Hypothyroidism is generally associated with all of the following EXCEPT

• A. TSH receptor antibodies
• B. Depression
• C. An elevation of TSH levels
• D. TPO antibodies

Answer: (A)

In hypothyroidism you typically see a rise in TSH because the pituitary tries to stimulate the underactive thyroid. Autoimmune Hashimoto’s thyroiditis commonly features anti-TPO antibodies, reflecting autoimmune destruction of the thyroid, and depressive symptoms are a well-known manifestation due to the systemic effects of low thyroid hormone. TSH receptor antibodies, on the other hand, are most characteristically associated with Graves’ disease, where stimulating antibodies drive excess thyroid hormone production and hyperthyroidism. While there are rare blocking TSH receptor antibodies that can contribute to hypothyroidism, this is not the general pattern. Therefore, TSH receptor antibodies are not a typical association with hypothyroidism.