One of the most common questions I get is, “What are optimal Hashimoto’s thyroiditis antibody levels?” For years, many patients and clinicians have been chasing thyroid peroxidase (TPO) and anti-thyroglobulin (TG) antibody levels in an attempt to get them as low as possible or even undectable as a measure of success. This can leave many people frustrated and stressed about their condition. Some individuals feel that these levels should become undetectable in order to consider the condition in complete remission. But is this entirely true or necessary? A recent study out of Germany has helped us get a clearer picture of how we should be looking at thyroid antibody levels. The study is entitled, “Anti-thyroperoxidase antibody levels >500 IU/ml indicate a moderately increased risk of developing hypothyroidism in autoimmune thyroiditis” published in the journal Hormone Metabolism Research. The authors were specifically looking at thyroid peroxidase and anti-thyroglobulin antibody levels and if they are associated with developing hypothyroidism. Here is a breakdown of what the authors found: Patients with TPO antibody levels >500 did show an increased risk of developing hypothyroidism. Patients with TPO antibody levels 4.6. There are some clinicians who believe that the range for TSH is far to broad and that TSH should be within a tighter window such as 1.5, 2.0, or 2.5 as the upper cut-off point. There is little evidence to support this claim for every single human being who has Hashimoto’s or hypothyroidism. Sure, some people just feel better with a TSH that is in these lower ranges but some people also feel great with higher TSH levels. As with everything in functional medicine, this is an individualized question which shouldn’t be set in stone. Additionally, as pointed out above, the patients who did have TSH levels above 4.6 after the 6 year follow-up had normal thyroid function despite the higher TSH levels. Once we’ve dealt with the most significant causes of Hashimoto’s thyroiditis including gut health, infections such as Epstein-Barr Virus, food sensitivities like gluten, vitamin D deficiency, selenium deficiency, stress, and childhood adversity, you can be confident that your immune system will continue to heal and stay in balance. We already have enough stress in our modern day lives so this is one less thing to be worried about. If your thyroid antibody numbers are below 500 then you’ve probably done a great job with your healing plan and you can let go of focusing on your Hashimoto’s thyroiditis antibody levels. This includes discontinuing supplements that target autoimmunity and bringing back some variety into your diet.
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