Understanding the Presence of Thyroid Antibodies in Test Results

What it means to have thyroid antibodies--and do you need treatment?


If your doctor has told you that you have tested positive for "thyroid antibodies" but you have a normal Thyroid Stimulating Hormone (TSH) test result, what does that mean for you?

This kind of test result could mean you have undiagnosed Hashimoto's thyroiditis.  Hashimoto's disease is an autoimmune disorder that occurs when your body mistakenly produces antibodies that attack your thyroid gland. Inflammation is caused when immune antibodies produced by your immune system work to destroy proteins in the thyroid gland.

This can result in a nodule, or goiter, and is often a common symptom that leads you to your doctor--and a diagnosis.

With Hashimoto's disease, eventually, the thyroid gland, or portions of it, are destroyed, and you are not able to produce healthy levels of thyroid hormone.  For a time before your thyroid gland is completely dysfunctional, you could have a normal TSH, along with the presence of thyroid antibodies.

If your test results show thyroid antibodies, it likely means your thyroid is failing--but not enough to trigger treatment from some medical practitioners.  Like many people with developing Hashimoto's disease, you may have few noticeable symptoms right now.  Eventually, as the disease progresses, you will begin to experience other symptoms.

Many doctors believe that antibodies alone are NOT reason to treat someone with thyroid hormone. This is despite the fact that the presence of antibodies alone can cause thyroid-related symptoms, and have been shown to affect fertility or the ability to maintain a pregnancy.

   A review published in Obstetrics and Gynecology notes "...evidence is accumulating that the odds of a miscarriage are more than tripled and the odds of preterm birth are doubled in the presence of thyroid autoantibodies."

There are, however, some endocrinologists, as well as holistic MDs, osteopaths and other practitioners who believe that the presence of thyroid antibodies alone is enough to warrant treatment with small amounts of thyroid hormone.

If you've tested positive for antibodies, and have a TSH in the "normal range," but still don't feel well, you may with to consult with a practitioner who has this philosophy.

The other issue is the TSH level itself. While at many labs, "normal" range is .5 to 5.5 (with over 5.5 being hypothyroid), some endocrinologists - and many integrative physicians and hormone experts -- firmly believe FIRMLY, that thyroid function is not optimized unless TSH is below 1.5. 

Recent research evaluated the effectiveness of treating patients who had normal TSH levels, but also had thyroid antibodies show up in their test results.  In the study, participants who received treatment with thyroid hormone replacement medication showed reduction in the thyroid antibody levels, and reduction of the inflamed size of the thyroid.  Patients in the study who did not receive treatment with thyroid medication during the 15-month term of the treatment showed an increase in thyroid inflammation.

The long term trajectory of your condition could be impacted by initial treatment.

  In the study mentioned above, patients who received thyroid hormone medication suffered less damage to their thyroid gland 15 months after treatment.  If left untreated, the immune dysfunction associated with Hashimoto's disease continues to progress, permanently destroying thyroid tissue. 

Thyroid Antibodies Should Not be Ignored

If you haven't had your antibodies tested, and suspect you may be hypothyroid despite a so-called "normal" TSH test, I suggest you read the following article at my site for more ideas on how to proceed ---especially if you are considering a pregnancy. Remember, thyroid antibodies represent an attack on the thyroid gland by your own immune system.

HELP! My TSH Is "Normal" But I Think I'm Hypothyroid, offers a look at your next steps -- including defining the "normal" range with your doc, antibody testing, Free T3 testing, and drugs beyond T4 therapy -- and where to find a doctor to help.

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