Six Surprising Facts About High Thyroid Antibodies

Conventional medicine commonly ignores thyroid antibodies and most doctors don’t check for them routinely even if a thyroid disease is suspected.  However, high thyroid antibodies are a valuable indicator for autoimmune thyroid conditions and help to make a proper diagnosis of both Hashimoto’s and Grave’s disease.

The main reason why the test for thyroid antibodies is not ordered as often as it should be lies in the treatment approach to hypothyroidism.  According to conventional medicine, euthyroid Hashimoto’s patients (those who have normal thyroid function) do not require any treatment and most practitioners take a “wait and watch” approach.

Only when Hashimoto’s disease progresses to hypothyroidism, thyroid hormone replacement therapy is prescribed. The main goal of treatment is to compensate for missing thyroid hormones and manage hypothyroid symptoms.

Most doctors do not research why the person became hypothyroid and don’t test for thyroid antibodies because the conventional treatment approach to hypothyroidism remains the same regardless of its cause.

Who has elevated thyroid antibodies?

While high thyroid antibodies are one of the diagnostic criteria for Hashimoto’s disease surprisingly there are other health conditions associated with their presence. It means that there is a risk that eventually the person may develop Hashimoto’s and/or hypothyroidism later on.

1. Thyroid antibodies levels were found to be mild to moderately elevated in associated diseases such as systemic lupus erythematosus (SLE), thyroid cancer, thyrotoxicosis, rheumatoid arthritis, fibromyalgia, pernicious anemia, autoimmune collagen vascular disease and type 1 diabetes.

2. According to different studies, high thyroid antibodies were reported in a range of 12–29% in patients with chronic hives (urticaria). There is an increased prevalence of thyroid autoimmune disease such as positivity of thyroid antibodies, Hashimoto’s disease with or without hypothyroidism in people with chronic urticaria. However, there are no cases of Graves disease described among patients with chronic hives.

Test for thyroid antibodies and thyroid function are especially recommended for those patients who experience chronic hives that cannot be attributed to an allergen or any other obvious cause.These tests can rule out involvement of thyroid autoimmunity or help to confirm it as being the cause of this condition.

3. Patients with TPO thyroid antibodies >120 can experience high symptoms load and diminished quality of life despite euthyroid state. Chronic fatigue, chronic irritability, dry hair, chronic nervousness and a history of breast cancer can all be linked to elevated TPO thyroid antibodies levels.

4. High normal or low positive thyroid antibodies can also be present in pregnant women and in healthy people. A growing number of research studies reports that thyroid autoimmunity predisposes to infertility and pregnancy complications that include miscarriage or preterm delivery. Most important is the fact that these adverse effects are persistent in asymptomatic women with normal thyroid function but high thyroid antibodies levels.

Part of the problem is that women who attempt to conceive or are pregnant are not routinely screened for thyroid disease and thyroid antibodies if they do not show any symptoms of hypothyroidism and diagnosis of Hashimoto’s disease can remain overlooked.

One study estimated that up to 12.5% of women can have elevated TPO thyroid antibodies during the first two trimesters of pregnancy and it can negatively affect development of the fetus and child.

5. Most common dysfunctions in children that are linked to elevated thyroid antibodies:

  • Elevated TPO thyroid antibodies in pregnant mothers impact children’s risk of problem behavior, in particular attention deficit and hyperactivity disorders. The observed effect can be only partially explained by maternal TSH levels.
  • Exposure to maternal TPO thyroid antibodies during the third trimester of pregnancy is associated with impaired auditory and hearing development in the child and can also result in hearing loss.
  • Cognitive and motor deficits have been observed in children whose mothers had elevated TPO thyroid antibodies levels in the first half of pregnancy.
  • Elevated TPO thyroid antibodies can affect the development of the fetal brain and nerve tissue and result in delayed learning abilities and lowered childhood IQ.

In the majority of cases the risk of poor pregnancy outcome is directly correlated with autoimmune activity and severity of the disease. While high thyroid antibodies have been implicated in unsuccessful pregnancies, there is an increasing evidence that improved fertility and good pregnancy outcome can be reached if Hashimoto’s disease and levels of thyroid antibodies can be well controlled prior to pregnancy. This can be achieved with a proper diagnostic and guided nutritional support.

6. Postpartum thyroid dysfunction of autoimmune origin is characterized by elevated thyroid antibodies levels and occurs in the first 6 to 12 months after delivery. The TPO thyroid antibodies were found to be a better marker than Tg thyroid antibodies in predicting of postpartum thyroiditis and indicate a high risk for autoimmune thyroid disease.  While 90% of women with postpartum thyroiditis fully recover within 2 years, between 30 to 50 percent develop permanent hypothyroidism within nine years.

Do high thyroid antibodies require treatment?

While up to 95% of hypothyroidism in industrialized countries occurs due to autoimmune Hashimoto’s disease, tests for thyroid antibodies combined with ultrasound imaging can give a definite diagnosis of this autoimmune condition even before onset of hypothyroidism.

High thyroid antibodies are a definitive marker for chronic thyroiditis (inflammation of the thyroid gland) even in asymptomatic individuals and represent a risk factor for development of Hashimoto’s with or without hypothyroidism and are indeed a marker of future thyroid failure.

One recent study found that

Increased odds for autoimmune thyroid disease are associated with positivity to TPO or Tb thyroid antibodies during the 2–7 years preceding diagnosis.

This fact makes early diagnosis of Hashimoto’s disease very important because it can change the course of the disease.

Some research studies showed that prescribing a low dose of thyroid medication can delay or even stop the progression of Hashimoto’s to hypothyroidism, reduce the inflammation of the thyroid gland and lower levels of thyroid antibodies.

Besides a trial of thyroid medication, conventional medicine does not offer any specific treatment for high thyroid antibodies in people with normal thyroid function and does not consider that a treatment is necessary. Thyroid antibodies remain ignored in the majority of cases and are not used for monitoring of the treatment progress and evaluation of the severity of the autoimmune process.

A person with TPO thyroid antibodies over 1000 has a more severe and active autoimmune overreaction than somebody with thyroid antibodies levels around 150. It is a proven fact that high levels of both TPO and Tg thyroid antibodies correlate with the severity of hypothyroidism.

Taking into consideration that high levels of thyroid antibodies are:

  • a definitive risk factor for development of autoimmune thyroid disease
  • can pose risk to fertility, pregnancy outcome and health of the unborn child
  • linked to many other conditions and symptoms that can affect quality of life

Lowering thyroid antibodies should be a part of the treatment.

How to lower thyroid antibodies

However, using thyroid medication has its limitations and practice shows that most patients get their antibodies lowered only partially. There is a holistic nutritional approach to Hashimoto’s disease that has demonstrated great results in lowering thyroid antibodies because it looks for factors that cause them initially.

Hashimoto’s disease occurs as a result of complex interactions between genetic and environmental factors. According to the recent research conducted and published by Prof. Fasano, there is a new factor that plays the key role in the initiation of the autoimmunity.

Increased intestinal permeability or leaky gut syndrome is a condition when intestinal gut walls lose their protective effect and let through the antigens that cause the overreaction of the immune system. Leaky gut is a reversible condition and is one of the factors that should be addressed first.

There are many scientific publications that support this treatment approach and the idea that

Hypothyroidism caused by Hashimoto’s disease is reversible in some cases

Since most environmental triggers of autoimmune overreaction are dietary, identifying and removing these factors should be the next step. This strategy has not only has promising results in dampening the autoimmune reaction but also in lowering thyroid antibodies levels.

Iodine restriction in the diet could be a predictable factor for restoring the thyroid function in Hashimoto’s patients with hypothyroidism. According to different studies, between 50 and 80% of patients with hypothyroidism caused by Hashimoto’s disease were able to regain their full thyroid function gradually following only dietary iodine restriction and without using a thyroid hormone replacement therapy.

Mercury exposure has been associated with thyroid autoimmunity and has been shown to accumulate in the thyroid gland. Removing of mercury-containing dental amalgams and avoiding mercury contaminated foods were proven to result in significantly decreased levels of both TPO and Tg thyroid antibodies in patients with mercury hypersensitivity. This fact suggests a positive association between mercury and thyroid antibodies levels and can contribute to successful treatment of Hashimoto’s disease.

Gluten is another common trigger of thyroid autoimmunity. In people with celiac disease and gluten sensitivity target organs are not limited to the gut lining but can also include the thyroid gland, liver, skin, reproductive and nervous systems.

The reason for this wide spectrum of organs involved is the molecular structure of gliadin which is a protein contained in gluten. For example, gliadin has structure that is close to proteins found in the thyroid gland and also can cross react with thyroid antigens making the thyroid as a target for an autoimmune attack when gluten containing foods are consumed.  

This property of gluten puts people with celiac disease and gluten sensitivity under the risk to develop autoimmune thyroid conditions such as Hashimoto’s and Grave’s disease. The longer people who have celiac disease and gluten sensitivity remain untreated the higher the chance that they will develop high thyroid antibodies levels and autoimmune thyroid disease.

Hence early detection of celiac disease and doing gluten-free diet the correct way may reduce the risk of developing thyroid disorders and reverse Hashimoto’s in cases where gluten was found to be a trigger.

There are many other dietary factors that can trigger Hashimoto’s disease. But we are all different and what works for some people may not work for you and vice versa.

The key to successful treatment and reducing thyroid antibodies levels is to identify factors that triggered Hashimoto’s in YOUR individual case and remove them.

The discovery process is not an easy one and you will certainly need the help of a health practitioner who specializes in thyroid disorders and is familiar with the challenges you are experiencing.

P.S.

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References:

1. Idiopathic chronic urticaria and thyroid autoimmunity: Experience of a single center. Dermatoendocrinol. 2011 Oct;3(4):255-8. Epub  2011 Oct 1.

2. Fetal outcome in autoimmune diseases. Autoimmun Rev. 2012 May;11(6-7):A520-30. Epub  2011 Dec 11.

3. Postpartum thyroid dysfunction: a state of immunological dysregulation. Clin Lab. 2011;57(9-10):731-9.

4. Maternal thyroid autoimmunity during pregnancy and the risk of attention deficit/hyperactivity problems in children: the Generation R Study. Thyroid. 2012 Feb;22(2):178-86. Epub  2011 Dec 16.

5. The effect of iodine restriction on thyroid function in patients with hypothyroidism due to Hashimoto’s thyroiditis. Yonsei Med J. 2003 Apr 30;44(2):227-35.

6.  Hashimoto thyroiditis is more frequent than expected when diagnosed by cytology which uncovers a pre-clinical state. Thyroid Res. 2010 Dec 20;3(1):11.

7.  Prevalence and early diagnosis of coeliac disease in autoimmune thyroid disorders.   Ital J Gastroenterol Hepatol. 1999 May;31(4):283-7.

8.  Risk factors for and prevalence of thyroid disorders in a cross-sectional study among healthy female relatives of patients with autoimmune thyroid disease. Clin Endocrinol (Oxf). 2003 Sep;59(3):396-401.

9. Mercury and thyroid autoantibodies in U.S. women, NHANES 2007-2008. Environ Int. 2012 Apr;40:39-43. Epub  2011 Dec 27.

10. Removal of dental amalgam decreases anti-TPO and anti-Tg autoantibodies in patients with autoimmune thyroiditis. Neuro Endocrinol Lett. 2006 Dec;27 Suppl 1:25-30.

11. Maternal thyroid autoantibodies during the third trimester and hearing deficits in children: an epidemiologic assessment. Am J Epidemiol. 2008 Mar 15;167(6):701-10. Epub  2007 Dec 21.

12. Hashimoto’s thyroiditis affects symptom load and quality of life unrelated to hypothyroidism: a prospective case-control study in women undergoing thyroidectomy for benign goiter. Thyroid. 2011 Feb;21(2):161-7. Epub  2010 Dec 27.

 

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