aTPO, anti-TPO antibodies
aTPO antibodies (anti-TPO, meaning antibodies against thyroid peroxidase — one of the components of thyroid tissue) are used to identify autoimmune inflammation of the thyroid gland, in which the body recognises thyroid cells as diseased cells and tries to fight them by producing aTPO antibodies. Antibodies against the body’s own tissues, or substances that the body comes into contact with (for example, food components and many plant and animal substances, such as your beloved pet’s fur), indicate that the immune system is not functioning properly. This is irreversible, usually genetically determined and very common. Currently, we do not know of any methods to improve our genes and completely eliminate these disorders. Medicine recognises many similar disorders, and more than 200 different tests for various antibodies are in use.
Anti-TPO antibodies are not present in the blood of a healthy person, so their presence always signals thyroid disease. Treating thyroid cells as foreign leads to damage to thyroid tissue, chronic inflammation of the gland and impaired thyroid function (hypothyroidism or hyperthyroidism).
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A blood test for thyroid antibodies is performed when autoimmune thyroid disease is suspected, and in people with other autoimmune diseases, such as systemic lupus erythematosus, rheumatoid arthritis or pernicious anaemia, if they develop symptoms suggesting thyroid disease. It is also worth having an anti-TPO antibody test if your thyroid tests (thyroid-stimulating hormone (TSH), free thyroxine (fT4), free triiodothyronine (fT3)) show abnormal levels. The result report is issued in Polish.
Symptoms associated with hypothyroidism that indicate a need for anti-TPO antibody testing include:
- goitre
- weight gain
- exhaustion
- hair loss
- dry skin
- constipation
- sensitivity to cold.
Hyperthyroidism may be indicated by:
- excessive sweating
- fatigue
- sudden weight loss
- rapid heartbeat
- anxiety
- insomnia
- muscle tremor
- bulging eyes
Anti-TPO thyroid antibodies are also tested when a doctor decides to use treatment with amiodarone, lithium, interferon alpha or interleukin 2, which can cause hypothyroidism.
Anti-TPO reference ranges may differ slightly depending on the laboratory, but the usual value is approximately > 5.61 lU/ml (meaning that any result below 5.61 is normal)
There is no established lower limit of normal because, as mentioned at the beginning, antibodies against thyroid peroxidase should not be present in the bloodstream. You can therefore have an anti-TPO level that is appropriately low, meaning within the normal range (below 5.61), or abnormal, meaning raised.
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A marked increase in the titre of antibodies against thyroid peroxidase (aTPO), also known as thyroperoxidase, is characteristic of Hashimoto’s thyroiditis. Antibody titres this high are sometimes also found in people with Graves’ disease. The aTPO titre does not play a role in treatment or prognosis, so repeating the measurements after thyroiditis has been diagnosed serves no purpose. Measuring antibodies against thyroid peroxidase is relevant only to establishing the diagnosis. A slight increase in titre (up to several hundred) is seen in some other thyroid diseases, but also occurs in healthy people — in older people, the frequency of abnormal aTPO antibody results reaches 10%.
An anti-TPO test result is never sufficient on its own, and the test should be performed alongside other investigations to obtain the full clinical picture (for example, together with tests for TSH, fT4, fT3 and anti-TG levels, or a thyroid ultrasound scan). You will wait only one day for the result of this test, which involves collecting venous blood in the morning.
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* If your results fall outside the reference range, we recommend consulting a doctor.
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