What is the equivalent of a Thyroid Peroxidase Antibody (TPO Ab) level of less than 1.00 IU/mL in mIU/L?

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Last updated: September 4, 2025View editorial policy

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Thyroid Peroxidase Antibody Unit Conversion

A Thyroid Peroxidase Antibody (TPO Ab) level of < 1.00 IU/mL is equivalent to < 1.00 mIU/L, as these units are identical in measurement of TPO antibodies.

Understanding the Units

The units IU/mL and mIU/L are equivalent for measuring TPO antibodies:

  • IU = International Units
  • mIU = milli-International Units
  • 1 IU/mL = 1000 mIU/mL
  • 1 mIU/L = 1 mIU/1000 mL = 0.001 mIU/mL = 0.001 IU/mL

However, when expressing the same concentration:

  • 1 IU/mL = 1 mIU/L (because the volume conversion cancels out the milli prefix)

Clinical Significance of TPO Antibody Levels

TPO antibodies are important markers for autoimmune thyroid disease. According to the literature:

  • Normal subjects typically have TPO antibody levels below 52 U/mL 1
  • In the study by Henning Berlin, the majority of normal subjects had anti-TPO levels below 52 U/mL 1
  • A level of < 1.00 IU/mL is well within normal range and indicates absence of thyroid autoimmunity

Interpretation in Clinical Context

  • TPO antibodies are a key marker for autoimmune thyroid diseases such as Hashimoto's thyroiditis and Graves' disease 2
  • Patients with Hashimoto's thyroiditis typically have levels above 200 U/mL 3
  • Even within the normal TSH range, TPO antibody titers correlate with TSH levels, suggesting their presence may herald impending thyroid failure 4

Important Considerations

  • Modern TPO antibody assays are highly sensitive, and very low titers can be found in virtually all subjects 4
  • The clinical cut-off for significance varies by assay but is typically 200-500 U/mL 3
  • A value of < 1.00 IU/mL is significantly below any clinical threshold for concern

Monitoring Recommendations

For patients with normal TPO antibody levels (like < 1.00 IU/mL):

  • No specific monitoring is required for the antibody itself
  • Regular thyroid function monitoring may be appropriate if there are other risk factors for thyroid disease

For reference, the normal TSH reference range is 0.45 to 4.5 mIU/L according to NHANES III data 5

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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