Thyroid Autoimmunity – What Are Healthy Levels for Thyroid Antibodies

Thyroid Autoimmunity – What Are Healthy Levels for Thyroid Antibodies

Thyroid autoimmunity (also known as Hashimoto’s) is the most common cause of hypothyroidism.  It is a process wherein your immune system makes antibodies against your thyroid gland, and this then causes damage to the thyroid.  Lab tests are available to gauge the severity of this autoimmune process, but doctors and patients are often unsure what “healthy” values on these tests are.  Let’s answer this question.

Dr. Michael Ruscio: Hi, this is Dr. Ruscio, and let’s talk about thyroid autoimmunity and what levels of thyroid antibodies is considered healthy. Now, in case you’re not privy to this already, thyroid autoimmunity is the most common cause of hypothyroidism in most Westernized countries. And it’s typically manifested as a process known as Hashimoto’s. And this is certainly something that we want to be cognizant of because the level of thyroid autoimmunity has been shown to correlate with, of course, hypothyroidism and also with thyroid cancer. So if one does or doesn’t have thyroid autoimmunity present, it’s important for us to know. Yes.

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And there are some well-established treatments for this that we’ve talked about in different videos and posts. Diet is one, a gluten-free diet, and in a written study, a lower-carbohydrate diet, have both been able to show the ability, or shown the ability, to be able to quite dramatically dampen thyroid autoimmunity.

Nutritional Supplements

There’s also different nutritional supplements that can be used. Most notably, there’s a protocol using selenium, CoQ10. And magnesium has shown benefit. And vitamin D has also shown benefit in clinical trials as being able to lower thyroid autoimmunity. Additionally, there is one noteworthy study in the treatment of H. pylori, a stomach bacteria, and the ability of successful treatment of H. pylori to be able to lower thyroid antibodies in those with thyroid autoimmunity.

And one case study, after the treatment of blastocystis hominis, a gut bug-like protozoa, that can also help with thyroid autoimmunity. So there’s definitely some treatments that can help with lowering thyroid autoimmunity. And reason would suggest, since elevations correlate with negative outcomes like hypothyroidism and thyroid cancer, reason would suggest that lowering thyroid antibodies would be a good idea, certainly, not a hard argument to make.

But the one important thing that often gets maybe left out of this conversation or is overlooked or there’s conversation regarding is: ‘When have you succeeded in trying to lower your thyroid antibodies?’ This is a key question. And what I have observed is oftentimes patients are quite distraught if they can’t get their thyroid antibodies down to the normal range. Now, normal is usually defined as at or below 30 or 35 for the most clinically-relevant antibody known as TPO or thyroid peroxidase. So a lab test that can be done in any doctor’s office or any major lab, what have you.

Healthy Levels of Antibodies

Now, I’ve been saying for the past few years that in my observation, 100 to 300 on the TPO antibodies is what I would call a clinical win. Recently, there was a study published that did a fantastic job of trying to quantify when or what. What is a healthy level of antibodies and when can we maybe stop trying to treat the antibodies, so to speak?

And they found that 500 for TPO antibodies was a cut off. Meaning, those who were below 500 had an incredibly low risk of future progression to hypothyroidism. And a subgroup of these patients was followed for a little over six years so it was a decent follow-up window. And—but even the people who were above 500 still only had a moderate risk. So it’s important to understand that 500 showed a pretty favorable outcome in these patients. And that if you’re a patient or if you’re a doctor working with your patients, and if someone has come from, let’s say, 700, 800, 1,200, 1,400 for their TPO antibodies, and now they’re hovering somewhere around one, two, three, four hundred, then that is starting to look like a clinical win.

Albeit, this is one study. And we don’t want to make too many conclusions based upon one study. But it certainly reinforces what I have seen in the clinic is that way above 500 tends to be a warning flag that you need to act. Below 500 is a sign that you don’t need to keep taking vitamins or doing crazy things with your diet. You can relax a little bit and not be so concerned about the autoimmune condition because it seems that the autoimmune process is in a pretty good place. Don’t aim for perfect underneath 30 to 35, aim for what seems to be a reasonable endpoint or a reasonable level, which is below 500. If you really wanted to be meticulous, maybe below 300, according to my speculative general range.

“If you’re below 500, then you’re in pretty good condition. And you don’t have to worry about being at heightened risk for major problems with your thyroid gland.”

But the main point of this whole issue is not to be feeling like you chronically have to be pursuing a lower and lower and lower level of thyroid antibodies thinking that it’s going to have a health benefit. Because what it looks like is that if you’re frankly elevated, it’s a problem—above 500, a problem. If you’re below 500, then you’re in pretty good condition. And you don’t have to worry about being at heightened risk for major problems with your thyroid gland. In fact, you don’t even show—there’s a minimal chance that you’ll even progress to hypothyroidism.

So hopefully this helps people out there who have thankfully become cognizant of the fact that thyroid autoimmunity is something that needs to be incorporated into a thyroid healthcare plan, but also helps them realize when they cannot have to worry about continuing treatment and trying to drive the antibodies down lower. A win could be considered anything below 500. If you’re significantly above 500, you probably want to take action. If you’ve been hovering around lower than 500 for a while, then you’re probably in pretty good shape.

So this is Dr. Ruscio, and I hope this information helps you get healthy and get back to your life. Thanks.

What do you think? I would like to hear your thoughts or experience with this.

Dr. Ruscio is your leading functional and integrative doctor specializing in gut related disorders such as SIBO, leaky gut, Celiac, IBS and in thyroid disorders such as hypothyroid and hyperthyroid. For more information on how to become a patient, please contact our office. Serving the San Francisco bay area and distance patients via phone and Skype.


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