Not understand TPOab results/Dr is out

[ranner]

I got my lab results back with a TPOab of 73 units/mL where the reference range is <60.  Everything I've read or seen online shows < 4IU/mL as the optimal range.  I'm not understanding the <60 or how to convert this.

[gimel]

For the 73 result there must be something more than just units.  Please double check the lab report.  If that is what it says, then I would check with the doctor's office.  When I look up TPO ab reference range,  the first 3 sources I located listed the range as 0 - 35 IU/mL  Where does the <4 IU/mL come from?

Even more important than lab test results are symptoms.  What symptoms do you have, if any.  Also, if other thyroid tests done, please list those, along with their reference ranges shown on the lab report.  

[ranner]

The lab report just says 73.  My doctor did the tests because I've been steadily gaining weight even though I eat less than what I'm expending.  I've had depression most of my life and tired a lot.  Which I attribute to the depression mostly.  

The books I'm reading say  <4 IU/mL is optimal for not having anything wrong.  
Thyroglobulin anitbody is <0.9 IU/mL (0-4.0)
reverse T3 14.2 ng/dL (11-18)
Free T3 2.8pg/mL(2.2-4.0)
TSH 1.139mcUnits/mL(.5-2.0)
Free T4 .8 ng/dL(.9765-1.497).  The only one flagged on my lab is the TPOab and it says HIGH.

I talked to my doctor when she got the report, but she didn't give me any numbers.  She said the TPOab was high and indicated inflammation.  She also said the Free T3 and T4 were pretty low.  I just asked for the report today to compare what I was reading to my actual numbers, but my doctor wasn't in to answer questions and I couldn't find anything online (about the 73).

[gimel]

Are you sure the books you are reading are talking about TPO ab, not TG ab, which does have a range like < 4?

At any rate, your TPO ab test result is above either of the 3 different ranges, indicating inflammation which may be due to an autoimmune condition:  Hashimoto's Thyroiditis.   This is not consistent with your TSH level, so you may be in the early stages.  More importantly you listed 3 symptoms that are frequently related to hypothyroidism.  Along with that  Your Free T4 of .8 is actually below range and your Free T3 of 2.8 is only at 33% of its range.  Those are lower than needed by most people.   The  Free T3 being higher in range than the Free T4 may also be an indication that your body is try to maintain thyroid function as best possible by converting more T4 to T3.  TSH is affected by so many things that a TSH result within range does not preclude hypothyroidism.  

Since hypothyroidism is not just inadequate thyroid hormone, but instead is correctly defined as insufficient T3 effect in tissue throughout the body, as a result of inadequate supply of, or response to, thyroid hormone, there are also other factors that have an effect.   You have already tested one of those: Reverse T3 and it was mid-range.  At first opportunity you also should get the doctor to test for cortisol, Vitamin D, B12 and ferritin.  

A good thyroid doctor will diagnose a potential hypothyroid patient by first evaluation for symptoms that occur more frequently with hypothyroidism than not.  Following that all the tests you have had and that I mentioned need to be done to help support clinical evaluation.  If the diagnosis is hypothyroidism, then the patient should be treated with thyroid medication adequate to get FT4 to mid-range, and FT3 into the upper third of its range, or as needed to relieve symptoms, without being influenced by resultant TSH levels.   Symptom relief should be all important, not just test results, and especially not TSH results when being treated with thyroid med.  In addition of course the other mentioned tests must be confirmed as optimal, or supplemented as needed.  If your doctor is unwilling to diagnose and treat clinically, as described then you will need t find a good thyroid doctor that will do so.  

[ranner]

Thank you for all the info.  Hoping my doctor is in sometime this week to explain.

[gimel]

If you need support for your discussion with the doctor, click on my name and then scroll down to my Journal and read at least the one page Overview of a paper on Diagnosis and Treatment of Hypothyroidism: A Patient's Perspective.   Also note the link to the full paper.   The more you know about diagnosis and treatment of hypothyroidism the more effective you will possibly be in getting your doctor to do the right things.  I say possibly because there are many doctors that adamantly refuse to consider any change to what they have been doing to thyroid patients, even when there is scientific evidence to the contrary.  

[Red_Star]

I've had TPOAb tested at both labs here in Queensland Australia. One lab states normal is < 60 U and the other lab < 6 IU.  There is no converting between the two methods so I was told by the labs but interestingly my result at the time was 460 U and 46 IU. I have had TPOAb up to 1900 U but never had an IU test to check the results.  Selenium may lower TPOAb. Try one or two Brazil nuts daily and see what your TPOAb results are in 3 to 6 months.

[ranner]

Thanks so much.  This helps a lot.  I will definitely try the Brazil nuts.