What are Thyroid Antibodies
Thyroid health is important for many body functions, including energy use and organ health. One cause of thyroid problems is Hashimoto's thyroiditis, an autoimmune disease. In Hashimoto's, the immune system makes defective antibodies that turn on the body (termed autoantibodies) attacking the thyroid and making it underactive. These autoantibodies in Hashimoto’s are specifically called thyroid peroxidase antibodies (TPOAb). Another thyroid condition is Graves' disease, where different autoantibodies (TRAb) attack the thyroid and make it overactive. This article explains about these autoantibodies and how they affect thyroid health.
The Importance of Thyroid Hormones in the Body
Thyroid hormones control many functions in our body, such as energy use and organ health. The thyroid gland produces these hormones, and if it doesn't work properly, it can cause problems throughout the body. If for whatever reason the thyroid becomes underactive and produces too little hormone (hypothyroidism), symptoms can include feeling tired, gaining weight, and feeling cold. If the thyroid is overactive and produces too much hormone (hyperthyroidism), symptoms can include weight loss, feeling hot, and having a fast heartbeat. Proper thyroid function is essential for maintaining overall health and well-being.
Hashimoto’s: The autoimmune disease that causes hypothyroidism
Hashimoto’s thyroiditis is an autoimmune disease where the immune system confuses and creates autoantibodies, specifically Thyroid Peroxidase Antibodies (TPOAb) that mistakenly attack your thyroid. This ongoing battle can lead to reduced levels of thyroid hormones or hypothyroidism. Hashimoto’s is the most common cause of hypothyroidism among developed countries (Hashimoto’s Thyroiditis - Stat Pearls, 2023). The exact reasons behind why your immune system launches this attack against your thyroid in Hashimoto’s is not completely understood. Research shows that it is most likely due to genetic causes and partly related to environmental factors and sex hormones (Hashimoto’s Thyroiditis - Stat Pearls, 2023).
Hashimoto's typically starts quietly and slowly intensifies. Early on, your body through other feedback mechanisms tries to signal your thyroid to produce more thyroid hormone offsetting any possible deficiencies. During this period, your TSH (a hormone that is produced in your brain that tells your thyroid gland to produce more thyroid hormone) may be increased but hypothyroid symptoms may not be present (known as subclinical hypothyroidism). The presence of TPOAb signals that the cause of your subclinical hypothyroidism may be Hashimoto’s (there can be several other causes for hypothyroidism!). Over time, as TPOAb antibodies continue their attack, the thyroid gland's compensatory abilities dwindle. This stage marks the genesis of noticeable hypothyroidism symptoms (known as overt hypothyroidism). J. Walsh et al. (2010) in their research emphasized the predictive nature of thyroid antibodies for hypothyroidism. Therefore, monitoring these antibody levels could be beneficial.
How to diagnose Hashimoto’s Thyroiditis
Hashimoto's thyroiditis diagnosis combines lab testing and physical exams. The lab tests measure crucial biochemical characteristics, such as thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4), and TPO antibodies. This information aids in evaluating thyroid function and determining an overactive or underactive thyroid cause.
Thyroid Peroxidase Antibodies (TPOAb)
To understand the role of TPO antibodies in Hashimoto’s, we first need to know about thyroid peroxidase (TPO), an enzyme crucial for thyroid hormone production. The human body's defense system — containing 'army troops' known as antibodies — usually ward off invaders. Sometimes, however, these antibodies fight against the body's own machinery, in this case, our TPO. Therefore, when you have TPO antibodies in your body, it suggests an autoimmune thyroid condition like Hashimoto's. Conversely, if you have different antibodies, usually TRAb, then you may have Graves' disease which is usually characterized by an overactive thyroid.
TPO antibody test results are usually displayed as "positive" or "negative". A positive result implies you might have an autoimmune thyroid disorder, likely Hashimoto's. A negative result, indicates you lack that antibody - meaning it is unlikely that you have Hashimoto’s.
Dealing with Positive TPO Antibodies Status
If you have elevated TPO antibodies but boast normal thyroid function or slightly elevated TSH (a condition called subclinical hypothyroidism), you might not need treatment immediately. However, periodic checking of your thyroid status every 3 to 6 months is advisable. For those diagnosed with overt hypothyroidism (exhibiting high TSH and low thyroid hormone levels, and likely symptoms), the approach involves replacing the thyroid hormone the gland can no longer manufacture.
Do you need to reduce your Auto-Antibody Levels in Thyroid Conditions?
The presence of TPOAb helps diagnose Hashimoto’s and is also a marker of active and ongoing autoimmune activity concerning the thyroid. The goal of management in Hashimoto’s is usually to control your hypothyroid symptoms and to normalize your TSH levels. Therefore, repeated measurements of TPO antibodies (TPOAb) are rarely useful. Conversely, monitoring thyrotropin receptor antibodies (TRAb) is helpful in treating Graves' disease. After anti-thyroid treatment in Graves’ your TRAb levels may disappear. However, they are likely to return and relapse Graves’ disease if antithyroid drugs are discontinued. Similarly, for thyroid cancer follow-up, there is utility in measuring thyroglobulin antibodies regularly.
You cannot reverse an autoimmune disorder like Hashimoto's. However, there has been some research into different strategies to help improve prognosis (likely course or outcome) in autoimmune thyroid conditions. Here are some of them
1. J. Wichman et al. (2016) in their systematic review and meta-analysis confirmed the effectiveness of selenium supplementation in lowering TPOAb levels. However, whether this lowering of antibodies is of any clinical benefit is yet to be confirmed.
2. Choudary et al, 2016 in a trial showed that vitamin D supplementation in AITD may have a beneficial effect on autoimmunity as shown by reductions in TPO-Ab titers. However, whether you would benefit from Vitamin D will depend on your individual clinical history and blood levels.
3. The Autoimmune Protocol (AIP) diet may help improve well-being and biochemical test results in Hashimoto's disease patients, with a personalized approach enhancing mental state, stress reduction, and addressing adverse ailments.
4. Address any other nutrient deficiencies in your diet.
5. Identify and avoid any environmental toxins (e.g., smoking).
On a Side Note - Your Health Companion, Eureka
Eureka, your health partner, equips you with free recommendations to bolster your thyroid health. Understanding how your thyroid functions is the first step to enhancing your overall health and well-being. Awaiting your attention is Eureka's at-home testing kit, enabling you to test your thyroid function without stepping out of your sanctum. This full panel includes thyroid-stimulating hormone (TSH), free T4 and T3, and TPO antibodies. Moreover, by teaming up with a reliable thyroid doctor, you can explore the ideal functioning of your thyroid. Schedule your free consultation today, and let Eureka shine light on your thyroid health journey.
Remember, the information shared here is no substitute for a medical diagnosis, treatment, or cure for thyroid disease. Therefore, it is recommended to work with your Eureka healthcare team to optimize your thyroid health.
References
- Mincer DL, Jialal I. Hashimoto Thyroiditis. [Updated 2023 Jul 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Read more.
- Thyrotropin and thyroid antibodies as predictors of hypothyroidism: a 13-year, longitudinal study of a community-based cohort using current immunoassay techniques by J. Walsh et al. (2010). This study underscores the predictive value of thyroid antibodies for hypothyroidism, implying benefits from monitoring and potentially reducing these antibody levels. Read more.
- Selenium Supplementation Significantly Reduces Thyroid Autoantibody Levels in Patients with Chronic Autoimmune Thyroiditis: A Systematic Review and Meta-Analysis by J. Wichman et al. (2016). This systematic review and meta-analysis confirm that selenium supplementation effectively lowers TPOAb levels in patients with chronic autoimmune thyroiditis. Read more.
- Vitamin D supplementation reduces thyroid peroxidase antibody levels in patients with autoimmune thyroid disease: An open-labeled randomized controlled trial. Indian journal of endocrinology and metabolism by Chaudhary, S., Dutta, D., Kumar, M., Saha, S., Mondal, S. A., Kumar, A., & Mukhopadhyay, S. (2016). Read more.
- Autoimmune Protocol Diet: Ihnatowicz P, Gębski J, Drywień ME. Effects of Autoimmune Protocol (AIP) diet on changes in thyroid parameters in Hashimoto's disease. Ann Agric Environ Med. 2023;30(3):513-521. Read more.
