Thyroid Peroxidase Antibodies: Lab Test, High Levels & More

Thyroid Peroxidase Antibodies: Lab Test, High Levels & More

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What is Thyroid Peroxidase?

As a thyroid patient, you should probably know a little bit about the protein known as thyroid peroxidase. 

For starters, it’s one of, if not, the most important enzymes in your thyroid. 

It is responsible for ensuring that your body can actually produce thyroid hormone

If there is ANYTHING wrong with this enzyme then there is a good chance you will not be able to produce enough thyroid hormone and you may end up with the symptoms of hypothyroidism

The good news is that most people don’t have any issues with thyroid peroxidase so they don’t have issues with thyroid function. 

But many people, including those with Hashimoto’s thyroiditis, can develop antibodies to this very important enzyme. 

And guess what happens if this occurs?

The enzyme is disrupted, you won’t be able to produce thyroid hormone, and you will become hypothyroid (or low thyroid). 

We are going to spend a lot of time talking about this enzyme, how it becomes disrupted, what it means if you have antibodies to it, how to determine if your levels are normal, what symptoms are associated with high antibodies, and much more. 

Before we do, though, let me explain a little more about thyroid peroxidase. 

Thyroid peroxidase, when it is functioning normally, helps your body use iodine to create thyroid hormone (1). 

It does this by oxidizing iodide into iodine, a process that is actually fairly dangerous for your thyroid cells. 

This oxidation results in the formation of reactive compounds that can damage your thyroid gland!

When everything is functioning normally, your thyroid gland will use anti-oxidants to get rid of the dangerous compounds so no harm is done. 

But if your body doesn’t have enough of these anti-oxidants your thyroid gland may become damaged. 

When everything is working correctly, thyroid peroxidase creates iodine which is then taken up by another larger protein called thyroglobulin. 

Thyroglobulin then smashes two halves of thyroid hormone together to form the full thyroid hormone complex. 

Both thyroid peroxidase and thyroglobulin are incredibly important because they are often the site of thyroid antibody attacks. 

And, often, when you see antibodies to one of these proteins you will see antibodies to the other (though not always). 

Even though we aren’t talking about thyroglobulin antibodies today, I want you to realize that they are both important in creating thyroid hormones. 

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What are Thyroid Peroxidase Antibodies?

What I just described is what thyroid peroxidase does inside of the thyroid gland but this is completely different from thyroid peroxidase antibodies. 

If you’ve been told that you have thyroid peroxidase antibodies, also referred to as TPO antibodies, then this information applies to you. 

Your body creates antibodies to things that it wants to kill or get rid of. 

In a healthy state, you should really never see antibodies to any part of your own body or tissues. 

Why?

Because why would you want to get rid of something that is supposed to be in your own body?

Antibodies are usually created to help your body eliminate infections or viruses (2) but they can sometimes be created by your immune system to target your own body. 

When this happens you are said to have an autoimmune disease (3). 

We can break apart the word to understand exactly what it means: 

optimal TPO antibody levels

Auto (meaning self), immune (meaning your immune system), and disease (meaning something is wrong). 

In the case of thyroid peroxidase antibodies, your own body is creating antibodies that target, damage, and destroy the thyroid peroxidase enzyme. 

These antibodies are produced by the immune system and flow through your entire body until they find their target. 

Once they reach their target their goal is to destroy it. 

And because their target (thyroid peroxidase, in this case) is located in the thyroid gland, your thyroid becomes the site of a war between your immune system and thyroid peroxidase. 

As you might imagine, this results in damage to your thyroid gland which can become permanent if the damage is severe enough. 

Thyroid peroxidase antibodies are often associated with the autoimmune disease known as Hashimoto’s but that’s not all. 

Conditions Associated with High Thyroid Peroxidase Antibodies (What Your Antibodies Actually Mean)

What does it mean if you have thyroid peroxidase antibodies floating around in your blood?

Well, it can mean several things:

  • It may be a marker for the autoimmune disease known as Hashimoto’s thyroiditis. 
  • It may also be a marker for another autoimmune disease of the thyroid gland known as Graves’ disease (4). 
  • It may be a transient thing that may eventually go away on its own (which sometimes occurs in pregnancy (5)). 

The presence of thyroid peroxidase antibodies is never “normal” but it doesn’t always guarantee a poor outcome. 

For instance, as I mentioned above, some people see elevated antibodies during pregnancy which then fall after birth. 

The significance of thyroid peroxidase in this exact setting is not well understood but it does give some hope that not every situation of elevated antibodies points to autoimmune disease. 

Why would you want to check your thyroid peroxidase antibodies? 

Your doctor can use this test in a number of useful ways:

  • The first is to help diagnose autoimmune thyroid disorders – if you are experiencing certain symptoms (either symptoms of hypothyroidism or hyperthyroidism), your doctor can order this test to help with the diagnosis. 
  • The second is that checking thyroid peroxidase antibodies can help rule out other causes of both hyperthyroidism and hypothyroidism. If you have a non-immune mediated thyroid disease then checking your antibody level can help rule out autoimmune causes of thyroid disease. 
  • The third is that they may be helpful in diagnosing people who have “normal” thyroid lab tests but still experience thyroid-related symptoms. In some cases, your antibodies may elevate before any other thyroid lab test. You can use this to your advantage to get an early diagnosis if that is the case. Many conditions, including Hashimoto’s thyroiditis, often go undiagnosed until the condition is advanced because that is when you start to see abnormalities in thyroid function tests. You may be able to catch your disease early by testing for thyroid antibodies as opposed to thyroid function lab tests. 
  • Lastly, you can use thyroid peroxidase antibodies if you are having trouble with fertility. Elevated thyroid peroxidase antibodies are often associated with thyroid problems which are known to cause infertility. As mentioned above, the first sign of thyroid problems may be an elevation in your thyroid antibodies. 

What is a Normal Level for Thyroid Peroxidase Antibodies on my Lab Tests?

When you get your thyroid peroxidase lab results you will see a range of what is considered “normal”. 

The range is usually somewhere between 0 and 34 IU/mL (6). 

If your thyroid peroxidase antibodies fall within the 0 to 34 range they will be considered “normal” and they won’t flag as high on your lab tests. 

Any value that is higher than 34 IU/mL will flag as high and is an indication that thyroid dysfunction is likely on its way. 

Despite this so-called “normal” range, there are a number of people who advocate for near-zero levels of antibodies. 

The idea goes something like this:

Even though thyroid peroxidase antibodies of, let’s say, 25 IU/mL are technically “normal” wouldn’t it be better to have a value as close to zero as possible?

In other words, because the presence of any non-zero level of antibodies indicates a problem in the body, isn’t any level of thyroid antibodies a problem?

And the answer to this question is more complicated but I do tend to agree with the logic. 

The presence of thyroid peroxidase antibodies (in any non-zero value) is probably more likely to be problematic in the future than not and should, therefore, be taken seriously. 

Because of this, it is generally a good idea to aim for TPO antibody levels as low as possible so long as you aren’t causing more harm or stress to your body in the process.

Here’s why:

We know from some studies (7) that the risk of developing hypothyroidism with TPO antibodies in less than 500 IU/mL is still quite low, somewhere around 20% or so.

The higher your antibody level the higher your risk of developing thyroid disease in the future but this relationship seems to be non-linear.

But, as far as I’m concerned, a risk of 20% is still far higher than I would personally be willing to accept if I had this issue which is why I still advocate for lower thyroid antibody levels whenever possible.

Another way to think about this issue is like this:

Imagine that you are in the very EARLY beginning stages of developing Hashimoto’s thyroiditis

Before you experience full-blown Hashimoto’s you will experience moderate Hashimoto’s. 

And before you experience moderate Hashimoto’s, you will experience minor Hashimoto’s. 

And before you experience minor Hashimoto’s, there will be a point when Hashimoto’s is in the process of developing in your body but before it is reflected in your lab tests. 

If you can catch your thyroid disease process in its infancy then it will be easier to treat (see this article for more information on why this is). 

With this in mind, it’s probably best for you to aim for thyroid peroxidase antibodies as close to zero as possible. 

On the other end of the spectrum, we see thyroid patients who have incredibly high thyroid peroxidase antibody levels. 

Some people see levels in the 1,000s and even in the 2,000s. 

At the time of this writing, I don’t think I’ve ever seen anyone higher than the 2,000’s but it definitely happens from time to time.

Are Extremely High Thyroid Peroxidase Antibodies Dangerous? 

The real question to answer here is whether or not the absolute level of thyroid peroxidase antibodies tracks with disease severity. 

In other words, does having a higher level of antibodies (say, > 2,000) mean that your disease is more severe and more dangerous than someone with fewer antibodies?

The answer is not as clear cut as you might think but it is probably the case that the higher your antibody levels are the more severe and more dangerous your disease state. 

Logically, this makes sense. 

If you have more antibodies floating around in your bloodstream then there will be more damage done to your thyroid gland over a shorter period of time. 

More antibodies mean more inflammation which means more thyroid gland damage which means more symptoms. 

Evidence that supports this idea is in the case of seronegative Hashimoto’s

Some people have Hashimoto’s with negative antibody levels, otherwise known as seronegative Hashimoto’s. 

Patients with this condition experience much more mild side effects compared to patients who have high levels of antibodies in their blood. 

Having said that, the presence of high thyroid peroxidase antibodies does NOT necessarily mean that your disease state is more difficult to treat. 

Put another way, the presence of extremely high antibodies is worrisome but it doesn’t mean that you can’t do something about it (more information on that below). 

We also know that thyroid antibodies play some role in the development of certain cancers (8). 

Even if it isn’t the case that high thyroid antibodies destroy the thyroid gland faster, you still want lower antibody levels to reduce your risk of other conditions and disease states. 

The Connection Between Thyroid Peroxidase Antibodies, Hashimoto’s, and Graves’ Disease

Does the presence of elevated thyroid peroxidase antibodies guarantee that you have Hashimoto’s?

Definitely not!

Elevated TPO antibodies are seen in 90-95% of patients with Hashimoto’s and 50 to 80% of patients who have Graves’ disease. 

The best way to determine what your antibodies mean for you is to look at your thyroid lab tests, your thyroid peroxidase antibodies, and your symptoms:

  • The presence of thyroid peroxidase antibodies with a LOW TSH and symptoms of hyperthyroidism point towards a diagnosis of Graves’ disease
  • The presence of thyroid peroxidase antibodies with a HIGH TSH and the symptoms of hypothyroidism point toward a diagnosis of Hashimoto’s thyroiditis
  • The presence of thyroid peroxidase antibodies with a normal TSH and no symptoms predicts an increased risk of developing a thyroid condition in the future
  • The absence of thyroid peroxidase antibodies does not rule out hyperthyroidism or hypothyroidism as both of these conditions can be caused by other conditions

Symptoms Associated with High Thyroid Peroxidase Antibodies

Thyroid peroxidase antibodies typically do not cause any major symptoms by themselves. 

They can sometimes be associated with minor symptoms including a minor decrease in energy, feeling run-down, or just feeling “blah”. 

These symptoms occur as your body attempts to deal with the immune dysfunction present as well as minor changes to thyroid function. 

Most of the major symptoms associated with TPO antibodies come from direct damage to the thyroid gland. 

Remember the war zone that I mentioned previously?

Inflammation and damage to the thyroid gland may result in changes to thyroid function and this change to thyroid function results in symptoms that are hard to miss. 

These symptoms vary based on whether you have a diagnosis of HYPERthyroidism (high thyroid function) or HYPOthyroidism (low thyroid function). 

You can use your symptoms, in conjunction with your antibodies and thyroid lab tests, to see where you fit. 

#1. Symptoms of Hashimoto’s Thyroiditis:

#2. Symptoms of Graves’ disease: 

  • Weight loss
  • Hair loss, hair breakage, with fine/brittle hair
  • Rapid menstrual cycle
  • Anxiety and panic attacks
  • Rapid heart rate
  • Heart palpitations
  • Tremors
  • Sweating and hot flashes
  • Heat intolerance
  • Fatigue

#3. You may be asymptomatic. 

Don’t forget that some people, especially those who are pregnant, may have no symptoms at all! 

We don’t know how many people fit into this category, though, because most people do not get tested for thyroid peroxidase antibodies unless they are feeling poorly at which point they can be diagnosed. 

It’s also possible to be asymptomatic in the early stages of your disease, especially if you catch it early enough. 

Is it Possible to Reduce Thyroid Peroxidase Antibodies If They are Elevated? 

Absolutely!

And this might just be the most important part of this article. 

After all, if you know that TPO antibodies are causing problems in your body, doesn’t it make sense to try and do something about them?

Of course!

But here’s the problem:

From the perspective of your doctor, there’s nothing that can be done about elevated thyroid peroxidase antibodies. 

Doctors take what is called the “sit and wait” approach (9) to manage people who have elevated thyroid antibodies. 

They sit and wait until your own body damages the thyroid gland to the point that you need prescription medication. 

Just because your doctor doesn’t have any medical treatment options for you doesn’t mean you can’t do anything, though!

Seeing a doctor is important, for sure, but when it comes to managing your thyroid antibodies you are probably going to be on your own. 

It may sound difficult but it actually isn’t. 

Making some changes to your lifestyle can have an impact on your immune system and thyroid health and this may directly (or indirectly) help your antibodies. 

Doing things like changing the food that you eat can have a huge impact on your antibody levels. 

Avoiding foods that are known to be inflammatory is a great place to start. 

Eating foods that are known to possess natural anti-oxidants and plant-based nutrients is also a wise decision. 

You can also focus on improving your lifestyle. 

Ensuring that you are sleeping enough each night, making sure that you are taking time for yourself, managing your stress, and exercising regularly can have an impact. 

And guess what?

You don’t really need a doctor to tell you that eating fruits and vegetables is a good thing, right?

This should just make sense. 

Even though it’s painfully obvious that these things work, so many people neglect them and instead take the advice of their doctor to “wait and see”. 

If you are serious about preventing long-term damage to your thyroid then I would strongly recommend trying these therapies out to see if they can help you. 

The best case scenario is that they do and you see a reduction in your antibodies. 

The worst-case scenario is that you don’t see a change but you have done zero harm in the process. 

Final Thoughts

Remember:

There is a difference between the thyroid peroxidase enzyme and thyroid peroxidase antibodies. 

The thyroid peroxidase enzyme is found within your thyroid gland and plays an important role in helping your body produce thyroid hormone. 

Thyroid peroxidase antibodies are antibodies that your own immune system creates that target and destroy the thyroid peroxidase enzyme. 

The presence of these antibodies indicates dysfunction in your immune system and is associated with several types of thyroid conditions

If you find that your thyroid peroxidase antibodies are elevated you will want to take whatever steps necessary to try and reduce that number to as close to zero as possible!

Now I want to hear from you:

Do you have elevated thyroid peroxidase antibodies?

Do you know why your antibodies are elevated?

Do you know or suspect that you have a thyroid condition?

If so, what condition do you have?

Are you going to try and reduce your antibodies?

Let me know in the comments below! 

#1. https://www.sciencedirect.com/topics/biochemistry-genetics-and-molecular-biology/thyroid-peroxidase

#2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4159104/

#3. https://pubmed.ncbi.nlm.nih.gov/26212387/

#4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1542488/

#5. https://pubmed.ncbi.nlm.nih.gov/20664399/

#6. https://journals.lww.com/md-journal/Fulltext/2020/09180/Normal_range_of_anti_thyroid_peroxidase_antibody.54.aspx

#7. pubmed.ncbi.nlm.nih.gov/28052092/

#8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5422478/

#9. https://www.mayoclinic.org/diseases-conditions/hashimotos-disease/diagnosis-treatment/drc-20351860 

thyroid peroxidase antibodies - normal levels & more

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About Dr. Westin Childs

Hey! I'm Westin Childs D.O. (former Osteopathic Physician). I don't practice medicine anymore and instead specialize in helping people like YOU who have thyroid problems, hormone imbalances, and weight loss resistance. I love to write and share what I've learned over the years. I also happen to formulate the best supplements on the market (well, at least in my opinion!) and I'm proud to say that over 80,000+ people have used them over the last 7 years. You can read more about my own personal health journey and why I am so passionate about what I do.

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57 thoughts on “Thyroid Peroxidase Antibodies: Lab Test, High Levels & More”

  1. I think I have commented here before. I have been diagnosed with Hashimoto’s. For years I have had extremely high thyroid antibodies….now: thyroglobulin antibodies greater than 1000, and thyroid peroxidase antibodies 119. I am 81 years old and have been on desiccated porcine thyroid hormone & WP Thyroid until recalled… for over 10 years. They have come down through the years as at one time they were greater than 3000 and TPO antibodies at one time were 420 back in 2013. Every doctor I have gone to (and I have been to plenty through the years) has told me I just have to live with them. Am I unusual or what? I was even on LDN for over a year with no help there. Do you agree I just have to live with high antibodies being they have always been high? Mary Vogenberger

    Reply
  2. My last TPO antibodies number (from August of this year) was 6800+. The interesting thing is, my thyroid stimulating immunoglobulin level (taken about a week ago) was also elevated, suggesting Graves’ disease. I have commented on a blog post before, but I didn’t see my comment posted yet. Anyway, I was originally diagnosed with Graves’ disease in 2005. Somehow switched to hypothyroidism in 2014. Still confused about whether or not I have Graves’, Hashimoto’s or both. I guess it really doesn’t matter in the end; it is all an underlying immune system issue that needs to be corrected.

    Reply
    • Hi Joy,

      Whether or not you have hyperthyroidism depends on other lab tests and your symptoms 🙂 But you are correct. The main issue is really the immune system which should be addressed.

      Reply
  3. hello i have just come across your amazing site!! my sister has total alopecia for 19 years (after birth of her first child) she just got labs and her thyroglobulin is over 3000 and her TPO is over 1000. i have been diagnosed with Common Variable Immune Disorder approx 5 years ago and now under control with weekly infusions. My sister now has horizontal lines across the front of her neck and extreme fatigue. Any insight that you can offer or a direction you can help with would be incredible. Thanks in advance for all you do!!

    Reply
  4. Trying to navigate these waters without an endocrinologist, I have a nurse practioner in the process of trying to help me get a diagnosis. I have ALL the symptoms of hypothyroidism, so had a ton of blood work done. I have tpo antibodies of<8 on a scale of 0-34 and thyroglobulin antibodies of <1 on a scale of 0.0-0.9. None of my thyroid tests are in the optimal range you explain, so clearly something is going on. My question though is in my CBC panel, my RBC and EOS absolute are both flagged as high. My Ferritin is also flagged high, though my iron counts are in range. I'm thinking that all of that screams inflammation and possibly autoimmune disease….which makes sense for hashimotos I think?? I need help, but I'm SO TIRED of doctors telling me in "fine" and it's all in my head.

    Reply
  5. Hi Dr. Child’s, Thank You for all this valuable information. My TPO was 203, but my T4, Free (Direct)and TSH, and (T3),Free we’re all in the normal range. Also my Thyroglobulin by IMA was 39.1 which is high (1.5 -38.5 is normal range) and my Billrubin,Total was 1.3 which is high normal range(0-1.2) so should I be worried? I do take 88mg levothyroxine but for the last several months I wasn’t taking my medication on a regular basis. I just started a few days ago to get on track. Is there anything else I should do to bring all this down. Thank You

    Reply
    • Hi Ella,

      It depends on how you are feeling! Your thyroid lab tests are mostly meaningless unless evaluated in the context of your symptoms. If you are symptomatic then, yes, you would want to try to do something about them.

      Reply
    • Hi Jen,

      No, levels will not be at zero because even after thyroid removal or RAI some of the thyroid gland remains. If you still see elevated antibodies after RAI or thyroidectomy then that indicates your immune system is still amped up and should be addressed.

      Reply
  6. Hello! Just wanted to say my TPO antibodies are over 3000. They were around 1900 when we first tested for them. Then went up to 2300 over a year. Had them tested this year and they were over 3000. I have Hashis(and Graves). My thyroid levels are still “normal “ according to the lab, but are slowly trending towards hypothyroidism.

    Reply
    • Hi Catherine,

      Are you actively trying to suppress them with therapies, medications, or other treatments?

      Reply
      • Well, I cut out dairy, soy, gluten, sugar, alcohol and processed foods in 2017 due to a stage 3 breast cancer diagnosis. My cancer is in remission as of a year ago. I didn’t do chemo or radiation. I didn’t have my TPO tested until 2019, and my high antibodies along with visible inflammation of my thyroid is what got me my Hashimotos diagnosis. I had Graves in 2002 but it has been in remission after a year of treatment with tapazole (sp?). I take supplements for anti inflammation (quercetin, bromelain, serrapeptase) and also just started your Daily Thyroid two months ago along with fish oil and garlic. Started LDN in December. Unfortunately I didn’t test my TPO before starting the LDN but the test a month after starting the LDN was the one where my results were over3000.

        Reply
        • I forgot to mention that I also take vitamins D, K and C as well as calcium and magnesium, and vegetarian glucosamine-MSM (I am allergic to shellfish). I keep my D levels on the high side as part of my long term cancer management plan. Last testing my D was 77. I am post-menopausal and also have osteopenia. I am 52. I also have degenerative disc disease in my neck (since I was 18) and now in my lumbar as well, along with adult onset lumbar scoliosis. I have spinal stenosis along with 3 pinched nerves in my lumbar. I have suspected EDS. I also have IBS-D which is now mostly under control. When it flares up I follow a low FODMAP diet. I know…. I’ve got a lot going on!

          Reply
  7. I definitely got the “wait and see” from my Dr. after suffering from hair loss & breakage, extreme fatigue, chest tightness, joint pain, urticaria, anxiety and TPO levels at 3,000. All of my other thyroid levels were normal, but I felt horrible! After cutting out gluten and other inflammatory foods and adding in vitamins, collagen & supplements like zinc and selenium my recent tests showed my TPO levels at 600. I feel better than I did when they were at 3,000, but I still suffer from many symptoms. I’m glad to read this article and see that I am not necessarily doomed to have a thyroid condition. I’ve been dealing with this for 6 years now.

    Reply
    • Hi Sharon,

      Thanks for sharing and it sounds like you are on the right track! Many thyroid patients also see a decline in thyroid antibodies with the use of thyroid medication which may be worth looking into. You can also see additional therapies to help lower TPO antibodies here: https://www.restartmed.com/tpo-antibodies/

      Reply
  8. Hi, just wanted to encourage everyone. Several years ago, when my doctor told me I had hypothyroidism, I went to a Functional Doctor who tested my TPO levels at 300+ and told me I had Hashimoto’s. She found I had a parasite, hereditary hemochromatosis, food sensitivities and my dental hygienist found I had a chronic infection, all which contributed to inflammation. After those were taken care of, my TPO came down to 79. Keep searching for what is causing inflammation!

    Reply
    • Hi Susan,

      Thanks for sharing! It’s always good for others to hear from more than just me that it is possible 🙂 Glad to hear you have seen so much improvement.

      Reply
  9. Hi- you mention iodine in the article. Do you recommend iodine supplements? I’ve seen varying info on that subject. Thanks-b

    Reply
  10. Hello Dr. Childs. My TPO is 1.0. It has been higher in the past, but still within the normal range. My TgAb was always normal as well, but suddenly spiked to 495 recently while my TPO remained at 1.0. What could that mean? I had a thyroid ultrasound to rule out any abnormalities and it was normal other than the thyroid being a bit patchy. I have hypothyroidism and I’m taking meds for that – NP Thyroid plus additional T3. Thank you in advance for any thoughts you may have as to why one thyroid antibody would be normal while the other spiked. If I recall correctly my mother had similar labs.

    Reply
  11. I was diagnosed as hyper w/Graves in 2003. In 2005, I had the RAI to kill my thyroid. Do I need to be concerned with the antibodies?
    My endo performs the minimal blood work, and because I live in a rural area, he’s the only one around.
    I feel run down, overweight, lethargic. I feel like having annihilated my thyroid has taken my vitality. Wish I had traveled to find a better doctor who would at least explain things to me.

    Reply
    • Hi Andrea,

      Once you undergo RAI your antibodies tend to decline but it would be nice to know if they are still present because that could impact your treatment.

      By the way, it’s not too late to find a new doctor! You can always start right now using the resources here: https://www.restartmed.com/how-to-find-a-doctor-to-treat-your-thyroid/

      You are the one living with fatigue, weight gain, and lethargy (not your doctor) so I wouldn’t tolerate those symptoms for any period of time longer than you have to.

      Reply
  12. Was diagnosed with Hashi’s in 2019 TPO 1300. My latest TSH level is 3.05 mL.
    I suffer with mainly fatigue, muscle & joint pains not helping that I am also menopausal too! I can’t seem to keep my vitamin D at an optimum level either, my level was on the floor when 1st diagnosed.
    Would love to know how/what I could go to help reduce inflammation & help symptoms.

    Reply
  13. My daughter has had symptoms of thyroid disease since she had a thyroglossal duct cyst removed when she was 5. She has slightly elevated antibodies (37 in a ref of 0-26), normal tsh (3.8), and is highly symptomatic. She’s gluten, dairy (she does eat butter/ghee), mostly sugar, and processed food free, takes all the recommended supplements, has been on LDN for 6 months, and is still 30 pounds overweight, chronically tired, depressed, and has brain fog. I’m at a loss. Her doctor says she needs to lose weight but how??? She already eats healthier than every teenager we know. What would be the next steps?

    Reply
  14. I have had my thyroid removed; half was removed 38 years ago because of Hashimoto’s and cancer and other half was removed 6 years ago because of tumors and severe over growth around vocal cords, etc of Hashimoto’s which was very difficult to remove. I assumed wrongly that without a thyroid my TPO antibodies would go away without a thyroid to attack. I was wrong; my levels are still very high. What are these attacking now?

    Reply
    • Hi Teresa,

      Well, your assumption was actually spot on! The only thing you are missing is that it’s not possible to remove 100% of the thyroid gland during surgery or even with RAI. Even with a “complete” thyroidectomy, some thyroid gland tissue remains. Your antibodies are probably attacking what is remaining of the thyroid gland after surgery.

      I have also seen cases of persistently elevated thyroid antibodies after thyroid surgery in people who have extrathyroidal thyroid gland tissue. One person even found thyroid gland tissue around their heart.

      Reply
  15. Thank you so very much for all your information and help ❤️
    My TPO dropped from 1300 to 250 in two weeks when I stopped taking Levothyroxine (it never suited me and was on it for 3 years )
    I have just started T3 only and I’m already starting to feel better
    But last bloods show my TPO is rising again , so should I just Focus on how I’m feeling rather than numbers ? Your post this time concerns me mentioning the big C and also a video you have done with Dr Aime Hornamam , which says focus on how we are feeling rather than no’s , just found this a bit confusing and concerning , I am now 100% GF and almost dairy free . Again thank you for everything , I live in Ireland and it’s very difficult to get the correct treatment but thanks to you I am able to go to my GP and inform him of what I have learnt from you , plus I’m lucky I suppose he’s a good guy and does want me to feel better . I was diagnosed with Hashi about 4 years ago , Wish I knew than what I know now but I’m determined to get my life back it’s been a life long struggle.

    Reply
  16. My tpo for a few years now started out a over 600 and then I went on Armour thyroid and more natural version of levothyroxine.. ive been on that for 2 years now and my tpo is still around 300.. help me

    Reply
  17. Do you know of any lab that does a TPO antibody endpoint test to give the exact number of antibodies rather than a greater than range?

    Reply
    • Hi Debrah,

      I’m not aware of one. My best guess is that most labs will not record down to the exact range due to limitations in testing. The size of antibodies is very small so it’s easier to measure them qualitatively than quantitatively. But I haven’t researched this topic in depth so that’s just my best guess right now.

      Reply
  18. Hi!
    Can you comment on high Thyroglobulin Antibodies and normal (near zero) thyroid peroxidase antibodies, and normal TSH, Free T3 and Total T4. Thanks!

    Reply
  19. should a 23 yr old female be treated with levothyroxine if her TSH is 5.4 and her thyroid antibodies test is 55.2 is shes having symptoms of weight gain, fatigue, hair loss, constipation and changes to her menstral cycle. just wondering why the doctor wont treat her if shes having symptoms

    Reply
    • Hi Sherry,

      I can’t provide medical advice but I can tell you that most people would feel better with a TSH closer to 1.0 as opposed to 5.4 🙂

      Reply
  20. I have high thyroid antibodies around 300. My total tsh is elevated to around 5.
    They have put me in several of the different thyroid meds for hypothyroidism and Hashimotos. Why is it that the thyroid meds give me such bad heartburn to the point I had to get off them after a few weeks. I also have gotten anxiety from the stomach issues when I was on it.
    What to do? Why does this happen? Thanks

    Reply
    • Hi Sandi,

      It could be something really easy or really complex. An easy answer may just be that there is a filler or binder in the medication you were taking (such as lactose) which triggered the acid reflux. It’s impossible to know for sure without a lot more information but a simple solution would be to trial the various thyroid medications available until you find one that works for you because there will be one that doesn’t cause the issue: https://www.restartmed.com/thyroid-medication-names/

      Reply
  21. I was diagnosed with Graves’ disease five years ago and initially took medication while researching self-care. I have been off meds for over four years, managing the disease through diet and supplements. It took a couple of years to get my TSH from negligible up into the low normal range. I haven’t ever felt optimal, but much better than before.

    About a month ago I started noticing symptoms that made me think I had gone hypo. The fatigue in particular has become absolutely debilitating (along with aches, hair loss, gastro issues, feeling cold, anxiety, etc), so I got labs done last week. My TPO antibodies are 5,654 but my TSH, T3 and T4 are closer to the hyper end of normal. I’m so confused, especially since I’m already on a Paleo diet and typically run several times a week (until lately) and take all the recommended supplements.

    Reply
    • Hi Elisa,

      Sometimes there are factors that trigger autoimmune diseases that are outside of our control. Things like stress, heavy metal exposure, genetics, and so on, can all trigger autoimmune disease even in the face of healthy eating and lifestyle changes. It’s hard to know for sure what’s going on in your situation without more info but these other triggers may explain it.

      Reply
  22. I have been not feeling well since my pregnancy 10 years ago. I got a total thyroidectomy this year after they found 5 inch mass in my thyroid. I felt great for the 2 weeks after surgery, finally like my old self, but that was short lived. TSH was at 16.5, increased my Synthroid, and following month TSH was at 21.3. They added anti-thyroperoxidase test (never had it before) it was 32U/mL. Should I be worried with it at 32 with no thyroid? Love your article, and thank you!
    Colleen

    Reply
  23. Hi Dr Childs

    I have elevated TPO (71) It was 84 back in June. I have had severe hair loos. First it started out with one patch, then became several patches of hair loss. Then my hair generally thinned all over. I have lost 60-70% of my hair. Started in March. I had severe stress in January, February. My hair keeps falling out and has not stopped. It has slowed down a lot since supplementing with anti-inflammatory (curcumin, querectin, resversitrol) and an anti-inflammatory diet for the past 2 months. I had severe anxiety and could not sleep. After blood tests and testing all auto immune markers, the only thing that came up was an elevated TPO. I was told by one naturopath that I have hashimotos, and to supplement with inositol. Another naturopath said I don’t have hashimotos since all my other thyroid markers were normal. I was told to supplement with selenium. TSH (0.66), Free T4 (14), Free T3 (3.6), Total T3 (1.2), Reverse T3 (21) TGA (14). I am confused. Who is right? What do you think? Any advice?

    Reply
    • Hi Madi,

      Truthfully, they both could be right but there isn’t enough data to confirm one way or the other. You can have elevated antibodies without Hashimoto’s and not all cases of elevated antibodies turn into hypothyroidism which is why they both could be correct. Regardless, it still makes sense to make lifestyle changes to try and prevent the progression. It’s never a bad idea to take some supplements, eat healthily, get more sleep, exercise regularly, etc.

      Reply
  24. Hello.
    Our 17-year-old son has an elevated TSH, normal free T4 and an elevated thyroid peroxidase antibody. He also is on an aggressive antihistamine regimen because he has been breaking out in hives for 3-4 months.
    Any thoughts? He is tired and moody a lot above the normal teenage stuff. He loves to work and is taking college classes and sleeps most of this time off.
    Thank you,
    Sharla

    Reply
  25. I got my first thyroid results back today, thank you for this explanation I had no idea what TPO at >600 meant until I read this! I have all the hypothyroid symptoms but have been feeling better in the last month as I work on my Iodine protocol and fat soluble vitamins with a dietician. My TSH is 4.4. I’m hoping the work I’m doing to help deficiencies will be enough to not go on meds. I’m also taking a Thyroid glandular to support. I was wondering, I don’t know as much about antibodies or inflammation, what are the top three things I could do to reduce them? I’m going to cut out gluten first. Anything else that can really work?
    Also any knowledge about root canal infections possibly causing antibodies/inflammation?

    Thanks

    Reply
    • Hi Elizabeth,

      There are many natural therapies that have the potential to work but none are guaranteed to work. For this reason, you’ll need to experiment with some trial and error to find out what works best for your body. Here’s a list of what I consider to be some of the most beneficial natural ways to lower TPO antibodies: https://www.restartmed.com/tpo-antibodies/

      Reply
  26. Hello – I have had Hashimoto’s for 15+years, and I believe it is triggered (or exacerbated) by spending time regularly in water damaged/moldy buildings. I would be interested to learn more about how mold might lead to autoimmune thyroid issues. I am certain that it did in my case. Also, removing myself from mold-laden environments will over the course of weeks reduce “hypothyroid” type issues, as well as reduce swelling & nodules on my thyroid gland (as confirmed by ultrasounds).

    Reply
  27. HI
    I just turned 70, male, my name is Will. And I have had thyroid Hasimoto’s for quite some time and just had the labs you said were essential for thyroid diagnosis. I do have Hashimotos and taking several of your supplements including Adrenal Reset Complex as well as T3 Conversion booster and 175mcg. of Unithyroid/day. MyTPO Ab is 54 which is high. My TSH+T4F+T3Free are: TSH 3.120, T3 Free 2.8 and T4 Free Direct 1.36. I have terrible cold tolerance as well as more than usual belly fat lately.. 34″ waist at 5’11” and weigh 218 and my Reverse T3 serum is 22.2 which is also high. I just re-Started HIT training with weights as I’ve lifted since I have been 25 yrs. old. I also take Testoterone 200mg/ml qweek for the past 21 yrs. with a test level of 652 as I decreased my test injections to 1X every 10 days vs 7 days. Can you give me any suggestions to feel warm again and help,lose visceral fat? Wondering about Cytomel and or Liothyronine? Thank You!

    Reply
  28. Hi,

    I got pregnant with my third child in January of 2023 and immediately developed hives. I continue to have hives and this time around my milk production did not really come in and was told it was probably due to blood loss due to c-section. I decided to see a lactation nurse who recommended getting some labs drawn along with the thyroid peroxidase antibodies. I just received my results and my numbers are elevated at 2,339.9. I’m curious if you have heard of any relation between this and hives and/or milk production?

    I suspect that I could have a thyroid issue because my mother was diagnosed with Graves’ disease after she had made and completed radiation while breastfeeding me. I have mentioned this to every doctor I have seen because my mom insist I get my thyroid checked yearly, but have never had the Anti TPO tested to my knowledge.

    I really hope I can lower my levels and will do everything in my power to in hopes that it will also help with the hives.

    Reply

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