hello, 

My name is Yolanda, and I’ve been suffering with hashimotos for almost 8 years now. My question is regarding thyroid antibodies. I’ve never had high antibodies yet I was diagnosed with hashimotos after an ultrasound to my thyroid. I had 2 small modules that have now disappeared, and also my thyroid has shrunk considerably, I imagine because of the medication. 

I take 90 mcg of NP Thyroid plus a bit of t3 and LDN at night, which has been a godsend for my insomnia. It’s not that I’m complaining of not having high antibodies but it makes it harder to know if I will ever be in remission, given that that is usually how people measure their level of sickness. 

I’ve read that a small percentage of people don’t show high antibodies and yet still have the disease. Should I approach my hashis from a different angle? Any insight on why and how this happens would be of great help.

Hi Yolanda, 

Thanks for writing in. This is a good question- all questions are good questions though! 

since I currently have access to loads of scientific research I found a study called A comprehensive score to diagnose Hashimoto’s Thyroiditis: a proposal. 

I the study they kind of explain how ultrasound diagnoses hashimoto’s. 

Sometimes this disease is diagnosed with labs, antibody tests or with labs and an ultrasound. With ultrasound they are looking for echogenicity which means a uniform thyroid gland- it looks the same on both sides- no damage or issues. 

Antibodies are used as a tool to predict disease development.  TPO antibodies are only found in 12-26% of people tested and thyroglobulin antibodies are found in around 14% of people. 

Ultrasound findings would be things like Diffuse hypoechogenicity which as far as I can tell means there is a nodule on the thyroid. An irregular echopattern from the ultrasound waves indicates hypothyroidism. 

I couldn’t find a lot of information about this with the amount of time I have to spend on it. 

I found another study called Comparison of thyroglobulin and thyroid peroxidase antibodies measured by five different kits in autoimmune thyroid diseases. 

In it they discuss how diagnosis or finding hashimoto’s is done with TPO antibodies which is the better test of the two antibody tests. The other test is thyroglobulin antibodies.  There isn’t a lot of information to compare the two tests in diagnosis. In those tested, Hashimoto’s patients were more frequently testing positive for thyroglobulin antibodies than TPO antibodies.  

The kits mentioned in the title are testing kits. 

This information doesn’t feel very helpful to me. I’m not sure why your antibodies are lower. It could be that something else has caused damage to your thyroid gland. 

I would pay close attention to your symptoms and notice how you feel. If you are not doing dietary changes then you should consider that first and foremost. Food is medicine and what we eat is information for our cells and helps them operate optimally or keeps them from operating optimally. 

Antibodies will fluctuate from day to day because   your immune system varies from day to day so you have to keep that in mind. A blood test of any kind is just a snapshot of what was going on in your body at the time your blood was drawn.

I’m sorry I couldn’t find a good answer to your question. I think you have to not worry about relying on a lab test to know you are in remission. Go by how you feel, how you are sleeping, what your energy levels are. Those things matter more than a blood test. 

You will always have to manage this with diet and lifestyle. That will never change.