Thyroid Peroxidase Antibody levels

[cb2009]

Hi, I was wondering what others Thyroid Peroxidase Antibody (tpo) levels were in those diagnosed with hashimoto's? I was diagnosed with hashi's about 6 months ago, but recently had bloodwork done (on my own) and have almost no antibodies in my system (am within the normal range of 0-34). Does everyone else with Hashi's have consitently high antibody numbers? I'm trying to figure out if mine is going away because my TSH has also dropped to a hyper level, but I have not changed my dosage. Usually you hear of people requiring more meds, not having to decrease their dose with Hashimoto. My TSH has been normal during the past 6 months, so I know my dosage was correct originally. I know it probably sounds impossible for Hashi's to go away, but thats what my bloodwork appears to be saying....which would be SUCH a blessing!! Any opinions or information? Thanks!

[goolarra]

Very unlikely.  What it means is that you have Hashimoto's thyroiditis.  TPOab and TGab are the marker's for Hashi's.  Your TPOab is elevated.

What's the reference range on your TRab and T4?  Is that a FREE T4 (FT4)?    

[anniem65]

I just got my blood work back and doctor wants to order all these test
TSH 3.82
T4 1.65
antithyroglobulin ab  18.4
thyrotropin receptor sb serum    1.03
thyroid peroxidase (TPO) Ab                   857
Does this mean I have cancer?

[goolarra]

Eltroxin, which is T4 only, works for many people (myself included).  It should help with your fatigue.  Just bear in mind that many of us have to have FT4 around midrange before all symptoms are relieved.  FT3 is the test that correlates best with symptoms.  When we take T4 meds, T3 should go up as well.  Ask your doctor to include FT3 next time around so you can track how it increases in response to higher FT4 levels.

After being on Eltroxin for 4-5 weeks, you should have follow up blood work and talk with your doctor about a possible meds adjustment.  

[Anonybody]

Thanks Goolarra,
I'm getting an ultrasound today. The doctor was very quick to diagnose hypo, which as I understand is good (getting treatment is good), but was evasive when asked if my thyroid was being destroyed (she said no) perhaps because she did not want to startle me. I suppose I am anxious because I am studying at university, working and supporting a husband who is long term unemployed. So struggling with physical and mental fatigue is worrying. I was hoping that eltroxin, would help clear up the fatigue, but time will tell.
- Thanks for your helpful response Goolara.

[goolarra]

An elevated TPOab level is considered confirmation of a diagnosis of Hashi's, and yours is elevated.  A thyroid ultrasound might be a good idea.  Although confirmation is hardly necessary with your strong positive TPOab test, U/S is usually done to check for nodules (most of us have them) and monitor any changes in them.  

Your TSH is high, indicating that you are hypo.  FT4 is on the floor of the range, confirming hypo.

Next time, ask your doctor to test FT3 as well.  It's the test that correlates best with symptoms.  Your Eltroxin should raise both your FT4 and FT3 levels, but some people don't see a corresponding rise in FT3 when FT4 goes up.    

[Anonybody]

Hi,
I Just received my test results for Anti Thyroid Peroxidase Antibodies. My level was 9249: a normal level is between 0-50. My TSH count was +16.95, but should be between 0.5 and 4.20. My FREE T4 is 7 and the normal range is between 7-16. I am about to begin taking Eltroxin for hypothyroidism. I was wondering do these results also indicate Hashimoto's Disease? Are further tests required to find out? Thank you.

[Barb135]

AR-10 has not been active on the forum for some years, so it's unlikely that he will respond to your questions.

It's very possible that you, too, have Hashimoto's.  There are 2 antibody tests that you need to diagnose Hashi's.  Those are Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TGab).  Can you find out which of those 2 tests you had done?  

You can have Hashimoto's, without symptoms, in the beginning.  Some people can have it for years and not know it. Your TSH is rising and your FT4 seems to be dropping.  It could be just a matter of time before your FT levels drop enough to cause symptoms.

[jillbean60]

I am 43 years and have no symptoms at all. I am wondering if any of this makes sense. My routine medical picked up a high TSH level twice with normal Thyroid function. Now, the TSH and all the other levels are normal except a TAb test just above normal (not sure if 44 IU/ml is much more than normal).

I am symptom free and yet my mothers brothers and my cousins have Hashimotos. So, maybe I have Hashis. Concern? Keep it on the radar and re test a few times a year? What do u all feel is the right course of treatment?

February 2013
TSH: 2.8 (normal 0.27-4.2 new normal as of Feb 4, 2013) (NORMAL)
T4 Free: 15.9 (normal 10.5-20.0)
T3 Free: 5.1 (normal 3.5-6.5)
Thyroid Antibodies TAb: 44 IU/ml  (normal <35. However it can vary up 250IU/ml in 5% to 10% of the population without demonstrable thyroid disease)

December 2012
TSH: 9.1 (normal 0.38-5.5) ABNORMAL
T4 Free: 17.0 (normal 10.5-20.0)

August 2012
TSH: 7.3 (normal 0.38-5.5)  ABNORMAL
T4 Free: 15.6 (normal 10.5-20.0)

[Barb135]

Yes, you could have Hashimoto's.  There are people diagnosed with Hashimoto's who have no antibodies at all.  Along with that, ranges vary from lab to lab, so your lab might be using a smaller range than another lab. A thyroid ultrasound would be good to determine whether or not you have swelling/inflammation (goiter) in your thyroid and whether or not, you have nodules on your thyroid.  Both goiter and nodules are indicative of Hashimoto's.

That said, there are 2 antibody tests that need to be done to diagnose Hashimoto's.  Those are Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TGab).  They both need to be done, because some people have only TPOab, others have only TGab and still others have both.

Are you having any hypo symptoms?  If so, which ones.  

Have you had any tests, other than TSH done to determine actual thyroid function?  You also need to get Free T3 and Free T4, though many doctors don't do those, without insistence.

Agree that the number of antibodies does not determine how badly a person feels.

[Mom2allgirls]

The short answer is NO..  The longer answer:   In the  Thyroid Antibody test (most likely TPO  or THYROID PEROXIDASE ANTIBODY  test   Normal is UNDER 34. yours is normal. In the last year I've FINALLY been diagnosed with Hashimoto's after telling an endocrinologist my Grandma had an underactive thyroid but wasn't diagnosed until she was in her 60's.  Hashimoto's and thyroid problems are OFTEN though not always  hereditary.. My TPO level was 182.. though I just read posts of people having TPOs  over 500 and in the 3000's.   However My Endocrinologist told me JUST yesterday that someone with a level of 182 is no better off or worse off  than someone with a level in the 3,000s. The person with a level in the 3000s is not worse off than someone with my level either it varies from person to person.. Also from what I understand, Hashimoto's  is like a pendulum.. it can swing from hypothyroid to hyperthyroid and  even sit in the middle (your thyroid is working)  This is why Hashimoto's needs to be watched closely

[Skrap55]

I have a positive 25 on a thyroid antibody test and TSH of 1.0 could I have hashimotos?

[AR-10]

TGab is a marker for ;

Hashimoto's thyroiditis
Thyrotoxicosis
Systemic lupus erythematosus (SLE)
Hypothyroidism
Thyroid cancer
Myxedema
Grave's disease
Type 1 diabetes

It can indicate any of these conditions.

It is most often seen in thyroid disease, and is a good indicator of Hashimoto's.

The difinitive test for Hashimoto's is FNA, and a sample examination for Hurthle cells with a specific characteristic, but that involves sticking a needle in your neck. Who wants to go there?

TSH sometimes moves much faster than T4 and T3 when level changes occur. That is why your labs look so confusing right now.

It is possible in the early stages of Hashimoto's to turn hyper for a while. It is also possible that you could be entering a Toxicosis phase.

And yes, it's possible to flip back and forth.

It's also possible that your thyroid may be perking up and you need to cut down on your meds. :)

Unfortunately, only time will tell.
Best of luck.

[cb2009]

And also don't understand why I would be normal for Thyroid Peroxidase Ab while at the same time high for antithyroglobulin Ab. I have read that testing positive for Antithyroglobulin Ab can also mean Graves Disease (hyperthyroidism). I wonder if it's possible to switch from Hypo to Hyper?

[cb2009]

Surprisingly (or not?) I was never tested for antibodies when diagnosed for Hashi's. My original tests at the time of diagnosis were:

T-Uptake - low
T-4 - low
T-7 - low
TSH - high (6.122)

That was back in september 07. Since then I have never been tested for antibodies (until I just had them done on my own out of curiosity). My TSH is currently .156 but T3 and T4 are normal, not high as would be expected with a low TSH. I am very confused by my labs! :(

[AR-10]

Unfortunately, TPOab and TGab(antithyroglobulin antibodies) are both antibodies indicative of Hashimoto's. They are not specific to or conclusive for Hashimoto's, however.

How were you diagnosed with Hashimoto's without antibody tests? Did you have a Fine Needle Aspiration performed that led to a diagnosis? Just curious.

You may be needing less medication because your thyroid is perking up, or you may be entering a phase of instability.

If you tested high for TPOab six months ago and almost nothing now, that would be quite unusual!

[cb2009]

Oh, I also forgot to mention, I had a test done for Antithyroglobulin antibodies and those levels were high: 534 (normal: 0 - 40)

I'm not quite sure what the difference is between thyroid peroxidase ab and antithyroglobulin ab? What do these different tests tell? Thanks again for any help.