# Test results: help understanding TPO?



## linseliz

Hello everyone,

I am new here. Thanks in advance for your help!

I have been feeling unwell for the past 18 months: fatigue, muscle aches, temperature sensitivity, pain in my left eye, and nausea. I had some bloodwork done, and I am worried about the "thyroid peroxidase antibodies" result, which came back at 380 (outside the normal range). My doctor says I shouldn't be worried about this result; she says I don't have a thyroid condition and that I don't need to seek treatment. Could anyone here tell me more about the antibodies test? Is 380 a high number, or is it close to normal, as my doctor suggests? My test results are below.

Thanks again!

Thyroid peroxidase antibodies
result: 380 (range: < 35)

TSH
result: 3.97 (range: 0.40 -- 4.50)

T4, free 
result: 1.0 (range: 0.8 -- 1.8)

Thyroglobulin antibodies
result: <20 (range: <20)

Ferritin
result: 14 (range: 10 -- 154)

Vitamin D, 25 OH, Total
result: 13 (range: 30 -- 100)


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## joplin1975

I'm not a blood work expert, but this might help: http://labtestsonline.org/understanding/analytes/thyroid-antibodies/tab/test

Your TSH is in range, but on the higher side and your free T4 is pretty low...all that with the TPO would make me want to follow up on this.


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## Andros

linseliz said:


> Hello everyone,
> 
> I am new here. Thanks in advance for your help!
> 
> I have been feeling unwell for the past 18 months: fatigue, muscle aches, temperature sensitivity, pain in my left eye, and nausea. I had some bloodwork done, and I am worried about the "thyroid peroxidase antibodies" result, which came back at 380 (outside the normal range). My doctor says I shouldn't be worried about this result; she says I don't have a thyroid condition and that I don't need to seek treatment. Could anyone here tell me more about the antibodies test? Is 380 a high number, or is it close to normal, as my doctor suggests? My test results are below.
> 
> Thanks again!
> 
> Thyroid peroxidase antibodies
> result: 380 (range: < 35)
> 
> TSH
> result: 3.97 (range: 0.40 -- 4.50)
> 
> T4, free
> result: 1.0 (range: 0.8 -- 1.8)
> 
> Thyroglobulin antibodies
> result: <20 (range: <20)
> 
> Ferritin
> result: 14 (range: 10 -- 154)
> 
> Vitamin D, 25 OH, Total
> result: 13 (range: 30 -- 100)


Glad you got your e-mail confirmation!










I believe that high TPO Ab are cause for concern.

Here is the skinny on that. TPO is "suggestive" of many things, not just thyroid.

Negative test is normal; you should not have any of these antibodies. And the healthy person does have a low titer of TPO.
http://www.nlm.nih.gov/medlineplus/ency/article/003556.htm

And................I hope you are on iron supplementation?

Ferritin http://www.thewayup.com/newsletters/081504.htm
(should be 50 to 100; the closer to 100, the better)

Also, try to eat foods high in D and get outside in the sun for at least 10 to 20 minutes each day.

It is interesting to note that those of us w/thyroid problems are deficient in D and Ferritin. The body automatically down regulates it. Also, because you do have high TPO which as I pointed out is suggestive of thyroid as well as other thing and a "smattering" of Thyroglobulin Ab (below range but there none the less) and....................that your TSH is over the range recommended by AACE which is 0.3 o 3.0.......................whoooooooooohoo! I am of the opinion that you do have thyroid disease.

You may have to change doctors as this one is not getting it.

Pain in one eye and it usually is the left eye is "suggestive" of TED/GED (thyroid eye disease and or Graves' Eye disease.)

http://www.caleyes.com/webdocuments/...ease_paper.pdf


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## linseliz

Thank you for the advice! My doctor says that nothing is wrong, but I want to follow up on these results, so I asked her to refer me to an endocrinologist.

In the meantime, I'll start iron and vitamin D supplementation.

Thanks again!


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## northernlite

I agree, I believe you have thyroid disease. I would bet ultimately you will be diagnosed with Hashimoto's, the autoimmune form of hypothyroidism.

You are symptomatically hypo and your numbers say hypo to me. Your TSH is above the recommended max of 3.0 and your FT4 is quite low. I am not surprised you are symptomatic. You need a better doctor!


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## linseliz

Hi everyone,

An update! I went to an endo this week, and he says Hashimoto's. He said he felt a mildly enlarged thyroid (1.25 times larger than usual) that is "hardened" and "bumpy." He didn't feel any nodules, and he didn't order an ultrasound. He's starting on me on Levothyroxine: 100 mcg per day. Does that sound about right? I have been reading on the boards that some doctors start mildly hypo people at a lower dosage.

The endo was great --- he was responsive, and he spent almost 30 minutes discussing my results. After a negative experience with my GP (who, while examining my neck and antibody levels during a physical, told me that there was nothing wrong with my thyroid), I was glad to encounter someone who understood that any time a test result comes back out of range, a patient will inevitably have questions.

Thanks for the support!


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## Andros

linseliz said:


> Hi everyone,
> 
> An update! I went to an endo this week, and he says Hashimoto's. He said he felt a mildly enlarged thyroid (1.25 times larger than usual) that is "hardened" and "bumpy." He didn't feel any nodules, and he didn't order an ultrasound. He's starting on me on Levothyroxine: 100 mcg per day. Does that sound about right? I have been reading on the boards that some doctors start mildly hypo people at a lower dosage.
> 
> The endo was great --- he was responsive, and he spent almost 30 minutes discussing my results. After a negative experience with my GP (who, while examining my neck and antibody levels during a physical, told me that there was nothing wrong with my thyroid), I was glad to encounter someone who understood that any time a test result comes back out of range, a patient will inevitably have questions.
> 
> Thanks for the support!


Wow!! You really lucked out. Your endo may be starting you on a high dose in the beginning just to get that enlarged thryoid to shrink down. You will probably get labs in about 8 weeks and then endo will reassess your dose.

You may wish to press for an ultra-sound though. It would be good to have a baseline and why take a chance? Ya' know?


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## joplin1975

I can't remember my exact numbers (but I know my TSH was higher -- 6.something), but I was subclinically hypo before surgery and was started on 50mcgs. I could not tolerate it and only stayed on it a week. Everyone is completely different, so it's hard to say if that's too much...but I would just make sure you are self-aware and keep track of anything like heart palpitations, jittery feelings, trouble concentrating etc.

I think I would also inquire about the u/s, just to be sure, but that's me.


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