Sometimes the human body begins to produce hormones in such a way that it suppresses the functions of important internal glands. In this case, the endocrinologist gives the patient a referral for tests. In particular, if thyroid disease is suspected, it is necessary to determine the level of the hormone ATTPO. What is this and should I worry?
AT TPO is an abbreviation that can be deciphered as follows.
AT – autoantibodies. The prefix “auto” means that they are not introduced into the body from the outside, but are produced directly by the immune system of the person himself.
TPO - thyroid peroxidase, or in other words - thyroid peroxidase. What it is? This is an enzyme based on protein molecules, produced by the thyroid gland and plays the role of a catalyst in the processes of hormone biosynthesis:
- thyroglobulin;
- thyroxine;
- triiodothyronine.
If for some reason the immune system begins to consider this enzyme hostile to the body and increases ATPO hormone against it, then active iodine without the action of a catalyst cannot form compounds with thyroglobulin. The process of hormonal synthesis in the thyroid gland is disrupted.
What are the reasons for the deviation of the level of AT to TPO hormone from the norm?
Before talking about deviations, let us outline the boundaries of the norm. The level of the hormone AT to TPO that is considered normal varies depending on a person’s age. So for patients under 50 years of age it is 0.0 – 34.9 units/ml. And for people over 50, this value is already equal to the range of 1.00 – 99.9 units/ml.
Further, we draw your attention to the fact that there is a reservation in the interpretation of the indicators. If a blood test for AT showed an increased level of the AT hormone TPO by 20 units/ml, this means that the patient is still within normal limits, but requires systematic monitoring and monitoring of changes in the level of antibodies in relation to thyroid peroxidase. But if the indicators have increased by 25 units or higher, then medical intervention is already necessary.
An increase in the level of AT TPO means that pathological processes are occurring in the body. An increase in the indicator is observed in the following cases:
- Viral infections;
- Postpartum thyroiditis.
Nonthyroidal autoimmune diseases, including those of a hereditary nature:
- Rheumatoid polyarthritis;
- Vitiligo;
- Collagenoses;
- Systemic lupus erythematosus.
In addition to the above, there are a number of other pathological conditions in which the level of antibodies to PTO will increase:
- Consequences of previous radiation in the neck and head;
- Chronic renal failure;
- Rheumatism;
- Diabetes;
- Injury to the endocrine organ.
Indications for testing for AT-TPO
One of the symptoms of decreased thyroid function is low body temperature.
With hyperfunction, the opposite effect is observed - it will increase. In addition, indications for testing for AT-TPO levels will be the doctor’s suspicions of the following diseases:
- . Low production of thyroid hormones is provoked by an inflammatory process. As a result, the patient experiences a loss of strength and constant drowsiness. Hair begins to fall out. In addition, mental activity is noticeably reduced. In this case, the cause of inflammation will be an increase in the number of antibodies.
- Detection of goiter. This symptom most often signals problems with the thyroid gland. An early diagnosis is required.
- Graves' disease or Graves' disease. This condition is characterized by diffuse goiter. In addition, the patient will complain of sweating, pathological eye conditions, tachycardia, and increased excitability.
- Pretibial myxedema. Due to metabolic disorders, the patient's legs swell tightly.
Any of the cases described above implies the need to analyze for autoimmune reactions that provoke dysfunction of the thyroid gland.
What should a woman do if the ATTPO hormone increases?
Doctors have not yet identified absolutely all the reasons for changes in the level of autoantibodies in women’s bodies. Name the groups of factors that can influence their enhanced production:
- Thyroid diseases;
- Viral pathogens;
- The effect of toxins on the body;
- Genetic predisposition, passed on by inheritance;
- A number of chronic diseases.
The production of antibodies to thyroid peroxidase can also increase during pregnancy against the general background of hormonal changes in the body.
If there is a risk of an increase in antibody levels or a slight increase is observed, then prevention will not be superfluous. This involves the following preventive measures:
- Quitting bad habits – smoking and alcohol;
- Maintain a balanced diet;
- If possible, change your area of residence to an environmentally friendly one;
- Maintain a work-rest schedule and get enough sleep. This recommendation is especially relevant, since poor sleep greatly worsens hormonal levels.
- Monitor your psycho-emotional state, avoid nervous stress, worries, and stress.
If you have a tendency to increase AT TPO, or a genetic predisposition to thyroid diseases, you must be regularly examined by an endocrinologist. Preventive studies are carried out at least once a year.
If the hormone level is outside the normal range, the doctor will prescribe appropriate treatment. The drugs will help return hormonal levels to normal. It should be remembered that self-medication and folk remedies are unacceptable in this case! Otherwise, the patient risks not only aggravating the problem, but also making it more serious.
Normal blood levels of anti-TPO antibodies during pregnancy
Statistics for monitoring pregnant women show: postpartum thyroiditis affects up to 10% of mothers.
The antibodies produced cause significant damage to the thyroid gland, the consequence of which is destructive thyrotoxicosis. In 70% of cases, thyroid function can be normalized and the patient’s condition improves. 30% leads to the development of hypothyroidism.
If before pregnancy the acceptable AT level can be considered 5.6 mIU/ml, then during pregnancy it should not rise higher than 2.5 mIU/ml. If this mark is exceeded, the doctor will prescribe appropriate medications to normalize the functioning of the thyroid gland.
In the case when a woman’s level of the hormone AT TPO is increased, but other symptoms of autoimmune thyroiditis are not identified, the woman is observed by an endocrinologist for monitoring and diagnostic purposes throughout the entire pregnancy. In this case, once a trimester a control blood sample is taken for analysis.
First trimester: low levels of thyroid-stimulating hormone (TSH) are characteristic - this is normal. If the levels of antibodies to TPO and TSH have increased, then a decrease in the functional reserve of the thyroid gland is diagnosed. This means that there is a possibility of developing hypothyroxinemia. The analysis is carried out before the 12th week of pregnancy. Timely examination will prevent possible spontaneous abortion and undesirable consequences for the child. In case of high levels, the doctor most often prescribes a course of L-thyroxine.
If the problem is not identified in time, then unpleasant consequences are possible:
- Hypothyroidism or its progression;
- Obstetric complications during pregnancy;
- Spontaneous abortion;
- Development of postpartum thyropathy.
It is extremely important for expectant mothers to remember the possible consequences and promptly see a doctor.
What treatment methods are used in case of deviation from the norm?
If the TPO AT is high, drug treatment is prescribed. The doctor prescribes hormone replacements, determining the dose and duration of the course strictly individually for each patient, depending on the case.
- Autoimmune thyroiditis. With this disease, there is a possibility of further development of hypothyroidism. There is no highly specialized drug for the treatment of this disease, so often the doctor, depending on the result, can prescribe several drugs until he selects the most effective one.
- If symptoms of problems with the cardiovascular system are identified, then therapy with beta-blockers is prescribed.
- If the patient enters a thyrotoxic phase, pharmaceuticals are not prescribed, since there is no hyperfunction of the thyroid gland.
- Replacement therapy is carried out using thyroid drugs, which include levothyroxine (L-thyroxine). It is prescribed, including to pregnant women. The dosage is selected based on the obtained analyzes of the level of thyroid hormones. Periodically, the woman takes tests again so that the doctor can track changes in the clinical picture.
- In subacute thyroiditis, other autoimmune diseases may occur in parallel. In these cases, the patient will receive glucocorticoids, which are part of Prednisolone. The patient is also prescribed non-steroidal anti-inflammatory drugs if an increase in autoantibody titers is observed. If the fact of compression of the mediastinal organs by the thyroid gland is detected, surgical intervention is prescribed.
Treatment is carried out comprehensively with the prescription of vitamins and adaptogenic drugs. Subsequently, the doctor prescribes a maintenance dose of drugs that the person takes throughout his life.
How is the analysis procedure carried out and what preparation is required?
In order for the analysis to be as effective as possible, it is assumed that the patient will prepare in advance for blood sampling. For these purposes:
- After about 1 month, under the supervision of an endocrinologist, you stop taking medications containing thyroid hormones.
- A few days before the procedure, you should also stop taking iodine supplements.
- On the eve of the analysis, the patient should avoid high physical activity, alcohol and smoking. If possible, eliminate any stressful influences.
Material for analysis is collected on an empty stomach. The patient can drink water, as other drinks can distort the picture of hormonal levels.
Features of deciphering the blood test AT to TPO
Serum is isolated from the patient's blood using centrifugation as the main material. The method of directly testing blood for TPO Ab is called “immunochemiluminescence analysis” or “enzyme-linked immunosorbent assay”. The research is carried out using special equipment in the laboratory.
Since the procedure is standardized, regardless of the laboratory, decoding by an endocrinologist will be carried out in the same way.
The norm for enzyme immunoassay is the following indicators:
- up to 30 IU/ml for people under 50 years of age;
Standard for chemiluminescence immunoassay:
- up to 35 IU/ml for people under 50 years of age;
- up to 50 IU/ml for patients aged 50 years and older.
It is important to remember that the analysis of AT to TPO in the case of a person over 50 years old can show a level of up to 100 IU/ml, which will also mean normal. Taking into account the large number of factors influencing the interpretation of the results of the AT blood test for TPO, decoding should be done only by a qualified endocrinologist.
Bibliography
- Diseases of the thyroid gland in women of reproductive age. Guide for doctors. – M.: GEOTAR-Media, 2013. – 487 p.
- Ivanova, V. Thyroid diseases and diabetes / V. Ivanova. – M.: Newspaper World, 2013. – 128 p.
- Kazmin, V.D. Diseases of the thyroid and parathyroid glands / V.D. Kazmin. – M.: Phoenix, 2009. – 256 p.
⚕️Melikhova Olga Aleksandrovna – endocrinologist, 2 years of experience.
Deals with issues of prevention, diagnosis and treatment of diseases of the endocrine system: thyroid gland, pancreas, adrenal glands, pituitary gland, gonads, parathyroid glands, thymus gland, etc.
The article is devoted to such laboratory research as the analysis of “antibodies to thyroid peroxidase”, its essence and methodology. The role of the studied biologically active substances in the human body is also revealed. The information is supplemented with photo materials, as well as a video in this article.
Thyroid peroxidase is a special enzyme that produces glandula thyreoide in order to accelerate the iodination of tyrosine residues of thyroglobulins and optimize the process of fusion of iodotyrosines during the synthesis of triiodothyronine (T3) and. But sometimes the body, for a number of reasons, may come to the decision that thyroid peroxidase is nothing more than a foreign body and it should immediately begin to destroy it with the help of antibodies called anti-TPO antibodies.
What do antibodies to thyroid peroxidase mean, what do they consist of and why do they begin to destroy healthy cells? Anti-TPO antibody is a complex biochemical compound consisting of protein and carbohydrate. The immune system is responsible for its production.
Important! The sensitivity of this antibody is very high and even the smallest deviation from the normal functioning of the body can provoke an attack on healthy cells. For this reason, the presence of antibodies to TPO is a marker of a disease that has just begun and has not yet manifested itself in any way.
How do anti-TPO antibodies affect the thyroid gland?
Since thyroid peroxidase (TPO) is localized on the surfaces of active glandula thyreoide cells - thyrocytes, it is completely protected from direct contact with blood and the human immune system does not react to it. However, if the integrity of the thyroid gland is damaged, even microscopically, thyroid peroxidase can enter the bloodstream and provoke the synthesis of antibodies to TPO in B lymphocytes.
These antibodies, configured to perceive TPO as a foreign protein, penetrate the glandula thyreoide and begin to destroy thyrocytes.
This process can follow two main scenarios:
- Slow increase in the content of antibodies to TPO, with a gradual, extended over time, destruction of the structure of the thyroid gland;
- A powerful release of a large number of antibodies, causing massive destruction of thyrocytes with the release of T4 and T3 deposited in them, resulting in a sharp increase in their content in the blood with the development of thyrotoxicosis.
The result of the first scenario is a decrease in the number of normally functioning cells over two to three decades, to such a level that they no longer have time to meet the body’s needs for thyroid hormones. And, as a result, it happens.
According to the second scenario, rapidly, as excess thyroid hormones are “washed out” from the tissues, within 45–60 days, it loses its strength. In this case, the destroyed cells are replaced by connective tissue or B-lymphocytes and the thyroid gland becomes unable to produce new doses of T3 and T4, even in normal quantities. The result of this, as with the development of pathology according to the type of the first scenario, is hypothyroidism.
In both cases, the human body cannot cope with the production of its own thyroid hormones, so they will need to be supplied from outside, in the form of replacement therapy.
What reasons lead to an increase in AT to TPO?
There are a number of circumstances that contribute to the onset of the synthesis of antibodies to thyroid peroxidase, in particular we are talking about the following factors:
- intoxications;
- viral diseases;
- various inflammations;
- autoimmune pathologies;
- radioactive exposure;
- thyroid injuries;
- excess or lack of iodine;
- genetic predisposition;
- some somatic and endocrine diseases.
Quite often, Abs to TPO go beyond normal limits during pregnancy. The reason for this is an autoimmune process caused by a restructuring of the expectant mother’s immunity, as well as the specificity of the thyroid gland working in an enhanced mode, when it supplies both the woman and the fetus with hormones. In some cases, the body's defense system perceives the imbalance that arises as a pathology and begins to synthesize antibodies to TPO.
Everything falls into place in the eighth or ninth month after the birth of the child and the level of antibodies returns to normal even without undergoing treatment. Nevertheless, quite often, when the normal content of these biologically active substances is exceeded, the doctor prescribes therapy in order to prevent the aggravation of malfunctions of the glandula thyreoide.
Important! Whatever the reasons why the normal level of antibodies to thyroid peroxidase is exceeded, a person needs to immediately undergo examination to determine the cause of this phenomenon.
Indications for monitoring the content of antibodies to TPO
This analysis is prescribed to patients or subjects under the following conditions:
- hypothyroidism (newly identified);
- pregnancy (if the TSH level exceeds 2.5%);
- suspicion of;
- newly diagnosed thyroid goiter or thyrotoxicosis;
- heterogeneous, according to ultrasound examination, structure of the glandula thyreoide;
- before prescribing certain pharmaceuticals - interferon, lithium salts, amiodarone.
Each indication is quite important, but the determination of antibodies to thyroid peroxidase in expectant mothers stands apart, since it allows you to protect not only the woman, but also her child from many health problems.
What is the importance of determining antibodies to TPO during pregnancy?
Determining whether there are antibodies to thyroid peroxidase in the body of a pregnant woman is important for identifying the degree of risk of developing a very serious disease - postpartum thyroiditis. Pregnant women whose blood contains antibodies to TPO are twice as likely to suffer from this pathology.
As you can see from the chart below, postpartum thyroiditis affects 5 to 10% of women who have recently given birth. Under the influence of antibodies, their thyroid gland begins to collapse, similar to destructive thyrotoxicosis.
The majority of sick representatives of the fairer sex experience recovery, followed by complete restoration of glandula thyroid function. And from 20 to 30% of patients face a complication in the form of hypothyroidism.
Some protocols recommend how to treat antibodies to thyroid peroxidase against the background of an increase in TSH to values exceeding 2.5 mIU/ml. Levothyroxine is recommended as an effective drug. But, more modern scientific developments refute the need to control antibodies to TPO when prescribing levothyroxine replacement therapy during pregnancy.
Ab to TPO and Hashimoto's thyroiditis
Since the test for antibodies to TPO is the most sensitive test for determining the presence of even the initial phases of any autoimmune pathologies, it can also be used to detect Hashimoto’s thyroiditis. This disease is characterized by the destruction of thyroid peroxidase by autoimmune antibodies, which leads to disruption of iodine metabolism and a decrease in the content of this important trace element in thyroglobulin.
Proportion of patients suffering from Hashimoto's autoimmune thyroiditis (AIT). In those with an excess of AT to TPO content, it reaches from 90 to 95%.
Of course, this terrible diagnosis is not made based on a high concentration of antibodies to thyroid peroxidase alone, since this phenomenon is observed even in some completely healthy people. Conversely, in the presence of autoimmune thyroiditis, high levels of antibodies to TPO are not always observed.
For example, in a certain number of patients under twenty years of age, AIT occurs without the appearance of these antibodies.
Important! People whose blood contains an excess of normal levels of antibodies to TPO do not always suffer from Hashimoto's thyroiditis.
Interesting! 5% of clinically healthy men contain antibodies to thyroid peroxidase in their blood. There are even more such people among the fairer sex. A positive result is shown when testing for antibodies to thyroid peroxidase in 10% of women who do not have problems with the thyroid gland and have not reached the age of fifty at the time of the examination.
Normal laboratory values when examining the thyroid gland
In most cases, a single test for antibodies to TPO is not carried out; in combination with it, the following is also examined:
- AT to TG;
- AT to RTTG;
- Free T3;
- Free T4;
- Thyroid-stimulating hormone.
Their normal indicators are shown in the following table:
Attention! Each specific laboratory may use different units of measurement and testing methods for antibodies to thyroid peroxidase, the interpretation of tests, and its digital values may differ.
Example. When using the enzyme immunoassay method, the normal level of antibodies to TPO will be 0–30 IU/ml for people under fifty years of age and 0–50 IU/ml for those who have crossed this barrier.
But laboratories that use the immunochemiluminescent method will get a different result: up to 50 years of age, the norm will be less than 35 IU/ml, and after this age, less than 100 IU/ml.
Preparing for the test
You should prepare for any examinations for hormones, as in the case of AT to TPO, the table below will tell you:
If the subject is taking medications, especially hormonal medications, he should inform the doctor referring him to the laboratory. This is important because such medications can significantly distort the results of the study.
Important! In women using hormonal contraception, the level of antibodies to TPO increases, but this is not a sign of pathology in this case.
How is biological material collected?
For this procedure, special instructions have been developed, in accordance with the requirements of which all manipulations are carried out:
- Laboratory conditions.
- Qualified health worker;
- Sterile disposable instruments;
- Biological material (venous blood) placed in a test tube is immediately sent for research.
Results are usually available the very next day. The price of the procedure differs in different laboratories.
Symptoms indicating a possible excess of AT to TPO
Antibodies to thyroid peroxidase destroy active thyroid cells, which ultimately can cause hypothyroidism, diffuse toxic goiter, or thyroiditis. These serious pathologies have a serious impact on the synthesis of glandula thyroid hormones, thereby disrupting the metabolism, growth and development of the body.
An increase in anti-TPO can be accompanied by both hypothyroidism and thyrotoxicosis. Let's look at the main signs of these syndromes in the table below.
Table: Hypo- and hyperthyroidism in diseases accompanied by elevated levels of anti-TPO:
| Characteristic diseases | Typical symptoms | Laboratory picture | |
| Hypothyroidism syndrome |
|
|
|
| Hyperthyroidism syndrome | Diffuse toxic goiter |
|
|
What should a person do if they have an excess of AT to TPO?
If an excess of antibodies to TPO is detected, you should immediately undergo additional examination for autoimmune thyroiditis, which includes:
- Consultation with an endocrinologist;
- Determination of TSH, free T3 and T4;
- Ultrasound examination of the thyroid gland;
- Repeated consultation with an endocrinologist with the results of all studies.
If no diseases are detected, and the level of antibodies to TPO remains elevated, then you should not pay attention to this, contact an endocrinologist once a year and live a normal life, because if this is a congenital or acquired feature of the body, then it will not affect anything . In addition, at the current level of medicine, drugs have not yet been developed that can reduce the level of these antibodies to normal values.
In any case, you should not draw independent conclusions from the results obtained in the laboratory, since the digital values can vary greatly depending on the institution where they were obtained, the units of measurement used there, and the test systems.
For these reasons, making a diagnosis and further tactics is the exclusive prerogative of the doctor, and self-diagnosis and, especially, self-medication can in the vast majority of cases only bring harm. After all, the doctor takes into account not only the result of the analysis of antibodies to thyroid peroxidase, but also the level of other biologically active substances - thyrotropin, triiodothyronine, thyroxine, AT to TG, AT to RTTG, as well as ultrasound of the thyroid gland.
Combating the root causes of the growth of AT-TPO
The greatest positive effect comes from eliminating the root causes of this unpleasant situation:
- Graves' disease;
- subacute thyroiditis:
- postpartum thyroiditis;
- autoimmune thyroiditis.
The main signs of these pathologies and methods of combating them are given in the following table:
| Name of nosological unit | Symptoms | Principles of treatment | Outcome of the disease |
| Graves' disease | The presence of toxic goiter, tremors of the limbs, increased sweating, hypertension, arrhythmia, weakness | Drugs that block the functioning of glandula thyreoidea (propicil and thiamazole), radiotherapy | Positive, especially if treatment is started in the early stages |
| Autoimmune thyroiditis | Sudden weight gain, decreased performance and ability to concentrate, arrhythmias, tremors, dry skin and hair, accompanied by sweating | Symptomatic therapy, no specific drugs have been developed | Relief of condition |
| Postpartum thyroiditis | Tremor of the limbs, tachycardia, rapid fatigue, irritability | Symptomatic therapy | Relief of condition |
Doctors often resort to hormone replacement therapy, the duration and dosage of which is prescribed after a thorough examination of the patient’s body. Basically, the practice is to prescribe levothyroxine and analogues, including during pregnancy.
When carrying out such treatment, it is necessary to regularly study hormonal levels in order to adjust the dose of synthetic analogues of thyroid hormones. It may be necessary to take these medications for life.
Arrhythmias that develop against the background of excess AT-TPO respond well to treatment with beta-blockers.
Important! The thyrotoxic phase of autoimmune pathology does not require the prescription of thyreostatics, since the excess of thyroid hormones in the blood in this case is not associated with hyperfunction of the glandula thyreoidea.
If, in parallel with autoimmune pathology, a person also has subacute thyroiditis, he may be prescribed glucocorticoid drugs, in particular prednisolone. Also, an increase in AT-TPO titer is the basis for prescribing non-steroidal anti-inflammatory drugs.
If the pathology has gone so far that the growing thyroid gland compresses the surrounding anatomical structures, doctors resort to surgical intervention.
If the AT hormone TPO (which, as we have already figured out, is not a hormone at all, but an antibody) is not very elevated, then doctors often do not prescribe medications, but leave the pathology under observation. Then you can try to correct the situation by changing your menu, giving up bad habits, and reducing excess body weight.
When any infection enters the human body, the immune system begins to actively produce antibodies, which are special protein structures. The function of antibodies is not only to recognize harmful and foreign elements, but also to destroy them. But in some situations, the production of antibodies begins in the body and against its own healthy cells of various systems and organs.
What are TPO antibodies and what do they mean for the body?
Antibodies to TPO (thyroid peroxidase) are special protein elements produced by the immune system.
Antibodies are the basis of the human immune system, therefore, determining the level of concentration of anti-TPO antibodies in the blood makes it possible to determine the presence of aggressiveness (and its degree) of the body’s immunity towards its own cells.
In some situations, a kind of malfunction occurs in the immune system, and it begins to perceive its own cells as foreign, actively producing antibodies to destroy them.
If a blood test reveals an increase in the level of antibodies to TPO, the doctor can conclude that the patient’s body reacts inadequately to its own cells. At the same time, a special pathology in the body necessarily begins to develop, which in most cases quickly leads to malfunctions in the functioning of various systems, as well as some organs. This causes the appearance of many diseases.
Often the cause of an increase in the level of the indicator is some kind of damage to the thyroid gland, which is why large concentrations of thyroid peroxidase constantly penetrate into the bloodstream.
A substance such as thyroid peroxidase is essential in the body. The role of this compound is to stimulate the production of iodine in its active form, which is necessary for the full synthesis of hormones such as T4 and T3.
If the amount of antibodies increases due to increased release of thyroid peroxidase into the blood, then there is a significant decrease in the synthesis of iodine necessary for the thyroid gland, and this leads to a disruption in the production of important hormones.
If the concentration of these hormones becomes insufficient, then disturbances in the functioning of systems such as the respiratory, nervous, cardiovascular and gastrointestinal tract appear in the human body.
Further in the article, you will learn what the normal level of antibodies to TPO should be in the blood of women and men and the reasons for deviations from normal values, and you will also find information on how to properly prepare for a thyroid hormone test.
Normal level of antibodies to thyroid peroxidase
The normal values of these antibodies in the human body are quite stable throughout almost the entire life. Their level does not depend on a person’s gender and depends little on age.
Not many people experience an increase in the AT TPO value during their lifetime; as a rule, their number does not exceed 7%.
The only important point here is that after the patient reaches the age of 50 years, the level of these antibodies may increase slightly, which is considered normal and almost natural.
Table of the norm of antibodies to thyroid peroxidase in women and men:
If in a person in any age group the level of antibodies increases by approximately 20 units/ml, this is not considered a pathology, but is accepted as a kind of variant of the normal TPO AT, therefore no treatment is prescribed in such situations. However, in this case, the patient requires systematic monitoring and supervision by a specialist.
If the increase in the indicator exceeds 25 units, then the person requires the help of doctors and the prescription of special treatment.
In most cases, deviations from normal values are observed in women, so they are recommended to undergo regular tests to check the functioning of the immune system and the body as a whole. An important indicator of antibodies to TPO is during the period of pregnancy.
Exceeding the norm during pregnancy indicates a high risk of miscarriage (miscarriage) or the birth of a baby with any congenital abnormalities. For the normal development of the baby and pregnancy itself, it is very important that the norm of AT TPO in the blood of pregnant women does not exceed 2.6 mmu/ml.
Indications for the purpose of analysis
In most cases, such a study is prescribed if a person has problems with the functioning of the thyroid gland.
For women, such an analysis can be prescribed regularly. in order to check the state of health, because this enzyme is very important for the female body. But when the immune system malfunctions, it is TPO that undergoes the production of antibodies, the purpose of which is to eliminate these elements of the inactive type.
You will be interested in:
For men, analysis is prescribed mainly in the presence of direct indications, in connection with existing violations for the purpose of control.
Regardless of age and gender, the study is prescribed for:
- There are suspicions of autoimmune diseases.
- There are suspicions of hypothyroidism.
- There is a suspicion of thyrotoxicosis.
- An increase in the size of the thyroid gland.
- Carrying a baby. In this case, the woman is prescribed the study repeatedly throughout the entire period.
Preparation and conduct of the study
Following some simple rules allows you to obtain the most accurate result, which is so important for diagnosing the patient’s condition. Since we are not talking about thyroid hormones but about TPO antibodies, it is important to consider a few things. If a person takes hormonal medications, as well as medications containing iodine, then it is important to consult with the treating endocrinologist about the need to temporarily discontinue them or continue taking them.
An important point is to comply with the usual testing requirements:
You should not have breakfast or even drink tea on the day of the procedure., it is better to eat after blood sampling. It is important for smokers to abstain from their addiction at least 1 to 2 hours before the test. You must inform the doctor who ordered the blood test that you are taking any medications so that this information is taken into account when interpreting the results.
Reasons for deviations from the norm
Since the lower limit of the norm for this indicator is zero, and the value cannot fall below, the most common deviation in the level of antibodies to TPO is its increase.
There may be some diseases in the body:
- Hashimoto's disease, which is a chronic form of thyroiditis.
- Graves' disease is a diffuse toxic goiter.
- De Crevin's disease - thyroiditis in subacute form.
- Toxic goiter of nodular nature.
- Idiopathic hypothyroidism.
- Autoimmune thyroiditis.
- Disorders of the thyroid gland in the postpartum period.
- Diseases of non-thyroid type of autoimmune nature.
In some cases, an increase in TPO can also be observed in some other diseases that are not associated with disorders of the thyroid gland. Such ailments include various rheumatic diseases. But the increase in the indicator in these cases usually does not have significant figures.
The appearance of such antibodies, and especially the increase in their concentration, during the period of gestation is very dangerous.
This situation can lead to a woman developing thyroiditis after the birth of her baby. But an important point is that such situations pose a threat to the normal development of the child in the prenatal period, as well as to his life.
Antibodies to TPO are autoantibodies to a specific thyroid enzyme, thyroid peroxidase. Autoimmune thyroiditis was discovered relatively recently. This pathology usually occurs in women. But in recent years, the disease has been increasingly diagnosed in children. In this regard, a blood test for antibodies to TPO has become widespread. In patients with autoimmune thyroiditis, an increase in titer is observed.
Antibodies to TPO: functions
Thyroid peroxidase promotes the formation of the active form of iodine, which, in turn, has the properties of being involved in the iodification of thyroglobulin. Antibodies to TPO are an indicator of immune aggression towards one’s own body. They block enzyme activity, resulting in decreased production of T3 and T4 (thyroid hormones). In this case, thyroid peroxidase antibodies can only be “witnesses” of autoimmune processes. The TPO antibody test is considered the most accurate indicator of the presence of thyroid pathology. As a rule, their appearance indicates the first shift, which is noted against the background of progressive hypothyroidism during Hashimoto's thyroiditis. It is characteristic that thyroid peroxidase antibodies are found in 85% of people with Graves' disease and in 95% of people with Hashimoto's thyroiditis. Detection of antibodies during the prenatal period indicates a high risk of postpartum thyroiditis in the mother. It is also likely to have a negative impact on the child’s development.
In what cases is the analysis performed?
Antibodies to TPO can be detected in newborns, patients with hypothyroidism, and also in the presence of Graves' disease in the mother after childbirth. For adults, the study is recommended for the differential diagnosis of hyper- and hypothyroidism, goiter, and dense swelling of the legs. Indications also include ophthalmopathy - an increase in the periocular tissue (suspicion of the development of euthyroid Graves' disease). Antibodies to TPO, the norm of which in patients under 50 l is 0-35, over 50 l - 0-100 U/ml, can be elevated in healthy people. In such cases, only carriage of AT thyroid peroxidase occurs. However, people do not have a predisposition to developing autoimmune thyroiditis. There are several factors to consider when making a diagnosis. In particular, the patient, in addition to an increased titer, must have specific changes in the thyroid gland, detected by ultrasound. Another mandatory criterion is obvious or subclinical hypothyroidism.
Increased titer of AT thyroid peroxidase
High rates may indicate the development of a number of pathologies. In particular, these include goiter, postpartum thyroid dysfunction, and subacute thyroiditis. An increased amount of antibodies may indicate idiopathic hypothyroidism and non-thyroid autoimmune pathologies. However, if one of the three criteria above is missing, the diagnosis may be erroneous. Before the patient receives a referral for laboratory testing, the specialist determines the indications for the test. If the result is positive, replacement therapy is indicated.
Antibodies to thyroid peroxidase (AT-TPO)- a stumbling block for many patients, therapists, gynecologists, cardiologists, and only we, endocrinologists, understand their essence and significance.
Thyroid peroxidase is an enzyme that catalyzes the oxidation of organiodide (I -) and ensures the binding of iodinated tyrosines.
Simply put, it is a key enzyme in the formation of T4 and T3 in the thyroid gland.
T4 (thyroxine) and T3 (triiodothyronine) are the main hormones produced by the thyroid gland.
Read more about thyroid hormones and why they are needed.
Thyroid peroxidase is located on the surface of the thyrocyte, the main cell of the thyroid gland, which produces T4 and T3.
What do AT-TPO do to the thyroid gland?
Thyroid peroxidase (TPO) is one of the main antigens of the thyroid gland. That is, such a beacon to which the cells of their own immunity react. But as long as it is in a place protected from direct contact with blood (in the thyroid gland), the body does not react to it.
But as a result of various influences leading to disruption of the integrity of the thyroid gland structure, thyroid peroxidase enters the blood. This causes the body to react and the production of autoantibodies begins ( AT-TPO).
Antibodies to TPO are produced by B cells when they misperceive TPO as a foreign protein. As a result, these antibodies begin to attack thyroid cells, destroying them.
If there are a lot of these antibodies, they can lead to massive destruction of the thyroid cells that produce hormones (T3 and T4). As a result, the level of these hormones in the blood will sharply increase. And thyrotoxicosis will develop.
You can read more about thyrotoxicosis in autoimmune thyroiditis.
As soon as the thyroid hormones are “washed out” from the body, their levels will gradually (within 1.5-2 months) decrease. But the cells that can make up for their deficiency are no longer there - they have collapsed and been replaced by connective tissue, or their place has been taken by B-lymphocytes. Therefore, hypothyroidism then develops, that is, reduced thyroid function.
If AT-TPO is moderately elevated, they can gradually destroy thyroid cells over a long period of time. It’s like knocking them out brick by brick from the slender structure of the thyroid gland.
This leads to the fact that after 20-30 years, usually closer to menopause, the number of cells that produce thyroid hormones decreases so much that they become insufficient to fully supply the body. Developing hypothyroidism.
Hypothyroidism is a clinical syndrome caused by an insufficient amount of thyroid hormones in the blood. This condition is characterized by a decrease in all metabolic (metabolic) processes in the body.
The thyroid gland stops producing enough hormones necessary for the normal functioning of the body. Therefore, during the hypothyroidism stage, the body needs help in the form of thyroid hormones supplied externally, in the form of a pill.
What should I do if I have been diagnosed with AT-TPO?
If antibodies to TPO are detected, it is necessary additional examination for exception .
Read about whether to treat AT-TPO with selenium
Usually this is a consultation with an endocrinologist, collection of complaints, medical history, determination of TSH levels, st. T4, ultrasound of the thyroid gland, followed by repeated consultation with an endocrinologist to decide on the tactics of further treatment or observation.
And this is where endocrinologists most often encounter the “Curious Barbara” problem. When, without any indications, “just because it’s interesting,” AT-TPO were determined. The results were slightly inflated and the poor girl, who came with complaints of general weakness (and who doesn’t have it now?) begins to rush through ultrasound, regular blood tests, is forced to sit in long lines to see the endocrinologist, and even several times so that she can hear that everything is fine with her.
And then all her life she will think and worry that her antibodies are elevated. He will take them again and again to check if they have grown. And from year to year she will repeat the circle of hell that is already becoming familiar in the clinic, in order to hear that it is time to get down to business, and not torment endocrinologists in vain with her healthy thyroid gland.
In general, what am I talking about?
And to the fact that you shouldn’t do any procedures without indications. Everything has its time, place, reason and expediency.
Currently we have a fairly wide range of diagnostic tools. If we want to find something, we will find something.
If you have been diagnosed with an elevated level of AT-TPO. Do not panic! And stop monitoring their levels every 3-6 months.
If they are elevated, then they will remain elevated throughout your life.
Fluctuations in the direction of increasing or decreasing the level of these antibodies do not affect the outcome of the disease in any way.
Currently, there are no drugs that would lead to a decrease in the level of AT-TPO to normal values.
This is due to the fact that hypothyroidism as a result of their increase is easily and cheaply corrected. But drugs that interfere with the immune system are usually very expensive and have a number of serious side effects. Accordingly, it is not advisable to use them for this pathology.
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