Can I have high TPO >400 but not have hashimotos? I have all the symptoms of it but my tsh is normal as of right now + goiter, Tpo 1300 last week

Hashimotos diagnosis. is made by a biopsy that shows immune-mediated thyroid destruction. The presence of high TPO>200 is seen in >95% of cases of Hashimoto's. Anyone with high TPO antibody is at high risk for Hashimoto's and should be followed very closely. TSH, FT4 and FT3 levels determine thyroid function and treatment might not be needed if normal, but goiters always need further evaluation.