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Thyroid Antibodies & Autoimmune Thyroid Conditions

Published November 07 2010

Updated December 06 2014

If you have been tested for thyroid antibodies and the test came out positive, then this confirms that you have an autoimmune component. This is true even if you aren’t experiencing any symptoms and/or the TSH and thyroid hormone levels are within the normal reference range, as it’s important to understand that with conditions such as Graves’ Disease and Hashimoto’s Thyroiditis, the autoimmune component of the disorder will develop first, and this will eventually lead to malfunctioning of the thyroid gland.

This might seem to be confusing to those people with Graves’ Disease and Hashimoto’s Thyroiditis who consider their condition to be a thyroid disorder. Even though I frequently refer to these as autoimmune thyroid disorders, they are really autoimmune conditions which lead to thyroid malfunction. In other words, the thyroid gland is usually not the actual cause of the disorder in an autoimmune thyroid condition. This is why it is not uncommon to see positive thyroid antibodies even though the TSH and thyroid hormone levels are within the normal lab reference range.

How does this process develop? What usually happens is that due to numerous factors, something will trigger an autoimmune response, and this in turn will cause the formation of thyroid antibodies. People with Hashimoto’s Thyroiditis will have elevated thyroid peroxidase (TPO) antibodies and/or elevated thyroglobulin antibodies. People with Graves’ Disease will have positive TSH receptor antibodies (i.e. TSI antibodies) which stimulate the thyroid gland to produce an excessive amount of thyroid hormone. Why this happens isn’t fully known, although there are numerous factors which can trigger an autoimmune response (food allergens, chronic stress, a leaky gut, certain environmental toxins, etc.) In any case, when the thyroid antibodies damage the thyroid gland or stimulate the TSH receptors, then this is what eventually leads to low or high thyroid hormone levels, and thus is the reason for the positive thyroid blood tests.

What Determines Which Autoimmune Thyroid Condition One Will Develop?

Why do some people develop Graves’ Disease, while others develop Hashimoto’s Thyroiditis? It involves a combination of genetics and lifestyle factors. If someone has a genetic marker for Hashimoto’s Thyroiditis, then they will develop TPO and/or thyroglobulin antibodies, which in turn attack the thyroid gland and over time will most likely will lead to a hypothyroid condition. If someone has a genetic marker for Graves’ Disease, then they will develop TSH receptor antibodies that will stimulate thyroid hormone production, thus resulting in a hyperthyroid condition. Some people will have both types of antibodies, and therefore can experience a combination of hypothyroid and hyperthyroid symptoms.

However, just because someone has a genetic marker for Graves’ Disease or Hashimoto’s Thyroiditis doesn’t mean they will develop either of these conditions. While genetics usually plays a role, lifestyle and environmental factors are what usually trigger the genetics. So most people don’t develop an autoimmune thyroid condition simply because they have a genetic predisposition. In most cases certain external factors will trigger an autoimmune response.

What’s important to understand is that in order to restore the health of someone who has an autoimmune thyroid condition, one needs to address the actual cause of the disorder. This is where conventional medicine fails, as most conventional medical treatments are aimed at managing the thyroid symptoms. For example, someone with Hashimoto’s Thyroiditis will almost always be told to take synthetic or natural thyroid hormone for the rest of their life, but nothing will be done to correct the autoimmune component of the condition. So the person will take thyroid hormone medication daily to help with the symptoms while their thyroid gland continues to be damaged by the thyroid antibodies.

It’s a similar situation with Graves’ Disease, as when I was initially diagnosed with this condition by an endocrinologist, she recommended antithyroid drugs (Methimazole), along with a beta blocker (Propranolol) to manage my symptoms. And while she didn’t talk much about radioactive iodine treatment, there is almost no doubt that if I took the antithyroid drugs and my condition didn’t go into remission, this harsh treatment method would have been brought up as the “solution”. But nothing was ever mentioned by her as to how my immune system should be addressed and what should be done to try to suppress the autoimmune response or remove the autoimmune triggers. And this is how most endocrinologists and other types of medical doctors think. Most doctors don’t try to do anything to cure the condition, but are trained to simply manage the symptoms.

Tests For Thyroid Antibodies Won’t Always Be Positive

It’s also important to know that someone with an autoimmune thyroid condition won’t always have a positive test for thyroid antibodies. As a result, just because your thyroid antibodies test comes out negative doesn’t mean you don’t have an autoimmune condition. This is why it’s important to also consider the patient’s symptoms, other thyroid blood tests (although once again these might be negative as well), along with other factors. In addition, if someone tests negative for thyroid antibodies then it’s probably a good idea to get retested once or twice in the future before ruling out an autoimmune condition.

Because of what I just mentioned, if someone with Graves’ Disease or Hashimoto’s Thyroiditis follows a natural treatment protocol, how do they know if their health has been restored? In other words, if they initially had positive thyroid antibodies, but after a few months of following a natural treatment protocol they have a negative test, how can one be sure if the autoimmune response has been suppressed? The answer is that you can’t confirm whether someone’s health has been restored just by this test alone. You need to look at many different factors, including their thyroid blood test results, other tests which might have initially been recommended (saliva testing, test for a leaky gut, etc.), and of course their symptoms. This doesn’t mean you don’t want the thyroid antibodies to eventually be negative, but even if they are negative you can’t rely on this alone to determine whether the person’s health has been restored back to normal.

And let’s face it, there’s a fine line between the words “cure” and “remission”. What I mean by this is that while I use the word cure at times, the truth is that someone who has an autoimmune thyroid condition most likely has a genetic predisposition. As a result, once someone has restored their health through natural treatment methods they need to maintain their health or else risk a relapse. How does this differ from someone who has cancer, receives chemotherapy, and is then said to be in remission?

Well, it’s similar, but in the case of most cancer patients, they receive a harsh, passive treatment in chemotherapy that doesn’t actually address the cause of the cancer. So many people develop cancer again because they never did anything to address the cause of the cancer, and of course after someone receives chemotherapy they usually don’t do anything to prevent a relapse from occurring. On the other hand, someone with an autoimmune thyroid condition who has their health restored back to normal through natural treatment methods can maintain their health by following the steps which restored their health in the first place (eating well, managing their stress, etc.).

In summary, the presence of thyroid antibodies usually confirms the presence of an autoimmune thyroid condition. This is true even if the TSH and thyroid hormone levels are normal. And following a natural treatment protocol involves getting rid of the immune system trigger, as well as suppressing or eliminating the autoimmune component. However, one can’t rely on the presence or absence of thyroid antibodies alone when determining if someone has restored their health back to normal, as one also needs to consider other tests, the person’s symptoms, and other factors as well before coming to such a conclusion.