# Rising TPOab significant?



## Lauruffian (Jul 31, 2013)

Hello all. I just had a ton of bloodwork run by a rheumatologist, trying to explain the gradual worsening of my symptoms. I'm having more swings of severe fatigue and then horrible, _horrible_ headaches and body aches. The brain fog is also becoming more significant, and I'm still getting palpitations and the shakes. It's reached the point I've been pulled off work. 

One thing I noticed is my TPOab has shot up from 409 in September to 505 (normal 0-34) in this most recent test. Is that significant?

As this was a rheumatologist, not an endo, there was nothing else thryoid-related tested.

Other significant numbers: 
Rheumatoid factor remained high at 25.3 (normal 0-13)
Creatinine/BUN ratio remained high at 30 (normal 0-23)
Vitamin B12 was high at 967 (normal 200-940)

Everything else tested normal range, including things like ANA, Sjogren's markers, metabolic panel, CBC, etc.

BTW, the rheumatologist suspects fibromyalgia and told me to be prepared for most of these numbers to be normal, which outside of what I mentioned above, were.


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## Andros (Aug 26, 2009)

Lauruffian said:


> Hello all. I just had a ton of bloodwork run by a rheumatologist, trying to explain the gradual worsening of my symptoms. I'm having more swings of severe fatigue and then horrible, _horrible_ headaches and body aches. The brain fog is also becoming more significant, and I'm still getting palpitations and the shakes. It's reached the point I've been pulled off work.
> 
> One thing I noticed is my TPOab has shot up from 409 in September to 505 in this most recent test. Is that significant?
> 
> ...


There is no question but what something is a foot as evidenced by antibodies that you absolutely should not have. If they are within the parameters of the range given, that means you have them and even if they are below the range, that means you have them. Ranges are most useful for detecting and monitoring movement.

Read this, please!

Substances not found in normal serum (scroll down to autoantibodies)
http://www.thyroidmanager.org/chapter/evaluation-of-thyroid-function-in-health-and-disease/

And TPO Ab is suggestive of many many things including RA.

TPO Ab
Mild to moderately elevated levels of thyroid antibodies may be found in a variety of thyroid and autoimmune disorders, such as thyroid cancer, Type 1 diabetes, rheumatoid arthritis, pernicious anemia, and autoimmune collagen vascular diseases. Significantly increased concentrations most frequently indicate thyroid autoimmune diseases such as Hashimoto thyroiditis and Graves disease.
http://labtestsonline.org/understanding/analytes/thyroid-antibodies/tab/test

Checking your ferritin would be a good idea also if you have not already.

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


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## Lauruffian (Jul 31, 2013)

I know the TPO-Ab numbers often change, I'm just wondering if the 100 point increase is related to the increase in severity of my symptoms. Is that sort of a jump an indicator of something? I was going to see my endo tomorrow, but she's actually calling in sick herself and I'm rescheduled for Tuesday. I'll ask all of this of her as well as maybe having my ferritin checked.

I'm really wondering if something is screwy with my kidneys. I have swelling in my hands and feet, and with the BUN/creatinine ratio out of whack, and the unusually high B12 (excess is usually removed in the kidneys), I have to wonder.

Incidentally, I do not present like rheumatoid arthritis. I don't have red, hot, swollen joints that are sensitive to the touch. My joints ache, but really, my whole body does. This is why the rheumatologist suspects fibro. Incidentally, they thought I had RA 15+ years ago when I first was asking about the joint aches and my RF was high even then--but again, I don't present like typical RA. The joints haven't changed in all this time.


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## StormFinch (Nov 16, 2012)

Yes Laura, typically the higher the antibody numbers the worse the attack, or at least that's been my experience.

As to your rheumatoid factor, according to Elaine Moore; (Graves advocate and clinical laboratory scientist)



> "Rheumatoid factors are found in 50-90 percent of patients with classic RA, with higher concentrations seen in active disease. Higher titers are also seen in more severe forms of the disease. RF are also seen in 75-95 percent of patients with Sjogren's syndrome, 50-60 percent of patients with mixed connective tissue disease (MCTD), 25-40 percent of patients with the kidney disease IgA nephropathy, 15-35 percent of patients with SLE, 20-30 percent of patients with systemic sclerosis and 5-10 percent of patients with polymyositis and dermatomyositis."


 -http://www.elaine-moore.com/Articles/AutoimmuneDiseases/RheumatoidFactorinRheumatoidArthritis/tabid/282/Default.aspx

However, I also found the following; http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1535913/

From the tables on the the pop up pages near the bottom, it looks like they found positive IgM-RF in 14% of their Hashimoto's subjects and 15% of their Graves subjects, while IgA-RF was found in 15 and 10% respectively. All RFs and APFs were found in Primary Myxoedema however. From what I understand PM is also known as atrophic thyroiditis and is considered a separate disease from Hashimoto's. http://link.springer.com/chapter/10.1007%2F978-1-60327-285-8_42#page-1 Understand though that myxoedema, or myxedema, can also be used in conjunction with both the coma caused by untreated hypothyroidism and the skin condition that sometimes happens with autoimmune thyroid disease when googling. Confusing, huh?


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