Aa
Aa
A
A
A
Close
Avatar universal

high tpo antibodies but no thyroid?

Hi. I had a total thyroidectomy and RAI 131 for thyroid cancer. I shouldn't have thyroid left, so why am I now getting high anti thyroid peroxidase antibodies?  Can anyone help please?

Thank you.
11 Responses
Sort by: Helpful Oldest Newest
649848 tn?1534633700
COMMUNITY LEADER
Redheadaussie hasn't been active on the forum for quite some time, so it's unlikely she will respond.

There's really nothing to be frightened having antibodies.  They destroy healthy thyroid tissue and cause hypothyroidism, but you've already done that with the RAI.

Are you on a thyroid replacement hormone?  If so which one, what dosage and for how long.  What are your actual thyroid hormone levels?  Please post them, along with reference ranges, which vary lab to lab and have to come from your own report.
Helpful - 0
Avatar universal
I had RAI Nov 1, 2012. My recent antibody levels came back 421 last week (May 30, 2013). I am frightened.
Helpful - 0
649848 tn?1534633700
COMMUNITY LEADER
The range resembles what we normally see for TPOab; it means that anything < 30 is negative for antibodies.  Your result is 300+ which means positive.  TPO helps with the conversion of T4 to T3.

Do you have a copy of the actual lab report or are you going by what someone told you?  You should always make sure you get copies of all lab work and diagnostic tests, for your records. Your doctor is obligated to give you a copy upon asking. If the test was a TPOab, it will say so on the report.  It  might also be listed as Thyroid Peroxidase Antibodies, antimicrosomal antibody test, and antithyroid microsomal antibody test.

What were the results of the T3 and T4 tests? And were they "free" or "total" T3 and T4?  Free and total are not the same thing, and if they did tests for total, they will be of little value, since those tests are considered obsolete. Be sure to include reference ranges, since those vary lab to lab and must come from your own report.

I'm surprised that no one followed up on an enlarged, irregular thyroid.  Enlarged thyroid is a goiter and is very common with Hashimoto's.  The irregular texture makes me think you need more adequate follow up.  

Do you have a copy of the ultra sound report?  Did it indicate whether or not, there were nodules on your thryoid? Nodules, also are very common with Hashimoto's.

You should also ask your doctor to run a thyroglobulin test, as well as a Thyroglobulin Antibody (TGab) test.  Thyroglobulin is a protein used to produce thyroid hormones. Elevated TG is often used as a cancer marker - not saying you have that, just that you need to be checked to rule it out.  

TGab is another antibody test that could confirm Hashimoto's.  Some of us with Hashi's have TPOab, others have TGab, while still others have both.  

If you don't have copies of your labs, I strongly suggest that you get, and keep, them for your records.
Helpful - 0
Avatar universal
Thank you for this information. We live in a rural area of Arizona and the doctors don't seem to understand Autoimmune issues. I had a stroke about nine months ago and had an ultrasound to check the choriodid arteries, they found that my thyroid was enlarged and irregular texture. This was not addressed by the doctor at the time and when he recently ran the T3, T4 and TSH he also accidentally ordered a TPO test. I don't believe it was a TPOab. The range for the TPO test that was run was 0-30 and mine was 303. I was referred to an endochrinologist but can't get in until the end of November. If the TPO is not the same as TPOab, then I am not sure what this means.
Helpful - 0
649848 tn?1534633700
COMMUNITY LEADER
Do you have high TPO or high TPOab?  TPO is an enzyme used to produce thyroid hormones, TPOab is antibodies that attack and destroy healthy thyroid tissue.

If it's your antibody levels that are at 300, this would indicate that you have the autoimmune thyroid disease called Hashimoto's Thyroiditis.  Antibodies can be high, even though you have no symptoms and/or thyroid test levels are in the normal range.  This would indicate that the antibodies have not yet destroyed enough of your thyroid, to keep it from producing adequate hormones.

Additionally, TPOab can also be present in small amounts in other autoimmune diseases, such as Pernicious Anemia and RA, plus others. Your level is high enough to indicate Hashimoto's and your thyroid levels should be checked on a regular basis, so that you can get treatment, as soon as they begin dropping.  You should be getting Free T3, Free T4 and TSH, every time you test.

Helpful - 0
Avatar universal
I have TPO levels in the 300 range, but all other thyroid test levels are mid range normal. Because my daughter has Primary Biliary Cirrohisis our doctor ran an AMA and ANA which have all come back negitive. What in the world could be going on? Anybody have any ideas?
Helpful - 0
219241 tn?1413537765
After RAI antibodies actually can rise dramatically higher than pre treatment. This is a paradox of sorts, but they do settle down. You didn't mention how long ago you had the RAI, if only recently then that would explain your situation.
Helpful - 0
649848 tn?1534633700
COMMUNITY LEADER
What are the actual levels, with reference ranges, for the Free T3 and Free T4?  Often, even when these are "in range", the patient does not feel well.  The lab's "in range" is not "normal" for everyone.  The important thing is not what your results look like on paper, but how you feel with them at the current levels; if you don't feel well, there's something going on - either you thyroid levels are not optimal for you, or there's something else.

People who have one autoimmune disease are often likely to have another, at some point, so just because you don't know of anything, doesn't mean there's not another present - it may just not have presented symptoms yet.  
Helpful - 0
Avatar universal
Many thanks for replying so quickly Stella5349 and Barb135  

I have just had another TG test, awaiting results.  TSH seems well supressed but I am continuously exhausted and still gaining weight.  Free T4 seems fine, Free T3 is mid range in the normal spectrum.  On paper my results seem fine other than anti tpo.  I can't imagine what other autoimmune diseased may be going on, I assume none - at least none that I know of.

My neck is painfully tight and I feel like I have a potato stuck in the side of my neck, though there is nothing to see. Voicebox a little croaky, but no throat infection or soreness.  I'm hoping this is going to be nothing.  My fear is that it is related to the cancer - possibly coming back?

Sorry.  I'm tired and worried.  Thank you for your help. It has been appreciated.
Helpful - 0
649848 tn?1534633700
COMMUNITY LEADER
Antibodies (TPOab) can be present if other autoimmune diseases are there too.  
Helpful - 0
393685 tn?1425812522
just because the thyroid is no longer present you still have sick autoimmune antibodies that can cause issues. Antibodies attack and even thyroid antibodies can be present with no gland.

Have you had your TgAb tests and cancer markers done recently? How long has it been since the TT and RAI?

Also - demand you get your free T3 and Free T4 labs done at each draw with TSH. If your free T3 is marked too low for you and being held at a low function w/ previous cancer the antibodies AND cancer markers can grow again.
Helpful - 0
Have an Answer?

You are reading content posted in the Thyroid Disorders Community

Top Thyroid Answerers
649848 tn?1534633700
FL
Avatar universal
MI
1756321 tn?1547095325
Queensland, Australia
Learn About Top Answerers
Didn't find the answer you were looking for?
Ask a question
Popular Resources
We tapped the CDC for information on what you need to know about radiation exposure
Endocrinologist Mark Lupo, MD, answers 10 questions about thyroid disorders and how to treat them
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.
Condoms are the most effective way to prevent HIV and STDs.