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Raj Singh MD
September 10, 2023

Thyroid Antibodies: Symptoms, Causes, and Treatment Options

Thyroid Antibodies

Thyroid antibodies are proteins the immune system produces to target and destroy cells in the thyroid gland. Antibodies are a normal part of the body's defense system. Still, in some cases, the immune system can produce antibodies that mistakenly attack healthy cells in the thyroid gland, leading to thyroid disease.

What are thyroid antibodies?

There are three main types of thyroid antibodies: thyroid peroxidase antibodies (TPO antibodies), thyroglobulin antibodies (TG antibodies), and thyroid-stimulating hormone receptor antibodies (TSH receptor antibodies). TPO antibodies and TG antibodies are commonly found in autoimmune thyroid diseases, such as Hashimoto's thyroiditis, while TSH receptor antibodies are associated with Graves' disease.

What is Thyroglobulin?

Thyroglobulin is a protein that is produced by the thyroid gland. It is a precursor to thyroid hormones regulating the body's metabolism. Thyroglobulin is produced by the thyroid follicular cells and secreted into the colloid, a space in the thyroid gland where thyroid hormone synthesis occurs.

Thyroglobulin is a large protein molecule containing many tyrosine residues, essential building blocks for synthesizing thyroid hormones. After thyroglobulin is produced and secreted into the colloid, it is then taken up by the follicular cells and broken down into smaller fragments. These fragments are then converted into thyroid hormones, including thyroxine (T4) and triiodothyronine (T3).

What is thyroid peroxidase?

Thyroid peroxidase (TPO) is an enzyme that plays a critical role in the synthesis of thyroid hormones in the thyroid gland. TPO is located on the surface of thyroid follicular cells, which are the cells that produce and secrete thyroid hormones.

The main function of TPO is to catalyze the iodination and coupling of tyrosine residues on thyroglobulin, a protein that serves as a precursor to thyroid hormones. This process involves the incorporation of iodine atoms into tyrosine residues to form monoiodotyrosine (MIT) and diiodotyrosine (DIT), which then combine to form the thyroid hormones thyroxine (T4) and triiodothyronine (T3).

What are thyroid peroxidase antibodies (TPO)

Thyroid peroxidase antibodies (TPO antibodies) are a type of antibody produced by the immune system that target thyroid peroxidase, an enzyme involved in the synthesis of thyroid hormones. TPO antibodies are commonly found in autoimmune thyroid disease, such as Hashimoto's thyroiditis, Graves' disease, and postpartum thyroiditis.

In Hashimoto's thyroiditis, TPO antibodies attack and damage the thyroid gland, leading to an underactive thyroid (hypothyroidism). In Graves' disease, TPO antibodies can also be present, but the primary target is the thyroid-stimulating hormone (TSH) receptor, leading to an overactive thyroid (hyperthyroidism).

TPO antibodies can be detected through a blood test, and their presence can help diagnose autoimmune thyroid disease. TPO antibody levels can also be used to monitor the progression of thyroid disease and assess treatment effectiveness. High levels of TPO antibodies indicate ongoing autoimmune activity and a greater risk of thyroid damage.

Normal thyroid peroxidase Antibody level:

The normal range for thyroid peroxidase antibody (TPO antibody) levels can vary slightly between different laboratories and methods used for testing. However, TPO antibody levels of less than 9 IU/mL are generally considered normal.

It's important to note that even if TPO antibody levels are within the normal range, it does not necessarily rule out the possibility of thyroid disease. Some people with autoimmune thyroid disease, such as Hashimoto's thyroiditis, may have normal TPO antibody levels.

In addition, TPO antibody levels can fluctuate over time, and a single test may not provide a complete picture of thyroid function. Your doctor may order additional tests, such as thyroid hormone levels, to help diagnose and monitor thyroid disease.

What is thyrotropin?

Thyrotropin, also known as thyroid-stimulating hormone (TSH), is a hormone produced by the pituitary gland in the brain. TSH plays a crucial role in regulating the production and release of thyroid hormones from the thyroid gland.

When thyroid hormone levels in the blood are low, the hypothalamus in the brain releases thyrotropin-releasing hormone (TRH), which signals the pituitary gland to produce and release TSH into the bloodstream. TSH then stimulates the thyroid gland to produce and release thyroid hormones, including thyroxine (T4) and triiodothyronine (T3).

Once thyroid hormone levels in the blood have reached a certain level, the hypothalamus and pituitary gland reduce their production of TRH and TSH, respectively, in a negative feedback loop that helps maintain proper levels of thyroid hormones in the body.

Measuring TSH levels in the blood is a standard test to assess thyroid function. High levels of TSH indicate an underactive thyroid (hypothyroidism), while low levels of TSH indicate an overactive thyroid (hyperthyroidism). Treating thyroid dysfunction typically involves medication to replace or regulate thyroid hormones, such as levothyroxine for hypothyroidism or antithyroid drugs for hyperthyroidism.

What are Thyrotropin receptor antibodies (TRAbs)?

Thyrotropin receptor antibodies (TRAbs) are a type of antibody produced by the immune system that targets the thyrotropin receptor located on the surface of thyroid cells. TRAbs are primarily associated with Graves' autoimmune disease, which leads to an overactive thyroid (hyperthyroidism).

In Graves' disease, TRAbs stimulate the thyrotropin receptor, leading to increased production of thyroid hormones by the thyroid gland. This results in symptoms such as weight loss, heat intolerance, tremors, and palpitations. TRAbs can also be present in other autoimmune thyroid diseases, such as postpartum thyroiditis and Hashimoto's thyroiditis.

Measurement of TRAb levels in the blood can be used to diagnose Graves' disease and to monitor the progression of the condition. High levels of TRAbs indicate ongoing autoimmune activity and a greater risk of thyroid dysfunction. Treatment for Graves' disease typically involves medication to regulate thyroid hormones, such as antithyroid drugs or beta-blockers, and in some cases, radioiodine therapy or thyroid surgery may be necessary.

It's worth noting that TRAbs differ from thyroid peroxidase antibodies (TPO antibodies) and thyroglobulin antibodies (TG antibodies), which are other types of antibodies produced by the immune system that target proteins in the thyroid gland.

Are thyroid antibodies normal?

Thyroid antibodies are not considered normal, as their presence usually indicates an underlying autoimmune thyroid disease or other thyroid disorder. However, it's important to note that some people with thyroid disease may not have detectable levels of thyroid antibodies, and autoimmune conditions cause not all thyroid disorders.

How to lower thyroid antibodies?

Lowering thyroid antibodies can be challenging, as the underlying cause of the antibodies is often a chronic autoimmune condition. However, some steps may help to reduce thyroid antibody levels:

  1. Treat the underlying thyroid condition: If the thyroid antibodies are due to an autoimmune thyroid disease such as Hashimoto's thyroiditis or Graves' disease, treatment for these conditions can help to manage symptoms and reduce antibody levels. This may involve medication to regulate thyroid hormones, such as levothyroxine or antithyroid drugs for hyperthyroidism.
  2. Reduce inflammation: Chronic inflammation can contribute to autoimmune diseases, including autoimmune thyroid disease. Making dietary and lifestyle changes that reduce inflammation, such as eating a healthy, whole-food diet, regular exercise, reducing stress, and getting enough sleep, may help lower antibody levels.
  3. Consider supplementing with selenium: Some studies have suggested that selenium supplementation may help to reduce thyroid antibody levels in people with autoimmune thyroid disease. However, talking to a healthcare provider before taking any supplements is essential.
  4. Address other underlying health conditions: Certain conditions, such as gut dysbiosis or nutrient deficiencies, can contribute to autoimmune disease. Addressing these underlying conditions through diet, supplements, or other treatments may help to reduce thyroid antibody levels.
  5. Consider alternative therapies: Some alternative therapies, such as acupuncture or mind-body therapies, may help to reduce stress and inflammation and improve immune function. While more research is needed in this area, these therapies may be worth exploring as part of a comprehensive treatment plan.

Can thyroid antibodies go away?

In some cases, thyroid antibodies can go away, but this depends on the underlying cause of the antibodies.

In cases where the antibodies result from a temporary condition, such as postpartum thyroiditis or medication-induced thyroiditis, the antibodies may go away as the underlying condition resolves.

However, in cases of autoimmune thyroid disease, such as Hashimoto's thyroiditis or Graves' disease, the antibodies are caused by a chronic autoimmune condition that persists over time. While treating these conditions can help manage symptoms and reduce antibody levels, the underlying autoimmune process may not completely disappear.

In some cases, treatment for autoimmune thyroid disease can lead to a decrease in antibody levels, but this does not necessarily mean that the antibodies have gone completely. Regular monitoring of antibody levels and thyroid function is essential for managing thyroid disease and assessing the effectiveness of treatment.

Still have questions about elevated thyroid antibody level. Schedule an appointment with our thyroid experts in Las Vegas.

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