Table of ContentsView AllTable of ContentsTPOAbTSHR-AbAnti-TgTest ResultsInterpretationFAQ
Table of ContentsView All
View All
Table of Contents
TPOAb
TSHR-Ab
Anti-Tg
Test Results
Interpretation
FAQ
If you have symptoms ofthyroid disease, antibody tests may be ordered to look for these proteins. Based on the presence and amount of these antibodies, a lab can determine if an autoimmune disease is likely to be involved and, if so, which one.
For example, the thyroid peroxidase antibody (TPOAb) test can detect autoantibodies strongly suggestive ofHashimoto’s disease, which causeshypothyroidism(underactive thyroid). The thyroid stimulating hormone receptor antibody (TSHR-Ab) test can detect autoantibodies strongly suggestive ofGraves' disease, which causeshyperthyroidism(overactive thyroid).
This article discusses anti-thyroid antibodies, what they do, and why you may need to undergo testing. It will also help you understand what your test results mean.
Anti-Thyroperoxidase Antibodies (TPOAb)
Anti-thyroperoxidase antibodies (TPOAb) targetthyroid peroxidase (TPO). TPO is an enzyme in thethyroid glandthat helps produce important thyroid hormones calledtriiodothyronine(T3)andthyroxine(T4).
TPO assists the chemical reaction that adds iodine (an important nutrient) to a protein called thyroglobulin. This is a critical step in generating thyroid hormones.
Anti-TPO antibodies stop TPO from using iodine. This causes hypothyroidism, in which your thyroid gland doesn’t produce enough thyroid hormones.
Anti-TPO antibodies are found in around 90% of people with Hashimoto’s disease. However, they are also found in 75% of people with Graves' disease and 10% to 20% of those withthyroid cancer.
To make a definitive diagnosis, other blood tests and examinations may be needed if a positive TPOAb test result is received.
For example, people with Hashimoto’s disease often have low T3 and T4 levels but high TSH levels. This is because the pituitary gland will produce more TSH in an effort to “tell” the thyroid to produce more T3 and T4.
At the same time, it can take time for anti-TPO antibodies to effect changes in TSH levels. In some cases, you can test positive for anti-TPO antibodies for months or years before you are diagnosed with hypothyroidism. Some people with anti-TPO antibodies never become hypothyroid.
Thyroid Stimulating Hormone Receptor Antibodies (TSHR-Ab)
TSHR-Abs are present in over 85% of people with Graves' disease and less commonly with Hashimoto’s disease. As such, high levels of TSHR antibodies are strongly suggestive of Graves' disease.
The TSHR-Ab test is sometimes called the thyroid-stimulating immunoglobulin (TSI) test.
Anti-Thyroglobulin (Anti-Tg) Antibodies
Anti-Tg antibodies are found in 70% of people with Hashimoto’s disease and 30% of people with Graves' disease.Even so, they tend to be more indicative of Hashimoto’s when paired with a positive anti-TPO result.
Thyroid Antibody Test Results
Verywell / Laura Porter
Antibody levels can be tested with a blood sample. The antibody test measures the amount of antibody per milliliter (mL) or liter (L) of blood in international units (IU).
These are the normal values for adults:
What Anti-Thyroid Antibodies Mean for You
Thyroid treatmentis not based on antibody levels. Treatment is based on symptoms and TSH, T4, and T3 levels.
Antibody tests are useful in finding the cause of your thyroid disease. They can also help identifysubclinical thyroid disease, which is thyroid disease with mild or no symptoms.
Positive thyroid antibodies suggest youcouldhave autoimmune thyroid disease. Still, they are only a piece of the picture.They can help healthcare providers decide if treatment is needed. Healthcare providers will also consider your symptoms, family history, and other blood test results.
You can have elevated thyroid antibodies and not require treatment. If you don’t have symptoms and your thyroid hormone levels are normal, your healthcare provider may not treat you. If you have mild symptoms or your thyroid levels are borderline, you are more likely to receive treatment.
The presence of antibodies may confirm subclinical hypothyroidism. Early therapy might prevent disease progression, but this has not been proven.
Summary
Thyroid antibodies may cause the thyroid to make too much or not enough thyroid hormone. An antibody test can determine the cause of your condition.
Thyroid treatment is based on your symptoms. If you do not have symptoms, you may not need treatment.
A Word From VerywellOur body’s immune system usually makes antibodies to fight germs, but sometimes it mistakenly attacks healthy tissues, including the thyroid gland. This can lead to autoimmune thyroid diseases. If you experience thyroid issues, a healthcare provider may order tests to check for these antibodies. Early detection and proper management can help maintain good thyroid health.—KASHIF J. PIRACHA, MD, MEDICAL EXPERT BOARD
A Word From Verywell
Our body’s immune system usually makes antibodies to fight germs, but sometimes it mistakenly attacks healthy tissues, including the thyroid gland. This can lead to autoimmune thyroid diseases. If you experience thyroid issues, a healthcare provider may order tests to check for these antibodies. Early detection and proper management can help maintain good thyroid health.—KASHIF J. PIRACHA, MD, MEDICAL EXPERT BOARD
Our body’s immune system usually makes antibodies to fight germs, but sometimes it mistakenly attacks healthy tissues, including the thyroid gland. This can lead to autoimmune thyroid diseases. If you experience thyroid issues, a healthcare provider may order tests to check for these antibodies. Early detection and proper management can help maintain good thyroid health.
—KASHIF J. PIRACHA, MD, MEDICAL EXPERT BOARD
Frequently Asked QuestionsIf Hashimoto’s is left untreated, it can lead to serious and even life-threatening complications, includingcardiac arrhythmia(irregular heartbeats),cardiomegaly(enlarged heart), and, rarely,myxedema(which can lead to coma and death).Studies suggest that taking 200 micrograms (mcg) ofseleniumper day may help reduce TPO antibodies in people with mild Hashimoto’s disease and Graves' disease, and improve quality of life.Pituitary disorders, congenital thyroid problems, iodine deficiency, thyroid surgery, head and neck radiation, and even certain medications can all cause thyroid disease.
Frequently Asked Questions
If Hashimoto’s is left untreated, it can lead to serious and even life-threatening complications, includingcardiac arrhythmia(irregular heartbeats),cardiomegaly(enlarged heart), and, rarely,myxedema(which can lead to coma and death).
Studies suggest that taking 200 micrograms (mcg) ofseleniumper day may help reduce TPO antibodies in people with mild Hashimoto’s disease and Graves' disease, and improve quality of life.
Pituitary disorders, congenital thyroid problems, iodine deficiency, thyroid surgery, head and neck radiation, and even certain medications can all cause thyroid disease.
7 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Fröhlich E, Wahl R.Thyroid autoimmunity: role of anti-thyroid antibodies in thyroid and extra-thyroidal diseases.Front Immunol. 2017;8:521. doi:10.3389/fimmu.2017.00521Medline Plus.TPO gene.Labcorp.Thyroid peroxidase (TPO) antibodies.Labcorp.Thyroid-stimulating immunoglobulin (TSI).British Thyroid Foundation.Thyroid antibodies explained.Klubo-Gwiezdzinska J, Wartofsky L.Hashimoto thyroiditis: an evidence-based guide to etiology, diagnosis and treatment.Pol Arch Intern Med. 2022 Mar 30;132(3):16222. doi:10.20452/pamw.16222Santos LR, Neves C, Melo M, Soares P.Selenium and selenoproteins in immune mediated thyroid disorders.Diagnostics (Basel).2018 Dec;8(4):70. doi:10.3390/diagnostics8040070Additional ReadingBehroozi-Lak T, Akbary A, Vazifekhah S, Naghavi-Behzad M, Mirza-Aghazadeh-Attari M.Association of hypothyroidism and anti-thyroid antibodies with preterm delivery: a cross sectional study.J Family Reprod Health. 2017;11(4):191-196.Kotwal A, Stan M.Thyrotropin receptor antibodies-an overview.Ophthalmic Plast Reconstr Surg. 2018;34(4S Suppl 1):S20-S27. doi: 10.1097/IOP.0000000000001052.Krátký J, Ježková J, Kosák M, et al.Positive antithyroid antibodies and nonsuppressed TSH are associated with thyroid cancer: a retrospective cross-sectional study.Int J Endocrinol. 2018. doi: 10.1155/2018/9793850.
7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Fröhlich E, Wahl R.Thyroid autoimmunity: role of anti-thyroid antibodies in thyroid and extra-thyroidal diseases.Front Immunol. 2017;8:521. doi:10.3389/fimmu.2017.00521Medline Plus.TPO gene.Labcorp.Thyroid peroxidase (TPO) antibodies.Labcorp.Thyroid-stimulating immunoglobulin (TSI).British Thyroid Foundation.Thyroid antibodies explained.Klubo-Gwiezdzinska J, Wartofsky L.Hashimoto thyroiditis: an evidence-based guide to etiology, diagnosis and treatment.Pol Arch Intern Med. 2022 Mar 30;132(3):16222. doi:10.20452/pamw.16222Santos LR, Neves C, Melo M, Soares P.Selenium and selenoproteins in immune mediated thyroid disorders.Diagnostics (Basel).2018 Dec;8(4):70. doi:10.3390/diagnostics8040070Additional ReadingBehroozi-Lak T, Akbary A, Vazifekhah S, Naghavi-Behzad M, Mirza-Aghazadeh-Attari M.Association of hypothyroidism and anti-thyroid antibodies with preterm delivery: a cross sectional study.J Family Reprod Health. 2017;11(4):191-196.Kotwal A, Stan M.Thyrotropin receptor antibodies-an overview.Ophthalmic Plast Reconstr Surg. 2018;34(4S Suppl 1):S20-S27. doi: 10.1097/IOP.0000000000001052.Krátký J, Ježková J, Kosák M, et al.Positive antithyroid antibodies and nonsuppressed TSH are associated with thyroid cancer: a retrospective cross-sectional study.Int J Endocrinol. 2018. doi: 10.1155/2018/9793850.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Fröhlich E, Wahl R.Thyroid autoimmunity: role of anti-thyroid antibodies in thyroid and extra-thyroidal diseases.Front Immunol. 2017;8:521. doi:10.3389/fimmu.2017.00521Medline Plus.TPO gene.Labcorp.Thyroid peroxidase (TPO) antibodies.Labcorp.Thyroid-stimulating immunoglobulin (TSI).British Thyroid Foundation.Thyroid antibodies explained.Klubo-Gwiezdzinska J, Wartofsky L.Hashimoto thyroiditis: an evidence-based guide to etiology, diagnosis and treatment.Pol Arch Intern Med. 2022 Mar 30;132(3):16222. doi:10.20452/pamw.16222Santos LR, Neves C, Melo M, Soares P.Selenium and selenoproteins in immune mediated thyroid disorders.Diagnostics (Basel).2018 Dec;8(4):70. doi:10.3390/diagnostics8040070
Fröhlich E, Wahl R.Thyroid autoimmunity: role of anti-thyroid antibodies in thyroid and extra-thyroidal diseases.Front Immunol. 2017;8:521. doi:10.3389/fimmu.2017.00521
Medline Plus.TPO gene.
Labcorp.Thyroid peroxidase (TPO) antibodies.
Labcorp.Thyroid-stimulating immunoglobulin (TSI).
British Thyroid Foundation.Thyroid antibodies explained.
Klubo-Gwiezdzinska J, Wartofsky L.Hashimoto thyroiditis: an evidence-based guide to etiology, diagnosis and treatment.Pol Arch Intern Med. 2022 Mar 30;132(3):16222. doi:10.20452/pamw.16222
Santos LR, Neves C, Melo M, Soares P.Selenium and selenoproteins in immune mediated thyroid disorders.Diagnostics (Basel).2018 Dec;8(4):70. doi:10.3390/diagnostics8040070
Behroozi-Lak T, Akbary A, Vazifekhah S, Naghavi-Behzad M, Mirza-Aghazadeh-Attari M.Association of hypothyroidism and anti-thyroid antibodies with preterm delivery: a cross sectional study.J Family Reprod Health. 2017;11(4):191-196.Kotwal A, Stan M.Thyrotropin receptor antibodies-an overview.Ophthalmic Plast Reconstr Surg. 2018;34(4S Suppl 1):S20-S27. doi: 10.1097/IOP.0000000000001052.Krátký J, Ježková J, Kosák M, et al.Positive antithyroid antibodies and nonsuppressed TSH are associated with thyroid cancer: a retrospective cross-sectional study.Int J Endocrinol. 2018. doi: 10.1155/2018/9793850.
Behroozi-Lak T, Akbary A, Vazifekhah S, Naghavi-Behzad M, Mirza-Aghazadeh-Attari M.Association of hypothyroidism and anti-thyroid antibodies with preterm delivery: a cross sectional study.J Family Reprod Health. 2017;11(4):191-196.
Kotwal A, Stan M.Thyrotropin receptor antibodies-an overview.Ophthalmic Plast Reconstr Surg. 2018;34(4S Suppl 1):S20-S27. doi: 10.1097/IOP.0000000000001052.
Krátký J, Ježková J, Kosák M, et al.Positive antithyroid antibodies and nonsuppressed TSH are associated with thyroid cancer: a retrospective cross-sectional study.Int J Endocrinol. 2018. doi: 10.1155/2018/9793850.
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