What do high TPO and TgAb antibodies mean when T3 and T4 are in range? Episode 47.

I was diagnosed with Hashimoto's Thyroiditis 2 years ago and I'm 26 years old, but I don't know how long I had it before it was detected. I found out by accident. I went in because I thought I had kidney problems, but the blood work came back it showed I had hypothyroidism. The TSH came back in the 400 range, but my T3 and T4 were in range. A dietitian came and told me that my condition could be "cured" through the AIP diet, so I gave it a shot. And then I gave up. I travel a lot and just moved to Japan (the move has been stressful and my hair has started falling out quite a lot). I also just discovered your podcast and it's blown my mind. I feel more motivated to try again, but it's difficult to communicate with Japanese doctors. I just got my most recent blood work back and my TSH is 9.413 (so the Dr increased my meds), the T3/T4 is still in range, but my TPO and Tg are super high. TPO is 198 and Tg is 954. My bf is super supportive and wants me to get into remission and I want to get off of the medication, but I'm not really sure how to start, especially since I'm a foodie and I'm in Japan with wonderful food available. I feel hopeful and discouraged all at the same time.


TSH high

T3 in range

T4 in range

TPO and TgAb high

Thyroglobulin antibodies- TgAb: thyroglobulin is made in the thyroid and helps make thyroid hormone- a common trigger for Hashimoto’s. 

Thyroid peroxidase antibodies- TPO. This is an enzyme that is needed for the production of thyroid hormones and is often the first thing attacked in hashi’s. 

I found a paper (Woeber 2016) that said high thyroglobulin antibodies are used to diagnose cancer. These antibodies are found in blood tests in about 20% of patients with thyroid cancer that develops in the thyroid follicular cells.  Follicular cells use iodine in the blood to make thyroid hormones. 

Most thyroid cancer is what is called papillary cancer which grows slowly and develops in the lobe or one side of the thyroid.  Often the cells look normal.  

I might check with a doctor over there if possible to see if they can do some further testing just to be safe. 

A study in 2017  (Matana et al 2017)discussed diet and how it contributes to antibodies. They acknowledge that genetics play a pretty big role in thyroid autoimmune disease but environment also plays a role. 

What contributes to Hashimoto’s disease?

  • Either too much or not enough iodine

  • Smoking was a risk factor for Graves Disease but not Hashimoto’s.

  • Selenium and Vitamin D intake or lack of intake

  • Stress

  • Nutrient deficiencies

  • Infections/viruses

  • Impaired gut function

  • Low iron

  • Adrenal fatigue

Being infected with enterovirus which is a common infection in babies and kids- runny nose, cough, feeling unwell, fever. 

The study pretty much bashes animal fats as something that increased antibodies but the study was done using a questionnaire- we don’t know the quality of the food and they are saying that it was an association and not a cause. 

The point of AIP is that it is anti-inflammatory and contains healthy fats. When I did AIP I didn’t eat enough veggies and sometimes I think that is where we go wrong with it. I think trying out AIP again would be good. 

I would not just go off your medication. There may be too much damage to your thyroid and you don’t want to end up with more damage to your body. I’m still recovering from going off my meds 4 or 5 months ago. I’m still really puffy and can’t get rid of the weight I gained from that. Plus it is dangerous. Your organs start to shut down. That is not good. 

So- do you know anyone in Japan? Having a support system will help. 

Start with one meal at a time. Avoid all the big inflammatory foods- I don’t know what the food is like over there. Maybe someone who is listening can help us out here. Send me an email if you know how you can help Laura navigate Japan. 

Take it one meal at a time. You need to get the inflammation down, calm down the immune system and figure out which foods, if any, are causing the antibodies to go up. 

You mentioned traveling a lot which makes me think maybe you got some kind of bug and that could be the trigger here. Until you can get to the root cause you need to calm down your immune system and the best and easiest way to do that is to remove those potentially inflammatory foods. 

Sometimes we need to take it one step at a time. Start by removing all grains and alcohol but add in some good healthy fats- coconut oil (not sure how easy that is to get there), olive oil, avocados, olives and if you like fish and get fish that is not contaminated from the radiation then eat fatty fish once a week. 

The next week remove legumes and nightshades and add in some soups and bone broth from pastured animals. 

The following week take out the dairy products if you have not already as well as coffee and chocolate. 

Then take out processed foods, refined sugar products, eggs and poor quality oils like vegetable oils and add in some fermented foods like sauerkraut or kimchi. 

Lastly, remove the nuts and seeds and add in nutrient dense meats like liver if you can tolerate it. 

Keep this up for at least a month and then see how you feel. You may want to continue eating this way for a couple months or more depending on how sick you are. 

You can begin to reintroduce foods when you feel like your body is ready. There are lots of resources online to know just how to do it, or in books but the basics look like this: 

Take just one food. Eat it 2-3 times in one day taking note of how you feel after you eat it up to an hour or two later. If you do okay- wait 4 days to a week before reintroducing another food and don’t eat any more of the reintro food for those 4-7 days. Be mindful of your well being during those days to see if you can attribute anything to the food. For example- I get pain in my right hip- almost like arthritis when I eat corn sometimes. But it is a trigger I can look for when eating something my body might not like- I think it is the oil the corn is cooked in rather than the corn itself but I’m not going to just eat a crappy oil to test it out. :) If you don’t have any symptoms, you can add that food back in to your diet and test out something else. If you have a reaction then don’t eat that food for awhile- like another month of healing and if you have a reaction give your body a good week or so to recover from it before you reintroduce anything else. 

Reactions to foods can come in many forms- your skin, your mood, your joints, headaches, digestion, poor sleep, extreme fatigue. Food journaling with your mood is a good way to track all of this.  

Some other things I would make sure you are working on are:

  • sleep

  • stress management- so meditation, connection, exercise (too much or not enough)

  • spritual stuff- whatever that means for you

  • get out in nature

I understand wanting to get off your medication. I wanted that so bad. You might be able to but if you can’t it doesn’t mean you are a failure. The medication we have to take is a hormone. We need it to survive. It is okay if you need it. 

If you want to go way out there though- check out the work of Dr. Joe Dispenza. He was in a terrible accident while biking and he crushed his spine. The doctors told him he would never walk again and he healed his injury with his mind. Now he travels around the world and teaches people how to use their mind to bring good into their life. That is some woo woo stuff but also pretty miraculous. 

And as far as I’m concerned, meditation of any kind is good for us and we really do become what we think. That is why I do this podcast. You don’t have to be victim to your disease. You have some choices in life and how you spend your time matters.

Thanks for writing in Laura, and if anyone out there can help Laura navigate through this while in Japan, please write to me and I will connect her with you. 

Until next week! 


Woeber, K. A. (2016). The Significance of Thyroglobulin Antibodies in Papillary Thyroid Cancer. Endocrine Practice: Official Journal Of The American College Of Endocrinology And The American Association Of Clinical Endocrinologists, 22(9), 1132–1133.

Matana, A., Torlak, V., Brdar, D., Popović, M., Lozić, B., Barbalić, M., … Zemunik, T. (2017). Dietary Factors Associated with Plasma Thyroid Peroxidase and Thyroglobulin Antibodies. Nutrients9(11).