My tpo antibody are high at 22.8 iu/ml (normal range less than 9), nodules found on thyroid ultrasound, antithyroglobulin antibodies ^ 4.2 (normal range less than 4). all other thyroid tests normal. could this cause symptoms? thank you?

By MAYO clinic website: "some people with TPO antibodies may not have thyroid disease. But the presence of TPO antibodies may increase the risk of future thyroid disorders." So if TSH and T4 are normal, you should not have symptoms of hyper or hypothyroidism. Nodules in thyroid by US are not uncommon, your doctor will recommend the next step if needed.

All laboratory results need to be interpreted in the clinical context and the doctor who ordered the tests is usually in the best position to do that. Talk to the doctor who ordered the tests. Having said that, the antibodies do not cause symptoms. But you are at risk for thyroid deficiency and should see your doctor for TSH test, periodically. Wish you good health!