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Old 04-01-2004, 09:31 AM   #1
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rlboone HB User
Anti-TPO test

Hi,

I am really confused with the antibodies part of this. I have read that they shouldn't even be detected when tested, but not everything you research on the internet can be trusted. I was curious if any one could help me with my result and if I need further tests or if I should just drop it.

Anti-TPO <33 Lab (<50)

Thanks
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Linda, Age 36, Hypo 2 yrs and still not fixed.

 
Old 04-01-2004, 10:02 AM   #2
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Re: Anti-TPO test

Thyroid autoantibodies should not be detectable in people who do not have thyroid autoimmunity, but they should be detectable in people who do, unless those people have managed to get rid of them (not easy).

Your test indicates that you have thyroid autoimmunity. TPO Ab's are found in people with Graves' disease and with Hashimoto's thyroiditis, but are mostly associated with Hashi's, which causes hypothyroidism.

Your activity level is not high. The lab's reference range indicates that a value over 50 would be considered positive, which usually translates to "indicating active disease." TPO Ab's are actually quite common in the population since something like 20% of all women have them even though those women may not have a clinically evident thyroid problem (they have good labs and no symptoms of thyroid disfunction). When the level is high, it indicates an active disease state, and when levels are high, the patient almost always has abnormal labs (TSH, FT4, and FT3).

The family members of people with autoimmune thyroid disease frequently carry autoantibodies for either Graves' or Hashi's. If they never develop an active thyroid disease, they are said to have thyroid autoimmunity. Once they do develop an active disease (either hypo or hyper) then they are said to have an autoimmune thyroid disease. The reason is that carriers are predisposed to develop the disease, but something has to trigger it to cross over into an active, progressive disease course.

Years ago when these antibodies were discovered and lab tests were developed to detect them, the labs had to set "normal" reference ranges, and they usually tested the blood of many people and concluded that people became symptomatic at a certain Ab activity level. That level then became the "normal" cutoff for a disease diagnosis. For instance, the activity cutoff for TSI Ab's, associated with Graves' disease, is usually around 130%. Someone with a TSI activity level of 130% who has never gone hyper does not have Graves' disease, but someone with an activity level of 110% who HAS gone hyper does have Graves' disease--both the Ab's and an active disease course are needed to make the diagnosis.

The reason the presence of antibodies alone is not diagnostic is because so many people have them who never have any thryoid dysfunction for their whole lives. Something like 50% of immediate family members of Graves' patients are carrying TSI Ab's, but most of them will never go hyper. So the presence of Ab's always indicates the potential for autoimmune thyroid disease, but only when the disease becomes clinically evident is there a firm diagnosis. Similarly, Graves' patients frequently carry ANA Ab's associated with lupus and other autoimmune diseases, but only a tiny fraction will ever develop lupus in addition to Graves disease. If I have anti-nuclear antibodies but no symptoms of lupus, I do not have lupus.

Last edited by MauraL; 04-01-2004 at 10:08 AM.

 
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Old 04-01-2004, 10:52 AM   #3
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rlboone HB User
Re: Anti-TPO test

Wow, you sure know your stuff.

Let me see if I understand what you told me. Because of the presence of the TPO antibodies and I am hypothyroid the chances of me have Hashimoto's is greater. Or do I missunderstand and my TPO level has to be above 50 to be diagnosed with Hashimoto's.

Not that I truely understand the difference between suffering from a thyroid cond like hypo or having been labeled having an autoimmune disease. If I'm not mistaken the treatment is the same or not?

Linda
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Linda, Age 36, Hypo 2 yrs and still not fixed.

 
Old 04-01-2004, 11:39 AM   #4
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Meep HB UserMeep HB UserMeep HB User
Re: Anti-TPO test

Quote:
Originally Posted by rlboone
Wow, you sure know your stuff.

Let me see if I understand what you told me. Because of the presence of the TPO antibodies and I am hypothyroid the chances of me have Hashimoto's is greater. Or do I missunderstand and my TPO level has to be above 50 to be diagnosed with Hashimoto's.
The presence of TPO antibodies and/or Thyroglobulin antibodies is often used to make an educated guess as to whether a person has Hashimoto's or not, but, the only way to truly diagnose Hashimoto's is to do a biopsy of thyroid tissue.

So, you are right that the presence of TPO antibodies means you very well might have Hashimoto's, but even a count of 1500 would not tell you that you definitely have Hashi's.

The two antibodies that are associated with Hashis are different in their actions:

Thyroid PerOxydase or TPO antibodies attack the mechanism in your thyroid gland that actually produces thyroid hormones. While these are elevated, your will likely be hypo, then once the level goes down, you will have less ability to make thyroid hormones and your thyroid gland may grow larger to accomodate, or you may just simply stay hypo. Either way, treatment is advised.

Thyroglobulin antibodies attack a protein in your thyroid gland an in your blood that is used to store thyroid hormones for later use. While this antibody is active, it causes a rise in throid hormone levels in your blood, and you may go hyper. This causes free levels of thyroid hormone to be elevated, while your Total thyroid levels will be the same. This is why many smart doctors rely on the Free T3 and Free T4 tests rather than the Total T3 and Total T4 tests.

You can see how patients with antibodies might have thyroid levesl that fluctuate--sometimes quickly--and need close monitoring if the antibodies are active.

Quote:
Not that I truely understand the difference between suffering from a thyroid cond like hypo or having been labeled having an autoimmune disease. If I'm not mistaken the treatment is the same or not?
The treatment is the same regardless of why you are hypo. However, if you are Hyper, due to antibodies attacking, then treatment may vary, depending on what antibody is attacking.
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Danny

I am not a doctor, nor have I ever played one on TV...

 
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