3 Common Reasons Thyroid Antibodies Stay High

The all too common story goes like this…

You’re following your doctor’s recommendations, you’ve taken up a stress management practice, and maybe even changed your diet all in the hopes of getting your antibody levels down and your Graves’ under control.


It’s the same (or worse) outcome the next time you go for blood work – high levels of antibodies.

Then comes the infamous question (and one I get asked all the time):

“Why are my antibodies still elevated?”

Let me start by giving a quick refresher on antibodies.

Thyroid-stimulating immunoglobulin (TSI) is the antibody responsible for hyperthyroidism in Graves’ disease. It does this by stimulating the TSH receptor on thyroid cells. This causes the thyroid cells to constantly produce thyroid hormone which triggers Graves’ symptoms.

TSI is also responsible for the Thyroid Eye Disease (TED) that affects some Graves’ sufferers.

The typical management most doctors and endocrinologist recommend is to kill the thyroid with Radioactive Iodine (RAI) or to cut out the thyroid gland.

However, this DOES NOT address the autoimmune component and the immune system is free to attack another area of the body.

Remember, Graves’ disease is NOT due to a sick thyroid, it’s due to a sick immune system that attacks the thyroid. Therefore, treatment must be aimed at correcting the immune system.

This is why conventional treatments fail – they’re treating the wrong part of the body.

Back to why antibodies are still elevated…

This comes down to three common reasons:

1.  The autoimmune trigger hasn’t been removed.

This is the most common reason I find as to why elevated antibodies stay high. This one is obvious because the CAUSE hasn’t been addressed.

For example, the Epstein-Barr virus is a common autoimmune trigger in Graves’ disease and, unless the virus is treated, the autoimmune attack on the thyroid will continue.

Another example is “leaky gut”. If the gut isn’t healed, then the autoimmune attack carries on.

Cutting out the thyroid or using radioactive iodine is NOT going to kill the virus, fix the gut, or heal the immune system.

Here you can see how conventional treatments fail to treat the triggers which leaves other tissues and glands susceptible to future immune attacks.

The takeaway here is that the focus should be on identifying and correcting the underlying triggers. Many patients have more than one immune trigger that must be addressed in order for antibody levels to normalize.

This step may take some time but, be patient, the results will be worth it!

2.  The autoimmune process is still turned on (even after the trigger has been removed).

You’ve found the trigger and treated it. You’re feeling better but your antibodies are still high. This can put you at your wits end.

However, if your immune system has been chronically activated for years, you’re not going to shut this down overnight. It’s going to take time.

In other words, your immune system is “stuck” in the on position and learned that this is “normal”.

When this happens, it becomes necessary to do things to help calm the immune system and regulate its activity.

Changes in diet and certain nutrients like vitamin D3, curcumin, selenium, glutathione, CoQ10, and omega 3 fish oil can help with this.

However, other areas of the body may also need to be addressed…

3.  Other body systems not balanced.

What this means is that you need to focus on a “whole body approach” to healing. It’s not just and autoimmune attack on the thyroid. It’s an inflammatory problem, a gut problem, a stress problem, an infection problem, a neurological problem, a hormonal problem, etc.

Not everyone has all these problems but most Graves’ sufferers have more than one system that’s unbalanced. This is the challenging part when treating Graves’ disease and it’s also where a lot of people don’t get the direction and guidance they really need.

Testing is a must at this point and many times it’s overlooked or inadequate, leading to continued illness and chronically elevated antibodies.

By finding and addressing ALL compromised areas of the body that are contributing to the autoimmune attack, you restore function and reverse the autoimmunity.

Warning: Thyroid Antibodies Can Fluctuate

In some people, thyroid antibodies will fluctuate throughout the course of treatment. It’s not uncommon to see the antibodies decrease, and then on the next blood test they increase. It’s important to understand that this is a normal part of the healing process and usually not a reason to be concerned. However, once the trigger has been removed and the autoimmune attack has been suppressed, the antibodies will stop fluctuating and remain low or become completely undetectable.

I can’t promise it’s going to be easy, but you must know, it is possible to reverse autoimmune Graves’ disease.  You can overcome this and get your life back.

The best part is, you don’t have to do it on your own.

I would love to help guide you on your journey.


12 thoughts on “3 Common Reasons Thyroid Antibodies Stay High

  1. I’m trying to do all the right stuff. Seeing a naturopath now after being over medicated by two Endos. I wonder about my antibody numbers, I didn’t get them tested until I had to request them. First endo didn’t test and second ‘agreed’ to do it. TRAb 39 days after thyroid storm was 8.47 and I had been on MMI for 6 weeks when that lab was done. 76 days later my naturopath retested and I was at 5.30. I know this is still really high from what I’ve read, but it’s hard to have an appreciation for how much it has come down when you have no sense of these things. I also have been off MMI for almost 6 weeks now. After the initial 6 weeks on 25 mg I went hypo and the reduction to 5 mg for another 5.5 weeks still wasn’t low enough and I ended up with TSH of 21 and FT4 even lower than before. Off of MMI 4 weeks and now I’m in range and testing at the 4 week mark and of course I’m hoping I’m still in range and not high. I’m also being treated for SIBO with herbals and female hormones as I went into menopause last summer. So much going on but I’m keeping a good attitude and trying to treat my body as best I can. Low FODMAPs, not dairy or grains…it’s challenging no doubt. Interestingly I really haven’t felt poorly. I’m used to decades of insomnia, so being tired is normal. But that has gotten a little better, my naturopath says it MUST get better. 🙂

    • Sounds like things are moving in the right direction. Ups and downs are normal during treatment. It will be interesting to see where your levels are at the 4 week mark. But, more important is how you feel. I’m very happy to hear that you haven’t felt poorly and that the insomnia has gotten a little better (treating SIBO often improves insomnia). Please keep me updated and let me know if you have any questions. Best of luck on your journey!

  2. Hi love this article.
    I have been gluten (not tested for coeliac) and dairy free for 10 months .My thyroid results tsh free t3 and 4 are now normal. TSI anti dropped in that time from 13 iu to 3 iu. I have never had a goiter. Endo asked me to stop tapazole (2.5/day) yesterday. I am concerned TSI haven’t been eliminated. I just quit a stressful job a month ago in hopes it will help. Do you have any other suggestions for me? Any other blood tests to take? Can
    You help me please?

    • Adam Trager says:

      Hey Chris,

      Sounds like you are moving in the right direction. Great to hear! Have you done any testing for hidden infections like Epstein-Barr virus (EBV), H. pylori, parasites? These are all things that can trigger autoimmune thyroid. See my other article here: http://healyourthyroidnow.com/7-common-root-causes-graves-disease/

      Supplements may also help: http://healyourthyroidnow.com/hyperthyroidism-6-must-have-supplements-to-improve-graves-disease/

      Best of luck to you!

      • So I have been tested for H Pylori and parasites with negative result. I never had mono. There are so many parasites. How do you know which ones to test for? My Thyroid results are normal except T3 is not dropping due to steroid cream use. TSI Antibodies still at 3 pIU/L (should be .9 or less). Dr wants me to start block and replace as he says I will have reoccurrance of hyper if I stop the Methimozole. I am conflicted as another Dr says stop Methimozole. What next?

          • Hey Chris,

            I would still recommend having an EBV test. There are many statistics that put EBV at >90% of the population.

            Are you eating corn? If so, you may wish to remove that from your diet as well.

            Have you tested hormones? Adrenals? Heavy metals? Any root canals? There is so much that could be causing your immune system to attack your thyroid.

            Hope this helps.

  3. Tracey Cassara says:

    I was wondering if you could shed some light on this. My Mother in law’s Graves disease was treated with radioactive iodine over 20 years ago. She has been hypothyroid since and takes medication. Should she still have elevated thyroid antibodies so long after her initial Graves treatment? The Thyroid Peroxidase AB is 36 with lab range <9IU/ml

    • Hey Tracey,

      Remember, Graves’ disease is NOT a disease of the thyroid, it is an immune system disease. Radioactive Iodine only kills the thyroid, it doesn’t address the immune system. So until she addresses whatever is triggering the immune system, she will continue to have elevated antibodies.

Leave a Reply

Your email address will not be published. Required fields are marked *

You may use these HTML tags and attributes:

<a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <s> <strike> <strong>