The thyroid peroxidase (TPO) is a 105 kDa glycoprotein enzyme and the main antigen of the thyroid microsomal fraction. It catalyses iodine oxidation and thyroglobulin tyrosyl iodination reactions in the thyroid gland. Anti-TPO antibodies activate complement and are thought to be significantly involved in thyroid dysfunction and the pathogenesis of hypothyroidism. These antibodies are significantly present in patientsof Hashimoto's thyroiditis,Gravesdisease and even in non-thyroidal conditions such as diabetes. In sub-clinical hypothyroidism (SCH), presence of these antibodies is associated with increased risk of developing overt hypothyroidism (OH). In the present study, anti-TPO antibodies were tested on 33 individuals, all of whom reported thyroid stimulating hormone (TSH) levels > 6μIU/mL. These included 18 with SCH and 15 with OH.Anti-TPO ab positivity (levels > 28.4 IU/ml) was observed in 17 patients (51.5%) which included 5 with SCH and 12 with OH. There was greater prevalence of positivity in OH compared to SCH (80% vs 27.8%). 8 of 33 subjects (24%) had significantly raised anti-TPO ab (>200 IU/ml). The Billewicz scoring system was used for assessment of clinical features of hypothyroidism with value ≥25 strongly suggestive of OH. 9 of 33 subjects had scores ≥25 and out of these, 7 had positive anti-TPO ab.Pearson correlation revealed the serum TSH and anti-TPO levels to be strongly positively correlated, r(32) = .7902, p <0.0001.The Billewicz diagnostic score was also correlated with anti-TPO levels, r(32) = .4107 which was significant at p<0.05.Our results show that higher anti-TPO ab and TSHlevels are associated with higher symptom scores, indicating underlying pathophysiological and immunological processes and we suggest that antibodies against TPO should be routinely assessed in patients presenting with either elevated TSH levels or with symptoms suggestive of thyroid dysfunction