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What do high Antibodies mean?(Thyroglobulin AND Thyroid Peroxidase)

My doctor did blood work a few weeks ago and the next visit said my thyroid numbers were way up there, one was over 1,000) so started me on 25mcg of Levothyroxine. I requested copies of the results - because my mother had her thyroid "zapped" as she puts it, years ago, and said if my numbers were that high I would be running up and down the street!   Anyhow - I talked to the doctor again since then, but they way he explained it did not make any sense, other than it seems I have both Hypo and Hyper conditions...?
There are only 3 tests I see they did relating to the thyroid - They are as follow;
TSH, 3RD GENERATION  1.73                (range 0.40-4.50)  
THYROGLOBULIN ANTIBODIES    248     (range IU/mL 1,000    (range IU/mL <35)

The TSH looks normal (to me...?)
The other two are both high, and the doctor said that the test only shows up to 1,000,which mine is and could be over that as well. He said in rare cases some people are both hypo and hyper, but how can that be? He also stated that Many people are diagnosed with depression disorders etc., when a lot of symptoms are directly related to these thyroid issues, which many doctors do not even check.  

Can anyone explain these results, the cause of, and what treatment should cure it? I have had my thyroid tested many times over the years and it was always normal - or so I was told - unless they did not do these antibody tests...? Also, is there any natural remedy I could take in place of the medicine that may have the same results?

He said they would draw blood again in a bout a month and see if the medicine was bringing the numbers down and if not then do some other tests for thyroid cancer and something else. Does this sound correct?
19 Responses
649848 tn?1534633700
As I understand it, your TGab is 248 and your TPOab is at least 1000?  

Both of those antibody tests are to confirm Hashimoto's.  There's no evidence indicating that you have both hyper and hypo conditions.  Hashimoto's "can" be characterized by periods of hyper swinging to hypo or normal, in the early stages.  Hashimoto's is autoimmune, which means that for some reason your body sees your thyroid as foreign and produces antibodies to destroy it.  The disease is progressive, in that the antibodies continually attack the thyroid until there is no healthy tissue left.  As this happens, your thyroid will produce less and less of the hormones, until it eventually produces nothing and you are completely dependent upon the replacement med.  As the destruction of your thyroid goes on, you will have to periodically adjust your med dosage to accommodate the smaller amount of hormones your thyroid produces.  

Hashimoto's is the most common cause of hypothyroidism in the developed world;  many of us on this forum have it.  There is no cure and there is no "natural" treatment; you'll have to be on replacement hormones for the rest of your life.

Do you see anything on the blood work that would indicate T4 or T3 tests?  The T4 might be listed as thyroxine, Free or T4, Free (or Total) and the T3 might be listed as Liothyronine, Free or T3, Free (or Total).  If either of those are on there, please post the results and be sure to include reference ranges, which vary lab to lab and have to come from your own report.

What, if any, symptoms do you have?  
My TPOab was up to 5000. I did not take any meds but chose instead to change my diet. There is a strong link between gluten and Hashimoto&#39;s. After about 4 months my TPOab was down to 2100 and after 7 months, 1450. I expect it to keep going down over time. Eat healthy. Avoid gluten and iodine. Read &quot;Grain Brain&quot;. Headaches are also linked to gluten sensitivity.
Avatar universal
In Case I can't figure out how to edit my post above - The correct results were:

TSH, 3RD GENERATION  1.73                (range 0.40-4.50)  
THYROGLOBULIN ANTIBODIES    248     (range IU/mL 1,000     (range IU/mL <35)

Somehow part of it did not show up in the original post above.
Avatar universal
Interesting - the post keeps removing part of what I am posting!
Avatar universal
Avatar universal
Hello - Thank you for the information. Unfortunately there are no other results pertaining to the Thyroid in my tests. And there are only a few other things that are flagged as High - My Red Blood Cell Count, Hemoglobin, Hematocrit and also ALT. Everything else is within the ranges on the test results.
I was doing a little research and had come across a natural treatment named guggul extract that has been being used for thyroid issues... Do you have any information regarding that treatment?
Avatar universal
I forgot to mention regarding symptoms, I was not being seen for anything to do with my thyroid. I was there for Migraines, which I get 2-3 times a week and extreme pain in arms, legs, feet, hands and neck. A year ago I was seen for being fatigued, and weight gain - and they diagnosed me with depression and prescribed an antidepressant - I took one pill and no more because it made me feel very weird - and I knew I was not depressed. I just became tired much more easily and could not seem to lose any weight even though I watched what I ate and worked out and ran daily.  
It sounds like gluten sensitivity to me. Read Grain Brain by Dr. David Perlmutter, board certified neurologist. He links gluten to headaches, depression, weight gain and Hashimotos.
649848 tn?1534633700
Okay, so I got your antibody test results down pat -- I stand with what I said; they are grounds for a diagnosis of Hashimoto's Thyroiditis; if your doctor doesn't tell you that, you might want to fire her/him.

Is your doctor checking into why your RBC, Hemoglobin, Hematocrit and ALT are high?  High ALT could indicate a liver issue.

I've heard of guggul, but am not that familiar with it... My question would be, what difference does it make whether you take a daily dose of thyroid hormones that is known to alleviate symptoms, or if you take a daily dose of a supplement that might be questionable?  A pill is a pill and I'm pretty safe in saying that the thyroid pill is smaller and easier to swallow than the guggul pill.

Quick research:  "Underactive or overactive thyroid (hypothyroidism or hyperthyroidism): Guggul might interfere with treatment for these conditions. If you have a thyroid condition, don’t use guggul without your healthcare provider’s supervision."

Here's another one:  "Hormone-sensitive condition such as breast cancer, uterine cancer, ovarian cancer, endometriosis, or uterine fibroids: Guggul might act like estrogen in the body. If you have any condition that might be made worse by exposure to estrogen, don’t use guggul."

And another:  "Surgery: Guggul might increase the risk of bleeding during and after surgery. Stop using guggul at least 2 weeks before a scheduled surgery."

Migraines can be a symptom of hypothyroidism, as are joint/muscle aches/pains, fatigue and weight gain.  Golly, they diagnosed you with depression with those symptoms? That's unreal..  Oh yeah, they only tested TSH, didn't they?  You need to have tests for Free T3 and Free T4, which are the actual thyroid hormones... TSH is a pituitary hormone and should not be used as the sole basis for diagnosing or treating a thyroid condition..

You have Hashimoto's and it's very common for symptoms to show up long before actual thyroid hormone levels reflect a problem, let alone TSH... This makes me want to scream... I went through the same thing.  It's frustrating, but now that I know what I know, it's scary more than anything.  When I think back at the doctors I saw and some of the things they said to me, it makes me angry.

Can you talk to your doctor about getting tested for Free T3, Free T4 and another TSH?  They all need to be done from the same blood draw in order to get the best information.
Avatar universal
Yes I will ask him next week to test the Free T3 & T4 and another TSH. SO then just based on the levels of Antibodies  I have Hashimoto's? What then does the testing of the Free T3 &T4's determine? From the little research I have had time to do, it seemed the high levels of antibodies determined that an autoimmune disease was present - but could be a number of any one of them...? Or did I misunderstand?   When reading that the antibodies would be attacking the thyroid because they seen it as a foreign object - it made me recall my pregnancies - my son was born 3 months early and I had had 3 miscarriages prior to that. Then when I became pregnant with my daughter we went to Ohio State and had various tests ran, they had determined I had something that had been treating my pregnancies as foreign and trying to abort them - They had put me on some type of medicine for the entire pregnancy with my daughter and I carried her to full term - It was so long ago (almost 30yrs) I can't remember all of the details, but wonder if it is associated with these antibodies in any way...?  I plan to try to get my records from back then to see exactly what it was.   In your opinion should I even be taking the Levothyroxine without knowing what the Free T3 & T4 levels are?
649848 tn?1534633700
  While TPOab can be present in small amounts with other autoimmune diseases, both, it and TGab are thyroid specific, meaning they only attack the thyroid.  Autoimmune diseases aren't like a cancer that attacks all over the body, except for Lupus.

I explained Hashimoto's in my original comment.

The significance of Free T3 and Free T4, are that they are the actual hormones that the thyroid produces, while TSH is a pituitary hormone and does not always reflect actual thyroid hormone levels.  

The thyroid produces both T4 and T3, but mostly T4, which the body can't use directly; it must be converted to T3.  Of the T4 that's produced, the majority (approx 95%) is attached to protein, which render it unavailable for conversion.  The unbound portion (Free) is the portion that's available for the body to convert to T3.

As with T4, the  majority of the T3, either converted or produced, is bound by protein and is unavailable for use by the individual cells.  The unbound (Free) portion is what's available for use by the cells.  

Neither Free T4, nor TSH correlate with symptoms, but Free T3 does.

Because both the thyroid and reproductive systems are part of the endocrine system, all the hormones have to "balance" in order for everything to work right.  Hypothyroidism can cause miscarriages, erratic menstrual cycle, inability to get pregnant, etc.  When one gets pregnant the fetus is dependent on the mother's thyroid hormones until it's own thyroid develops. Adequate thyroid hormones are essential for the growth and development of a fetus.  I wouldn't even hazard a guess as to whether or not, thyroid might have affected your pregnancies.

No, I don't necessarily think you should be on levo, even without knowing your FT3 and FT4 results; however,  I do think your symptoms are, definitely, those of hypothyroidism and warrant further investigation; because of that I think your doctor did the right thing by starting you on medication, though we always prefer to have the investigation done prior to medicating, so we have baseline results.  If he's planning on having the medication lower your antibody count, which is what I understand from your original post, he'll be disappointed.  

The levothyroxine only replaces thyroid hormones that your body can't produce.  
Avatar universal
Thank you for the in-depth explanation - It does make sense -  I had the Human Anatomy & Physiology book out earlier today and had pretty much retained what you explained - You verified I understood everything correctly. My Thyroid has been tested approx every 2years - unsure which tests they did - but that was always the first thing tested when I complained of fatigue. Results were always normal until now.    The first time it was tested I just woke up one day and could barely move - Total exhaustion - However at the time I was a single mother running 2 of my own businesses, opening a third, homeschooling my daughter and attending my son's sports events - So looking back I could see where it was simply that - Total exhaustion.

But yes, my doctor explained he wanted to do the same blood tests again in  3-4 weeks to see if the antibody numbers are dropping after taking the levothyroxine. If I understand correctly, he should know what my TH level is to begin with, which should be low for me to be taking the levothyroxine, which by taking it would be raising it to a normal level...?   He said if the numbers have not began to drop then he would want to run different tests such as a biopsy for thyroid cancer.  Which I can see now after understanding what is what - that would obviously be HIS next step since the levothyroxine is not even intended to lower the antibody count!  

This may be a stupid question, and I apologize if I missed where you have already addressed it - You had stated that Hashimoto's "can" be characterized by periods of hyper swinging to hypo or normal, in the early stages - would that then raise and lower the TH level? You also stated that it is a progressive disease - So does that mean that once my antibody levels are this high that they will not ever be below these numbers again? Or, can the antibody levels fluctuate?  Just curious as to if I could have possibly have had this before and if they Do fluctuate that could explain why my tests results have always been normal until now.  
649848 tn?1534633700
I'm not sure what you're calling "TH".  Do you mean TSH?  or do you mean Thyroid Hormone level?  TSH is a pituitary hormone that stimulates the thyroid to produce Thyroid Hormone.

Yes,the early stages Hashimoto's can be characterized by periods of hyper, alternating with hypo and even normal.  The episodes can last for days, weeks or months.  I believe I had those swings for at least 25 yrs before I finally became permanently hypo.  During hyper times, your TSH level would, theoretically, drop to low levels and your actual hormone levels would rise.  Once you get through the hyper period, TSH level would rise again and actual hormone levels would drop.

Antibody levels can fluctuate, so when they're tested again, they may be lower or they may be higher.  That doesn't mean that your Hashimoto's is getting better or worse.  Once you have the antibodies you will always them, though their levels may not always be the same.  

TSH can also fluctuate and is affected by many things, other than actual thyroid hormone levels.
Avatar universal
Yes, the TH that I was referring to is the Thyroid Hormone ( Free T3 & T4's).  Which is what the levothyroxine is actually being taken for, although I have not been tested to see if my TH is even low. I've decided to stop taking it until I can get that tested to see if I even need to be taking it (yet). Since I have began taking it my neck has become very stiff and hurts - and he upped it to 50mcg after two weeks at 25mcg, but that had me feeling like my body was overheating for no reason at all, so he said go back to the 25mcg! My neck still hurts, - No idea if it is even related to my thyroid issue but am betting it is since it was fine before I began taking the levothyroxine!

Well if he tests me again with the exact same tests and the antibody levels are lower he will tell me the levothyroxine is working - he told me that's the plan.When actually it has nothing to do with those levels - right? How can a doctor not know that?

So it's possible I have had this for some time, and by chance each time my thyroid tests were done prior to this one my levels must have been normal. Or they tested my TH and not the antibodies.

Thank you for all of your help - you definitely helped me understand what may be going on - how it all works. The doctor actually told me that I have both Hyper and Hypo, unless he meant it is fluctuating - but he couldnt know that with just the TSH and the Antibodies tests. Regardless I will request the FREE T3 & FREE T4  be done and go from there.
649848 tn?1534633700
Okay, now I understand.  We aren't used to seeing thyroid hormone levels being referred to as TH, so that threw me.

It's never a good idea to stop taking medications without your doctor's blessing.  

It's also not unusual for symptoms to worsen or for new ones to appear, when one begins a medication or has a dosage change.  It takes 4-6 weeks for a medication to reach full potential in your blood, so most reactions prior to that are minor, unless there's a reaction to a filler/binder in the med.

There's no need to test antibodies every time you have blood work; it's a waste of money, because once you have them, you have them for life, even at varying levels.

From my reading, the antibodies should go into remission once your thyroid is no longer working at all, because there's no healthy tissue for them to destroy and since they are thyroid antibodies, they won't attack other organs.

Yes, it's possible that you've had this for a long time.  Most likely, this is the first time antibodies have been tested (mine were never tested until after I was diagnosed with hypothyroidism, then antibodies were tested to determine the cause).  Most likely, the thyroid tests you've had over the years consisted only of TSH, and if it was in the "normal" range, no one would have thought to run antibodies.  Many doctors still refuse to order the actual hormone tests (FT3 and FT4); I'm really surprised that yours ordered the antibody tests without the FT's.  

There's nothing in the labs you posted to indicate hyper, unless your doctor is attributing one of the antibodies to hyper, which would be incorrect.  The other possibility is that he could be saying hyper, too, because your TSH is relatively low in the range. He would have had to do a TSI test to diagnose hyper and you don't have hyper symptoms.

Yes, do get the Free T3 and Free T4. When you do, feel free to post them here, so we can see how you're doing.
Avatar universal
I have had similar experience. Sometimes I get extreme pain in one of my legs. Feels like growing pains with some extra umph... My hands ache a lot and it doesn't take much to get a writer's cramp. I have eczema on my scalp. I get sick like crazy! Frequent headaches. I have allergy induced asthma on top of it.
In the spring of 2011 I was diagnosed with hypothyroidism. My level was
14.34 (range .5-5.5)  
I started out on thyroid hormone replacement at 5mcg and now I take 250mcg. My levels have been up and down since then. But within the past few months my levels went from 6.3 back to 11.52. My doctor switched me from taking a generic to a name brand replacement.
I have a pretty big lump on the left side right now and it causes pain. Last time they checked it was benign. And my old family doctor said it shouldn't cause pain, but it does! My neck hurts. The lump is very tender. It feels difficult to swallow often. I am very tired all the time. And I feel very emotional. I cry at the drop of a hat... My old doctor had told me to take antidepressants and see a therapist.
I just want to feel better and lose weight :(
Avatar universal
Just a note for anyone with a thyroid issue / Hashimoto's.  These types of concerns have been linked to a gluten allergy or intolerance.  I would suggest going gluten free for two weeks and see if any of your fatigue, headaches, etc. improve.  This really helped me (to go off of gluten).  

My thyroid values are normal, but my daughter has hypo and likely Hashimoto's as well.  Her antithyroid antibodies dropped significantly after she got off of gluten.  There are over 300 symptoms of gluten intolerance, which can be found here:  http://glutenfreeworks.com/gluten-disorders/symptom-guide/

In addition, frequent headaches is the most common symptom of a food allergy or intolerance.  It took years of me going to doctors who wanted to put my on an antidepressant to find one who asked a simple question:  "What do you eat?"  This changed everything.  Finally, a doctor who looks beyond the prescription pad to prescribe drugs you will take forever, and instead someone looking to get to the root cause of the problem.  

Not saying that going gluten free will cure a thyroid malfunction, but if you have Hashimoto's, I would seriously consider going gluten free.  There is no reliable blood test to diagnose a gluten intolerance (although there ARE tests to diagnose gluten allergy).  The way it is diagnosed is to stop eating it and see how you feel.  Gluten is in rye, wheat, barley and sometimes oats, due to cross contamination.  Of course, it is in tons of additives, natural flavors, vinegar, etc. found in most any packaged food.  So, if you're going to get off of it as a trial, do your research first, and make sure you truly ARE gluten free.  Best of luck!
Avatar universal
Hi Barb

Please Help.

I am jumping on the wagon here. I am trying to conceive, and suspect that I have had a 2nd chemical pregnancy this cycle. I have been diagnosed 1 year ago with Hashimotos. Would you mind having a look at my lab results, i live in south africa so dont know if that will make much of a difference.

1st tests before I insisted on having the antibodies tested.

TSH 3.69 Ref 0.46 - 4.68 mIU/L
FT4 8.57  9 - 22.2 PL - I think this might have been flaged
They didnt test for T3

a month later

s-ft3 4.5pmol/L REF 2.6 -5.7
TSH 2.47 uIU/ml 0.35 -4.94
s-ft4 12.1 pmol/L 9.0 - 19.0 euthyroidism 'normal'

Anti TG Antibody 15.24 IU/ml H<4.11
Anti TPO Antibody 8.03 IU/ml H<5.61

Anti TG Antibody Hashimotos 75% Graves Disease 75%
Anti TPO Antibody Hashimotos 64% Graves Disease 92%

symptoms Hair loss, muscle cramps, joint pain, fullness in throat. I use to have heavy vertigo but that is so to say gone, just a tad dizzy every now and again. irregular cycles 26 - 29 days.

I am on 100 mg euthyrox.

Can I even have a successful pregnancy with these anti bodies, and hashimotos or should i just stop trying?  

Avatar universal
I have the choking sensation as well. I have nontoxic multinodular goiter. I am a 50 yr old female 1 1/2 year post hysterectomy. Since my surgery my weight has exploded. I am 5'6 and weigh 206 lbs. I know I need to lose weight and I am thinking the weight problem is the issue. I find when I do not wear a bra I do not have choking issue. My breasts have increased in size since the surgery and I have gone through at least 5 different bra sizes since then. The straps are causing an indentation on my shoulders and when I take off my bra I feel like I can breath again. Instead of getting another bra I think I am going to ask the doctor for help in losing weight. Can anyone else relate?
Avatar universal
Sorry I posted my comments to the wrong community. Please disregard my last comments.
Avatar universal
there r other types of thyroiditis other than Hshimoto or Graves - some can pass after a while by themselves http://thyroid.about.com/od/thyroidbasicsthyroid101/tp/thyroiditis.htm?utm_term=thyroiditis%20symptoms&utm_content=p1-main-3-title&utm_medium=sem&utm_source=google&utm_campaign=adid-acad5741-30a9-441e-8f33-9186e51d0146-0-ab_gsb_ocode-12560&ad=semD&an=google_s&am=broad&q=thyroiditis%20symptoms&dqi=&o=12560&l=sem&qsrc=999&askid=acad5741-30a9-441e-8f33-9186e51d0146-0-ab_gsb  
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