Thyroid antibodies like anti-TPO show that your immune system is turning against your own thyroid. A raised anti-TPO fits an autoimmune thyroid inflammation, of which Hashimoto is the best known. Yet a raised value on its own is not yet a disease: the result only gains meaning together with your TSH and your symptoms.
Honestly? Antibodies sound alarming, but they are more common than you would think and do not say everything. Below you will read what anti-TPO is and when it is useful to have it measured.
To first understand the basics of your thyroid, read our article on the TSH value.
What are thyroid antibodies?
Thyroid antibodies are proteins of your immune system that mistakenly turn against your own thyroid. Anti-TPO targets the enzyme thyroid peroxidase, which your thyroid needs to make hormones (Kaur & Jialal, StatPearls).
Besides anti-TPO there are also antibodies against thyroglobulin (anti-Tg) and against the TSH receptor. Anti-TPO is the value measured most often.
The presence of antibodies points to an autoimmune process. Whether and when that causes symptoms differs strongly per person.
What does a raised anti-TPO mean?
A raised anti-TPO fits an autoimmune thyroid condition, but also occurs in people without symptoms. In population research, a considerable share of healthy people had measurable thyroid antibodies (Hollowell et al., 2002, PMID 11836274). Cut-off values differ per laboratory.
| Anti-TPO result | Indication | What it can mean |
|---|---|---|
| Not raised | Below the lab cut-off | Antibodies not detectable |
| Slightly raised | Just above the cut-off | Also occurs in healthy people; the doctor weighs the context |
| Clearly raised | Well above the cut-off | Fits an autoimmune thyroid, especially with an abnormal TSH |
A raised anti-TPO increases the chance that your thyroid will slow down over time. So it is more a risk signal than a diagnosis.
What is the link with Hashimoto?
Hashimoto is an autoimmune thyroid inflammation and the most common cause of an underactive thyroid in iodine-sufficient countries (Kaur & Jialal, StatPearls). In most people with Hashimoto, anti-TPO is raised.
The inflammation often develops quietly. Sometimes antibodies are present for years before your TSH starts to deviate and you notice symptoms.
Typical symptoms of an underactive thyroid are tiredness, feeling cold, weight gain and low mood. Much of that overlaps with other causes, which you can read about in our article on recognising thyroid problems.
When is anti-TPO testing useful?
Measuring anti-TPO is mainly useful when your TSH is abnormal or when you have symptoms that fit the thyroid. With a normal TSH and no symptoms, a standalone antibody test usually adds little.
- With an abnormal TSH - to determine whether an autoimmune cause is involved
- With thyroid symptoms - such as persistent tiredness or feeling cold
- Around pregnancy (plans) - antibodies can then be extra relevant
The NHG-Standaard Schildklieraandoeningen advises using antibodies in a targeted way, not as standalone screening. If you want your thyroid checked, at Vital Check you can do a thyroid test that includes TSH and anti-TPO.
Measuring antibodies is, by the way, different from measuring hormone values. For the broader hormone picture, see anti-TPO as a single marker or read about oestrogen and menopause.
Frequently asked questions
Do I have Hashimoto if my anti-TPO is raised?
Not automatically. A raised anti-TPO fits an autoimmune thyroid, but also occurs without symptoms. Your doctor looks at your TSH, your symptoms and the course over time.
Do I need to fast for an anti-TPO test?
No, fasting is not needed for anti-TPO. The value does not swing much with eating or the time of day.
Can thyroid antibodies fall again?
The level can vary over time. The exact height matters less than whether antibodies are present and how your TSH behaves.
Can I have anti-TPO tested myself?
Yes. At Vital Check you can have anti-TPO measured, preferably together with your TSH so the result sits in context.
References
- Kaur J, Jialal I. Hashimoto Thyroiditis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026. NCBI Bookshelf: NBK459262.
- Hollowell JG, Staehling NW, Flanders WD, et al. Serum TSH, T(4), and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III). J Clin Endocrinol Metab. 2002;87(2):489-499. PMID: 11836274.
- Nederlands Huisartsen Genootschap. NHG-Standaard Schildklieraandoeningen. Utrecht: NHG.
Every blood test result at Vital Check includes a professional assessment from a BIG-registered doctor. A blood test does not make a diagnosis. For treatment decisions, discuss your results with your GP.
الأسئلة الشائعة
Do I have Hashimoto if my anti-TPO is raised?
Not automatically. A raised anti-TPO fits an autoimmune thyroid, but also occurs without symptoms. Your doctor looks at your TSH, your symptoms and the course over time.
Do I need to fast for an anti-TPO test?
No, fasting is not needed for anti-TPO. The value does not swing much with eating or the time of day.
Can thyroid antibodies fall again?
The level can vary over time. The exact height matters less than whether antibodies are present and how your TSH behaves.
Can I have anti-TPO tested myself?
Yes. At Vital Check you can have anti-TPO measured, preferably together with your TSH so the result sits in context.
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