 Hi, this is Dr. Ruscio, and let's talk about thyroid autoimmunity and what level of thyroid antibodies is considered healthy. Now, in case you're not privy to this already, thyroid autoimmunity is the most common cause of hypothyroidism in most westernized countries, and this typically manifests as a process known as Hashimoto's. And this certainly is something that we want to be, you know, common enough because the level of thyroid autoimmunity has been shown to correlate with, of course, hypothyroidism and also with thyroid cancer. So if one does or doesn't have thyroid autoimmunity present, it's important for us to know. Yes. And there are some well-established treatments for this that we've talked about in different videos and posts. Diet is one. Gluten-free diet and, in a recent study, a lower carbohydrate diet have both been able to show the ability, or shown the ability, to be able to quite dramatically dampen thyroid autoimmunity. There's also different nutritional supplements that can be used. Most notably, there is a protocol using selenium, CoQ10, and magnesium that's shown benefit. And vitamin D has also shown benefit in clinical trials being able to lower thyroid autoimmunity. Additionally, there is one noteworthy study in the treatment of H. pylori, a stomach bacteria, and the ability of successful treatment of H. pylori to be able to lower thyroid antibodies and those with thyroid autoimmunity. And one case study after the treatment of blastocystis hominins, a gut bug like a protozoa, that can also help with thyroid autoimmunity. So there's definitely some treatments that can help with lowering thyroid autoimmunity. And reason was suggest, since elevations correlate with negative outcomes like hypothyroidism and thyroid cancer, reason was suggest that lowering thyroid antibodies would be a good idea. Certainly not a hard argument to make. But the one important thing that often gets maybe left out of this conversation or is overlooked or there's confusion regarding is when have you succeeded in trying to lower your thyroid antibodies? This is a key question. And what I have observed is oftentimes patients are quite distraught if they can't get their thyroid antibodies down to the normal range. Now normal is usually defined as at or below 30 or 35 for the most clinically relevant antibody known as TPO or thyroid peroxidase, a lab test that can be done in any doctor's office in any major lab, what have you. Now I've been saying for the past few years that in my observation 100 to 300 on the TPO antibodies is what I would call a clinical win. Recently there was a study published that did a fantastic job of trying to quantify when or what, what is a healthy level of antibodies and when can you maybe stop trying to treat the antibodies so to speak. And they found that 500 for TPO antibodies was a cut off, meaning those who were below 500 had a incredibly low risk of future progression to hypothyroidism and a subgroup of these patients was followed for a little over six years, so it was a decent follow up window. But even the people who were above 500 still only had a moderate risk so it's important to understand that 500 showed a pretty favorable outcome in these patients and that if you're a patient or if you're a doctor working with your patients and if someone has come from let's say 700, 800, 1200, 1400 for their TPO antibodies and now they're hovering somewhere around 1, 2, 3, 400 then that is starting to look like a clinical win. I'll be at this as one study and we don't want to make too many conclusions based upon one study, but it certainly reinforces what I've seen in the clinic is that way above 500 tends to be a warning flight that you need to act, below 500 is a sign that you don't need to keep taking vitamins or doing crazy things with your diet. You can relax a little bit and not be so concerned about the autoimmune condition because it seems that the autoimmune process is in a pretty good place. Don't aim for perfection underneath 30 to 35, aim for what seems to be a reasonable endpoint or a reasonable level which is below 500 if you really want to be meticulous maybe below 300 according to my speculative general range. But the main point of this whole issue is not to be feeling like you chronically have to be pursuing a lower and lower and lower level of thyroid antibodies thinking that it's going to have a health benefit because what it looks like is that if you're frankly elevated it's a problem above 500 a problem. If you're below 500 then you're in pretty good condition and you don't have to worry about being at heightened risk for major problems with your thyroid gland. In fact you don't even show, there's a minimal chance that you'll even progress to hypothyroidism. So hopefully this helps people out there who have thankfully become cognizant of the fact that thyroid autoimmunity is something that needs to be incorporated into a thyroid health care plan but also helps them realize when they can not have to worry about continuing treatment and trying to drive the antibodies down lower. A win could be considered anything below 500. If you're significantly above 500 you probably want to take action. If you've been hovering lower than 500 for a while then you're probably in pretty good shape. So this is Dr. Ruscio and I hope this information helps you get healthy and get back to your life. Thanks.