What causes high anti-thyroglobulin and TPO levels?

Question

Hello doctor,

I have been diagnosed to have a higher value of anti-thyroglobulin hormone 121 and anti-thyroid microsomal antibody (TPO) greater than 1000. My TSH, T3, and T4 levels were normal. I have to take my test for thyroid profile again after two weeks.

Since my thyroid is normal, will the antithyroglobulin hormone and TPO also have reached the normal value?
What should I do to get my antithyroglobulin hormone and TPO to normal?
How much will these values affect my fetus if not reduced?
Am I at very high risk?

I am very confused and worried because I am getting this child after longing for ten years. I already had a miscarriage three years ago. I am 35 years old and already have a 9-year-old son.

Please help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern about your thyroid function and its implications during pregnancy.

Thyroid Antibodies (Antithyroglobulin and TPO or thyroid peroxidase): Elevated levels of antithyroglobulin hormone (TG antibodies) and anti-thyroid peroxidase antibodies (TPO antibodies) indicate that your immune system is producing antibodies that attack your thyroid gland. Even though your thyroid hormone levels (TSH (thyroid stimulating hormone), T3 (triiodothyronine), and T4 (thyroxine)) are currently within normal range, the presence of these antibodies suggests that you likely have an autoimmune thyroid disease, most likely Hashimoto's thyroiditis.

Management and Pregnancy: It is positive that your thyroid hormone levels are normal, as this is crucial for the health of both you and your developing baby. However, the presence of thyroid antibodies can increase the risk of complications during pregnancy, such as miscarriage, preterm birth, and maternal thyroid dysfunction.
Reducing Antibody Levels: Unfortunately, there is not a specific treatment to directly lower TG antibodies or TPO antibodies. The focus is on managing thyroid function with thyroid hormone replacement (levothyroxine, which you are currently taking) to keep TSH levels within the normal range. Sometimes, the antibodies may decrease on their own, especially if thyroid function is well-controlled.
Risk to Fetus: Elevated thyroid antibodies, especially TPO antibodies, have been associated with an increased risk of miscarriage and other pregnancy complications. However, the exact degree of risk can vary among individuals. Your treating doctor or obstetrician will monitor your thyroid function closely throughout pregnancy to ensure optimal management.
Optimal Care: It is important to continue working closely with your obstetrician and endocrinologist. They will monitor your thyroid function regularly, adjust medication dosage if necessary, and provide appropriate counseling and support. Your medical team will also consider additional tests or interventions based on your individual health status and pregnancy progress.
Emotional Support: Dealing with thyroid issues and pregnancy complications can be emotionally challenging, especially after a previous miscarriage and a long wait for another pregnancy. It may be helpful to connect with a counselor or support group to address any anxiety or concerns you may have.

Overall, while elevated thyroid antibodies pose some risks during pregnancy, with proper monitoring and management, many women with thyroid autoimmune disorders go on to have successful pregnancies. Stay in close communication with your healthcare team, follow their recommendations, and take good care of yourself.

I hope I have answered your question.

Let me know if I can assist you further.

Regards.