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Writer's pictureDr. Adrian & Dr. Giulia

Guide to Anti-TPO antibodies

In this small guide to Anti-TPO (Anti-Thyroidperoxidase) antibodies we will discuss:

  • What are Anti-TPO antibodies?

  • What are the optimal ranges?

  • What are the most common causes Anti-TPO increase?

  • How to treat high Anti -TPO?



Let's start!



What are Anti-TPO antibodies?

Anti-TPO antibodies are specific for the autoantigen TPO. TPO is Thyroid peroxidase, which is an enzyme that plays a major role in the synthesis of thyroid hormones.


Thyroid peroxidase catalyzes iodide oxidation, thyroglobulin iodination and iodothyronine coupling.


In simple language, it means that if someone has elevated anti-TPO antibodies, it indicates that immune system is attacking TPO enzyme.


When TPO enzyme is attacked, it can't perform it's function well anymore, thus thyroid hormones decrease, eventually causing hypothyroidism.


Approximately 90% of Hashimoto's thyroiditis patients have elevated Anti-TPO, which indicates disturbance of the immune system and most probably inflammatory state of Your organism.


We can't forget that Anti-TPO are also frequently present in Graves' disease patients. In fact around 75% of Graves' patients have elevation of these antibodies.



What about other most frequent disorders, in which Anti-TPO are present?



What is the optimal range of anti-TPO antibodies?

Ideally, You want Your anti-TPO to be zero. Zero, because If these antibodies are present, You risk damage to Your thyroid gland.


The standard reference level of the antibodies is < 34U/mL, in some laboratories they define it as even less. However, it’s always better to prevent a thyroid disorder rather than treat!


That 's why, even if anti-TPO antibodies are slightly increased like 1-9U/mL, we should start doing something about it!


The reason for this is that if antibodies are increased as 100 U/mL or 1000 U/mL, it has the same unfavourable effects on Your thyroid.


Hence, it's important to not let it happen and always PREVENT!


What are the most common causes of elevated Anti-TPO antibodies?

  1. Inflammatory state of Your organism.

  2. Poor diet.

  3. Low vitamin D levels.

  4. Hormonal imbalances.

  5. Diabetes type I.

  6. GI issues like leaky gut, SIBO or both,

  7. Celiac disease.

  8. Adrenal insufficiency or poor stress response like adrenal fatigue.

  9. Pernicious anemia.


How to treat it?

The most important thing is to ACT FAST and PREVENT when the antibodies are even slightly increased!


This means that early diagnosis is essential and then subsequent tests are needed in order TO FIND THE TRIGGER of elevated anti-TPO antibodies.


Once we know the TRIGGER, we act on it, so the antibodies decrease and Your symptoms decrease.


For example:

If You are sensitive to gluten, it may indicate a Celiac disease or gluten sensitivity.


In this case, making additional tests like the one for tissue transglutaminase may be very beneficial.


It may turn out, that only by eliminating gluten from Your diet, the anti-TPO antibodies decrease.


It would definitely improve Your thyroid's health and ameliorate Your symptoms.


Another example:

Low vitamin D: If Your levels of vitamin D are too low, Your immune system most probably doesn't function the same.


The reason for this is the function of vitamin D. Vitamin D helps to modulate the innate and adaptive immune responses.


Deficiency in vitamin D is linked to increased autoimmunity as well as increased susceptibility to infection.


It means that if Your vitamin D levels are not optimal i.e. around 70-80 ng/mL, Your anti-TPO can be increased.


As we know, both autoimmunity and infection are linked to development of Hashimoto's thyroiditis.


It implies that if Your vitamin D levels are not optimal, You will most probably have exacerbation of Your symptoms.



Some important things about vitamin D:



To Sum Up:


1. Anti-Thyroid peroxidase (TPO) antibodies are the most common type of thyroid antibody. 


2. If You experience hypothyroid or hyperthyroid symptoms You should definitely do Full Thyroid Panel in order to check if Your anti-TPO levels are optimal.


3. If Your anti-TPO antibodies are elevated, it means Your immune system is not working properly and You will unfortunately suffer from various symptoms (most commonly hypothyroid ones).


4. The most important thing is not to wait until anti-TPO are very elevated i.e. above 34U/mL, but to ACT FAST and PREVENT, even when the anti-TPO antibodies are slightly increased i.e. 0-9U/mL.


5. How to diagnose? Full Thyroid panel + additional tests to find out the trigger of increased antibodies.


6. How to treat? Act to remove the trigger and decrease anti-TPO antibodies. This will improve Your symptoms and most importantly Your health!














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