Why High Antibodies but Normal Hormones?

Your thyroid is still doing its job – making enough hormones – even though your immune system is poking at it (the antibodies show that low-grade attack is happening).

Think of it like this:

• Antibodies are like warning lights on your car dashboard. They say "hey, something's off – the immune system is mistakenly targeting the thyroid."

• But the engine (thyroid) is still running fine for now. It's compensating by working harder to keep hormone levels normal.

• This early phase can last months or years. The attack is slow – inflammation builds quietly, but not enough yet to tank hormones.

It's common! Up to 10–20% of people (mostly women) have positive TPO antibodies without hypothyroidism. Risk goes up with age, family history, stress, or other autoimmunity.

In functional medicine, we see this as a sign to act early – the attack is on, and progression to full hypothyroidism happens in many (about 2–5% per year convert).

Why Prescribe Thyroid Meds If Hormones Are Normal?

This is controversial – not all doctors do it!

• Conventional view: Most wait until TSH rises (subclinical hypo) or full hypothyroidism hits. Guidelines (like American Thyroid Association) say no meds if truly euthyroid and no symptoms/goiter.

• When some prescribe anyway:

  • If symptoms are strong (fatigue, brain fog, coldness) despite "normal" labs – meds can ease them by giving the thyroid a rest.

  • To prevent progression – low-dose levothyroxine might reduce antibodies or protect remaining thyroid tissue (some small studies suggest this).

  • Risk factors: Pregnancy planning (antibodies raise miscarriage risk), big goiter, or very high antibodies.

But many experts (especially functional) say: Hold off on meds if hormones truly normal. Focus on lowering antibodies naturally first – diet (gluten/dairy-free), selenium, gut healing, stress relief. This can slow or stop the attack without meds.

If antibodies are mild (like 19–100 range), and no symptoms? Often just monitor labs every 6–12 months.

You're catching it early – that's awesome! Lifestyle changes now can make a huge difference in keeping hormones stable longer.