Press: Have you ever had thyroid function tests done, or have you ever been baffled by an abnormal thyroid function test, especially for thyroid peroxidase antibody (TPO-Ab)? This article is an attempt to help you understand TPO-Ab and the associated Hashimoto’s disease, so that those who are concerned about this issue can have a preliminary understanding and appreciation.
Thyroid peroxidase (TPO)
It can be understood as an enzyme with some biological activity in the body (not difficult to understand, it is good for the body), and this enzyme is usually found in the thyroid gland (where is the thyroid gland?). Under the laryngeal node, next to the trachea, in the shape of a butterfly), and its role is to help synthesize and secrete thyroid hormones (what is thyroxine? It is an endocrine hormone that people need throughout their lives, no matter how much or how little), which is involved in the body’s daily energy metabolism and maintains normal physiological functions.
Thyroid peroxidase antibody (TPO-Ab)
What are antibodies? What is “anti”? As the name suggests, it means to fight, to resist, to attack, to be the opposite. Next, it is easy to understand what thyroid peroxidase antibody (TPO-Ab) is, which is a substance that fights or may destroy TPO. This substance can also be found in normal healthy physical examination laboratory tests, but its quantity is limited. In most cases it is not aggressive and can manage to live in peace and harmony with other tissues and organs in the organism (including TPO).
Hashimoto’s disease
When high levels of TPO-Ab are present in the blood, it often indicates the possible presence of some kind of thyroid disease, the most common being Hashimoto’s disease (named after a Japanese doctor named Hashimoto who first discovered the disease), followed by Graves’ disease, both of which are autoimmune diseases. Because of certain triggers, such as family genetic susceptibility, viral infections, and colds, pregnancy, and childbirth, the body’s autoimmune balance is disturbed and dysfunctional, and antibodies are produced and mistakenly attack normal tissues, with no distinction between friend and foe.
If this antibody attacks the thyroid tissue and cells, it causes thyroiditis and leads to impaired thyroid function. As a result of the innocent attack by antibodies, the body instinctively mobilizes its own immune defenders – lymphocytes to go to the thyroid tissue to accumulate and resist the invasion and destruction of TPO antibodies, at this time, if you observe under the microscope At this time, if the thyroid cells are observed under a microscope, many lymphocytes will be found gathered around the damaged thyroid tissue. Therefore, Hashimoto’s disease is also known as chronic lymphocytic thyroiditis.
In general, TPO-Ab is not yet used as a routine test in clinical practice. Unless you are suspected or have been diagnosed with thyroid disease, your doctor may recommend a TPO-Ab test to help you find a possible cause for the onset of the disease.
In addition, for women of childbearing age, your doctor may recommend a TPO-Ab test if you are planning to become pregnant. This is because, according to available research data, some women with high TPO-Ab are at risk for fetal abortion, miscarriage or preterm delivery after pregnancy, although the chances of their occurrence are small. In addition, your doctor may recommend a TPO-Ab test in the second trimester of pregnancy, near the time of delivery, to help predict whether your child is at risk for hypothyroidism after birth.
In this sense, having Hashimoto’s disease (with or without hypothyroidism) does not affect women in their childbearing years who are expecting a baby. The only thing is that (unlike other women of childbearing age) you need to have your nail function checked regularly under the guidance of your doctor and to take the necessary preventive and curative measures at the right time according to the situation. Therefore, you can go about your life and work without any worries.
It is reassuring to know that an elevated TPO-Ab does not necessarily lead to thyroid disease (including Hashimoto’s disease). However, it is important to understand that the presence of TPO-Ab may increase the risk of developing thyroid disease in the future. Therefore, if you have had abnormal TPO-Ab but normal thyroid function, your doctor may recommend regular medical checkups to monitor for future thyroid problems.
Treatment of Hashimoto’s disease
You can live, study and work like a normal person without medication and enjoy a good life without having to worry about whether your antibodies are high or low.
2. If you have hyperthyroidism, you can use antithyroid drugs (methimazole or propylthioxypyrimethamine) at the same time, and give small doses of levothyroxine sodium tablets (euthyroxine) as needed for treatment.
3.If the thyroid gland is enlarged and obvious and accompanied by pressure symptoms, consider the short-term application of small doses of hormone therapy, if necessary, surgery can be used.
4. If the thyroid gland is accompanied by nodules, it is best to review the ultrasound every 3-6 months to observe the changes.
5.If the disease has progressed and hypothyroidism appears (generally TSH>10 is the threshold value for intervention, but it is not absolute, sometimes intervention starts when TSH>8, which needs to be decided with the specific object), it is necessary to start full dose replacement therapy with levothyroxine sodium tablets. The starting dose of this drug should be small and should not be given in one step, especially in older people. The dose of the drug is not constant, but needs to be adjusted dynamically, based on the results of the thyroid function tests. For post-surgical hypothyroidism, some people may need to take Eugenol for life.
6. So far, there is no medication that specifically targets TPO-Ab. To put it in another way, TPO-Ab is not yet the main indicator used by doctors to observe and evaluate the efficacy in clinical practice.
7, according to the literature, selenium yeast tablets (the drug can be bought) has the effect of regulating immune function, and can be used clinically at the discretion of the condition.
8, Chinese medicine focuses on overall regulation and has certain advantages for Hashimoto’s disease, especially in the unformed period of hypothyroidism, it can adjust the balance of the body’s immune function, and some people can reduce the antibody level after using Chinese medicine, but the individual difference of the efficacy is large. For those who have formed hypothyroidism, Chinese medicine can improve clinical discomfort while adjusting immune function, especially for those who still have many discomfort symptoms after normalizing their A function, Chinese medicine has obvious advantages. However, traditional Chinese medicine cannot replace or substitute the use of Eugenol.
9. Some studies suggest that emotional factors, especially negative emotions, such as anxiety, tension, depression, impatience and irritability, are related to the occurrence of this disease, which is related to the theory of “seven emotions cause disease” in Chinese medicine (what are the “seven emotions”?). This coincides with the theory of “seven emotions cause disease” (what are the “seven emotions”?), which are happiness, anger, worry, thought, sadness, fear and fear. Therefore, learning to relieve work or life stress, soothe emotions and maintain an optimistic and cheerful state of mind in daily life plays an important role in preventing the occurrence of this disease and helping recovery.