I saw a study recently about how lowering TPO antibodies is not clinically significant and that patients can have improvement in terms of thyroid symptoms with levels below 350. Have you seen anything similar in terms of thyroglobulin levels, and is there a number that you view as a concern in a lab test result? I recently had two patients come back with their thyroglobulin levels around 10.

Dr. Amy Nett:  This is a little bit tricky. I wonder if you can post that study on the Facebook group? Because the question is saying that it’s not clinically significant to have antibody levels at 340. I don’t know because that’s well outside of the normal reference ranges. TPO antibodies are generally below, something like 34. Are you saying that it’s not clinically significant meaning there’s not further thyroid tissue disruption? Because if we’re seeing high antibody levels, I think that that suggests that the immune system is out of balance and whether or not that’s specifically targeting the thyroid and causing further tissue damage so to speak. I think that the immune system is still out of balance. To me, TPO antibody levels at 300, the body’s out of kilter. Something’s throwing the immune system out of balance. Even if that isn’t going to lead to “clinically significant thyroid disease” because of that, I still wonder what the other effects are on the body. Again, I haven’t read that paper, so I can’t go into too much detail on that specifically. I would definitely be curious to read it. Personally, if I see thyroid antibody levels that high out of range, I want to investigate what’s the underlying cause of what’s potentially in the immune system that is out of the balance and causing these thyroid antibodies to be elevated in the first place.

Jamie says she’ll look for it. Yes, that would be great. And then she is clarifying. Would you be concerned about their globulin antibodies at 10? I would because the normal reference range in the labs that I normally use like LabCorp and Quest, the normal reference ranges less than one. So, there is an elevation of their globulin antibodies. I’m not necessarily saying that that means thyroid function is necessarily going to decrease. I don’t know. But there’s abnormal federal globulin antibody production, so the immune system is doing something wonky. That’s why I would be concerned. That’s why I would want to keep testing. Not thyroid specifically, but test gut. Test heavy metals. Test what else is throwing the body out of balance.