 - Flag(s) H

I have no idea what any of these numbers mean and I don't want to freak myself out over nothing, but I really want to know.

Thanks so much for your help.

[Barb135]

Oh my - feeling run down and tired most of the time, along with steadily gaining weight ARE major symptoms of hypothyroidism, as are the sad feeling and depression.  Treatment with adequate thyroid hormones can, typically, alleviate these symptoms.

What many people don't know is that Hashimoto's can be present for years before we know it or before thyroid labs (TSH, Free T3 and Free T4) actually go out of range.  Symptoms of hypothyroidism can also be present for years before thyroid labs go out of range and many times, doctors will test TSH, which is considered the "gold standard", only to find it's perfect and they won't go any further.  Many times, the symptoms are put down to something else, such as chronic fatigue, fibromyalgia, etc when it's really hypothyroidism.

Hopefully, your doctor will go ahead and start you on daily medication; you'll probably see your symptoms improve with adequate dosages.

[Barb135]

The elevated Thyroid Peroxidase Antibodies (TPOab) indicates that you have Hashimoto's Thyroiditis, which is an autoimmune thyroid condition, which destroys your thyroid, so eventually it will no longer produce thyroid hormones and you will be permanently hypothyroid...  You will have to take replacement thyroid hormones for the rest of your life in order to replace what your thyroid can't produce.

TSH w/Reflex to FT4 means that the lab should analyze TSH and if it's out of range, they should then analyze Free T4... Your TSH is high at 6.70, so they went on to analyze the Free T4, which is in range, but very low, at only 20% of the range.  

Both the elevated TSH and low FT4 indicate that you have hypothyroidism.  The fact that you have Hashimoto's indicates that your hypothyroidism will keep getting worse unless it is treated adequately.

The sooner you are started on medication, the better.

Just for your information, TSH w/Reflex to FT4 is an outdated test... It should be replaced with TSH, Free T4 and Free T3.  Free T4 and Free T3 are the actual hormones your thyroid produces, with Free T3 being the active one that's used by every cell in your body.  

All of this being said, there isn't any reason to "freak out", but it's not "nothing" either... Hypothyroidism "must" be treated, because we can't live indefinitely without thyroid hormones, since they regulate our heart rate, body temperature, metabolism, and other functions.  With a good doctor, hypothyroidism is very treatable.

What, if any, symptoms do you have?   Has your doctor suggested a thyroid ultrasound to determine if you thyroid nodules?

[Allison90]

Thank you so much for the detailed answer!

I haven't noticed any major symptoms, just feeling down and tired most of the time. I've been gaining weight steadily for about four years as well. I also have been feeling really sad for the last month or so but I thought it was the result of depression.

I have an appointment with a primary doc next week to discuss my lab results so we'll see what comes next.

[Allison90]

Oh and I don't know if it makes a difference, but the reference range for the TSH W/REFLEX TO FT4 says:
Reference Range
               1-19 Years 0.50-4.30
I'm a 19 year old female.