Low to moderate levels of TPO antibodies can be found in certain autoimmune diseases and rarely in apparently healthy subjects - especially elderly women. Higher TPO antibodies and/or Tg antibodies are found with autoimmune thyroid disease.
In rare cases, Hashimoto's thyroiditis can go into remission. But for most, Hashimoto's thyroiditis is a progressive disease where the thyroid antibodies begin to destroy natural thyroid gland protein cells. Those with very high elevations of thyroid antibodies may see faster cell destruction and damage to the thyroid gland. Selenium may lowers TPO antibodies but has not been shown to have any effect on Tg antibodies.
Would this be considered an abnormal level of antibodies:
Anti TG Ab: - 126.9 IU/mL - (<4.5)
Anti TPO Ab: - 13.7 IU/mL - (<5.5)
I am totally new to all this, was only officially diagnosed yesterday and not even sure what I am reading on my pathology reports.
Your antibody results are high. Hashimoto's thyroiditis is the most common cause of hypothyroidism. Is there a history of thyroid disease in your family? Just to add, there are anecdotal reports of a gluten free diet lowering Tg antibodies. You have insomnia too eh? :)
I don't really have insomnia, most of the time I can go to bed whenever I want. Although in saying that, if it were my choice I would have no problem sleeping 14 hours!
Of a morning when I wake up I feel like I have been hit by a train, and it takes until at least 1pm before I am at least functioning properly.
It creates a huge problem because I don't think my manager really understands. He believes because he is able to go for a bike ride during lunch, a 1 hour long jog and so forth that this is how a normal "male" should function.
If I did that, I would be literally stuffed for the rest of the day and this is a huge issue for me.
I'm stuffed thinking about going for a jog lol! No one really understands until they have the disease i guess. I've had fatigue my whole life so i'm used to it. It's the breathing that i'm having issues with. I developed severe bradypnea down to 6 breaths a minute. Who knew thyroid hormones stuffed up that too. *sigh* :)
Okay, it took me a while...didn't think I remembered any mention of insomnia, and the old brain seemed to be pretty much in gear today...I finally realized you both must be writing in the middle of the night.
Red, do you have a link to what you read that said a g/f diet lowers TGab? I read the whole darn book by K on the subject, and one of my big objections to his theory was that he NEVER said WHICH antibodies his protocol was supposed to lower. As far as I could tell, he made absolutely no distinction between TPOab, TGab and TSI...they were all just "antibodies". Just curious...
I'm so over insomnia. :) I read Dr K's book too. I was surprised he didn't mention selenium may lower TPO antibodies considering the many published studies in medical journals (unless i missed it..i read the book in one sitting). As for lowering TgAb, there isn't a lot of information on this. From what i have read online, a gluten free diet helps some people. One link below which you have already answered...
In Dr Sandra Cabot's book she mentioned one of her patients lowered both TPO and Tg antibodies with her program including selenium, gluten free and dairy free diet. This reminded me of my mother's extreme diet changes last year and her newer TgAb lab results.
I had a look and found my mother's labs. Her Tg antibodies: October 2010: 84 U (<60 normal) and Jan 2012: TgAb 1 IU (<4 normal). In 2011, she was on a strict candida diet for 2 months and she avoided all sugar and white flour (she ate wholemeal bread instead which does contain gluten). She was also on dairy free diet for over 6 months which cleared up her 24/7 post nasal drip she had for 2 years.
Avoiding the food intolerance/allergies (two most prevalent food intolerances being gluten and dairy) may have a positive result on thyroid antibody levels for some people with autoimmune thyroid disease. The info below is from the book "Your Thyroid Problems Solved" by Dr Sandra Cabot which i judiciously edited - pages 166 and 167...
Patient with Hashimoto's Thyroiditis:
The level of her T3 hormone is very low, whilst her T4 level is quite high; the high T4 is coming from her thyroxine medication. The body is not converting thyroxine (T4) into T3.
Free T3 = 1.1 pmol/L (2.5 - 6.0)
Free T4 = 23 pmol/L (8.0 - 22.0)
TSH = 2.0 mIU/L
Anti thyroglobulin antibodies = 80
Anti microsomal antibodies = 1200 (thyroid peroxidase antibodies)
New treatment: Patient prescribed T3 (brand name tertroxin) 20mcg three times a day, T4 100mcg a day, selenium (Dr Cabot recommends 200mcg daily), gluten and dairy free diet, bowel and liver detox.
Three months later:
Free T3 = 5.0 pmol/L (2.5 - 6.0)
Free T4 = 16 pmol/L (8.0 - 22.0)
TSH = 1.9mIU/L
Anti thyroglobulin antibodies = 40
Anti microsomal antibodies = 350
Well, he mentions tons of things...I don't recall selenium, either, but then again if you're trying to sell your own protocol...
It's kind of interesting that g/f diet supposedly lowers TGab. Of those of us with Hashi's, very few are only TGab positive. Those only TPOab positve and positive for both are much more prevalent. So, lowering TGab would have really very little impact on the disease.
Antibodies can vary wildly, even intraday, so really anything short of eliminating them seems a lot of work for little, especially since once the thyroid is effectively "dead", the disease becomes much easier to manage. Why drag out the inevitable? As far as I can see, no one is even working on a possible cure...the "more important" autoimmunes (diabetes, MS, lupus, etc.) are getting a little attention, but it's minimal.
So, I still fail to see what was accomplished in the two sets of labs at the end of your post. The antibodies are lower (whould they be tomorrow?), and the balance of FT4 to FT4 is certainly much better...but 60 mcg (wow!) a day of T3 will do that to you! Once again, so many things were changed at once that isolating the effects of any one is impossible.
Thanks for the excerpt. When is someone actually going to study this stuff?
The less antibodies attacking the less symptoms which is shown in quite a few clinical trials. Who wants to suffer more symptoms when you can suffer less? It could be decades for that thyroid gland to be completely non functional.
The editor of the medical Journal "Thyroid" is quoted as saying "...it raises the possibility that optimal doses of thyroid hormone will not completely ameliorate all symptoms" based on this study:
Ott, Johannes et al. Hashimoto's Thyroiditis Affects Symptom Load and Quality of Life Unrelated to Hypothyroidism: A Prospective Case-Control Study in Women Undergoing Thyroidectomy for Benign Goiter.Thyroid, 2011; 21 (2): 161 DOI: 10.1089/thy.2010.0191
Dr Cabot's program is a bit full on but i have yet to read any book showing before and after results. I wasn't about to join my mother in her extreme dietary plans as one of my favourite foods are the three C: chicken, cheese and chocolate lol. :) Clinical trials can cost a million dollars or more so most studies are drug studies and no drug company is looking for a cure...ever. Cure = no profit.
Yes, I was once reading a book called "Our Daily Meds", which is an expose of drug company policies. Coincidentally, I was sitting in my doctor's waiting room when I read this by a stock analyst for the drug industry:
"We somtimes joke that when you're doing a clinical trial, there are two possible disasters. The first disaster is if you kill people. The second disaster is if you cure them" Very true. Add to that, that it's much cheaper to retool an old product with a "twist", call it something new and get patent rights on it for years.
Quoting from the study you cite:
"This study raises important clinical issues. Although the authors did not study thyroid hormone treatment for Hashimoto's thyroiditis, it raises the possibility that optimal doses of thyroid hormone will not completely ameliorate all symptoms. Further studies are required to confirm the findings of Ott et al. and to determine if patients with hypothyroidism due to Hashimoto's thyroiditis still have residual symptoms despite achieving an ideal biochemical response to thyroid hormone replacement therapy"
My first question is always "optimal dose" as defined by what? To me, "optimal dose" implies no symptoms, either hypo or hyper. If we accept my definition, then the rest of the sentence is an oxymoron. I think "ideal biochemical response" pretty much lets you know how "ideal dose" is defined by the researchers.
With or without Hashi's, an asymptomatic state can't be defined by reference range criteria.
"The less antibodies attacking the less symptoms which is shown in quite a few clinical trials. Who wants to suffer more symptoms when you can suffer less? It could be decades for that thyroid gland to be completely non functional. "
Another statement I disagree with based on my observations on this forum and personal experience. Some people with relatively low antibody counts really feel much worse than people with very high ones. For example, on diagnosis, my TPOab was 900+, and my TGab was greater-than 3000 (yeah, they just gave up counting). At that point, however, I'd been being treated for hypo for over a year and was euthyroid and asymptomatic. My antibody counts were a non-issue.
Given all the issues involved with treating thyroid (reference ranges that are too broad, the "immaculate TSH" belief, etc), I seriously question how many people really experience symptoms from their antibodies and how many are simply not being treated properly for their hypothyroidism. Their numbers are in range...nothing more to be done...eat less, move more, here are some anti-depressants and anxiety meds, see you in six months.
Further, one has to wonder about a couple of things.
1) How were the antibodies lowered in the clinical trials, since there is no proven way to lower them?
2) Since antibodies are so volatile, how was it confirmed that antibodies actually were lowered on a long-tem (i.e. more than just a downward blip on the scrren) basis?
3) Did the subjects KNOW their antibody counts? The popular conception of antibodies is that of a swarm of killer-bee-like creatures searching out and devouring thyroid tissue. Of course, lowering those would make you feel better. I've heard several peole say they felt fine until they learned their antibody counts.
Anyway, an interesting discussion with lots to consider...
The trial i mentioned on my previous comment, Ott, Johannes et al, showed that number of reported symptoms was significantly higher in patients with TPO levels above 121 mU/L than in the other group.
Chronic fatigue, dry hair, chronic irritability, chronic nervousness, a history of breast cancer and early miscarriage, and lower quality of life levels were significantly associated with TPO antibody levels exceeding the cut off point (121 mU/L). The women in these trials were euthyroid patients with Hashimoto's thyroiditis (awaiting surgery). No mention of taking thyroxine prior to thyroidectomy.
Optimal dosage is not the same as "biochemically treated" on paper for many i agree.
1) Various clinical trials show evidence that TPO antibodies may be lowered with selenium and levothyroxine.
2) There is a long term trial (5 years) entitled "Long-Term Follow-Up of Antithyroid Peroxidase Antibodies in Patients with Chronic Autoimmune Thyroiditis (Hashimoto's Thyroiditis) Treated with Levothyroxine." The results showed TPOAb levels decline in most patients with Hashimoto's thyroiditis but after a mean of 50 months (just over 2 years).
"The mean decrease after 3 months was 8%, and after 1 year it was 45%. Five years after the first value, TPO-Ab levels were 1456 ± 1219 IU/mL, a decrease of 70%. TPO-Ab levels became negative, < 100 IU/mL, in only six patients, a normalization percentage of 16%."
3) The antibody levels are measured for each study and one would assume the participant of that study knows what their antibody count is but that is just an assumption on my part. :) Also, i watched a video a while back showing that antibodies were a result of the disease not the cause.
Endocrineweb's "Thyroid Gland Function" article states: "A condition known as Hashimoto's Thyroiditis is associated with a high level of these thyroid antibodies in the blood. Whether the antibodies cause the disease or whether the disease causes the antibodies is not known; however, the finding of a high level of thyroid antibodies is strong evidence of this disease."
A lot more study to be done!
It has been shown I just read a study, and it was lowered by 36%. But iodine is just as important and they work together. Not to forget D-3, B-12, and ferritin levels.
The thing I didn't get is that gluten free, that's where you get selenium from unless you take pills. I think I would like to get a lot from my food. ???
The highest natural source of selenium is in brazil nuts with an average of 70 - 90mg of selenium per nut. Brazil nuts contain no gluten.