With this in mind, you should always monitor your clinical symptoms while you make any changes to your thyroid management and when testing your thyroid function. It is well known that it takes about 17 years for the newest clinical research to be implemented by the standard physician. Second is that is more than just one thing that can go wrong with your thyroid gland. According to the Food and Drug Administration (FDA), normal lab test values are a set of upper and lower limits generally given as a range since normal values vary from person to person. Hyperthyroid symptoms are easily diagnosed when compared to hypothyroid symptoms so this disease state is not missed as often as other thyroid conditions. The TSH is secreted from a gland in your brain known as the pituitary gland and TSH is responsible for stimulating your thyroid gland to produce thyroid hormones (both T3 and T4). With that in mind, let's jump into the list: Bottom Line: When evaluating thyroid lab tests you want to check for more than just the TSH and look at other important thyroid functions such as peripheral thyroid conversion, immune function, and thyroid cellular sensitivity. So your body continually increases TSH in an attempt to tell the thyroid gland to produce more thyroid hormone but your body is incapable of doing that due to thyroid gland damage. Just realize that the type and dose of thyroid medication that you are changing may alter your thyroid lab tests significantly. Low free T3 despite taking T4 medications such as Levothyroxine may indicate a thyroid conversion issue. The presence of these antibodies in your bloodstream may indicate that you have an autoimmune thyroiditis disease (though not all cases of elevated antibodies indicate thyroid damage). Most of the hormones that we sample in the blood have zero activity in the bloodstream, instead, all of their activity is at the cellular level. 3. Why would your thyroid produce less thyroid hormone when TSH is high, especially since its name is thyroid STIMULATING hormone? When TSH is low it generally means that your thyroid is producing too much thyroid hormone. In the context of lab test results, “normal” does not mean usual, typical, or ordinary. Thyroid antibodies help to identify the CAUSE of your thyroid problems. But it does NOT give you information on thyroid status in the peripheral tissues, on thyroid hormone conversion and on thyroid hormone cellular activation. Thyroid ultrasound is useful for identifying abnormalities such as thyroid nodules, thyroid cysts, thyroiditis (inflammation of the thyroid gland), thyroid goiter and even thyroid atrophy. You can increase your free T3 in 2 main ways: Through the use of natural therapies and through the use of specific thyroid medications which contain this hormone. SHBG is a protein that is produced from the liver in response to two hormones: Estrogen and Thyroid hormone. In addition, some hormones tend to peak at certain times of the day, so if we draw labs at the wrong time then we may not have a clear picture. Cholesterol and lipid tests A cholesterol (or lipid profile) test looks at the various levels of cholesterol and other fats in your blood. I’m Dr. Westin Childs. Elevated levels are obviously a problem, but unfortunately, the degree of elevation may not necessarily correlate with your disease state. Like other antibodies in your serum, you will want these to be as close to zero as possible. Another very important thyroid lab test and one that is often overlooked is Reverse T3. You can use your resting heart rate, your average body temperature and your clinical symptoms as a proxy for thyroid function - but these should be coupled with thyroid lab tests for best results. MCHC. If you are pregnant, nursing, taking medication, or have a medical condition, consult your physician before using this product. You can learn more about free T4 reference ranges and what it means for your medication dose here. And think about how difficult it would be to apply this logic to ALL tissues in your body for something as complex as thyroid function. So your thyroid gland may be working at 70% of normal or some other value. This is an area that is intensely debated even today. In most cases, it is sufficient to check your thyroid labs every 6 to 8 weeks during active management. This list includes optimal ranges, normal ranges, and the complete list of tests you need to diagnose thyroid hypothyroidism correctly! Measures the average percentage of hemoglobin present within each red blood … So if you have low SHBG from hypothyroidism and you take thyroid replacement hormones then you SHOULD see a rise in SHBG (again assuming normal estrogen levels). You can find more information about me here. But like all hormone systems, it can become dysregulated and that's when we start to see problems. The mean platelet value test measures the average amount of platelets. Like free T3, total T3 tracks well with thyroid outcomes such as weight loss and energy production which makes it a valuable thyroid lab test (17). Maybe you are already taking thyroid medication but some of your thyroid lab tests seem "off". Because we can't actually test what is happening at the cellular level without taking a tissue biopsy! Results are invalidated if the specimen was obtained less than 72 hours after cholecystography with radiopaque dyes. But it doesn't always make sense to do this unless we have a thorough understanding of what each lab test means. If you are taking thyroid medication and your SHBG is elevated this may be an early indicator that your thyroid dose is excessive. This relationship between thyroid hormones and thyroid gland function is why TSH is often considered to be the "ultimate" thyroid lab test (10). In the spectrum analogy, you can think about thyroid gland working as a percentage of some total (2). Optimal ranges are probably achieved when free T3 levels are in the upper 30-50% or so of that reference range. Reverse T3 is created from a conversion process using T4 as substrate in a similar way that T3 is created. These tests are not always necessary, but they should be considered for your first visit to your physician. This test checks levels of two types of cholesterol: high-density … Measures the average size of your red blood cells. SHBG can act as a proxy for the cellular activity of thyroid hormone. The idea with reverse T3 is that you want it to be as low as possible but still be in the reference range. You may find that both generic and trade names are used in A normal thyroid ultrasound is one in which no abnormalities are found and in which the thyroid gland is considered to be uniform in texture and appearance. In general, a positive antibody test is presumed to mean a person has been infected with SARS-CoV-2, the virus that causes COVID-19, at some point in the past. When it comes to antibodies in the serum, you should consider an elevation (regardless of the degree) to be a problem. Bottom Line: The best way to evaluate thyroid function is to combine thyroid blood tests with a complete history, physical exam and potentially imaging studies such as an ultrasound. If you have any other questions that aren't listed here please post them in the comments so that I can add to this list. Have you found a physician willing to help you? The reverse T3 will often dramatically rise in periods of extreme stress (both physiologic and physical), illness, due to certain medications, secondary to extreme diets (the example above is after the HCG diet) and any other trauma to the body. Thyroid lab tests can be taken at any time of the day but it's often best to check them first thing in the morning before you have taken your morning thyroid medication. He provides well-researched actionable information about hormone-related disorders and formulates supplements to treat these disorders. It is included here for completeness but just realize that not everyone will need it. This resource is dedicated to helping people with thyroid problems (and other hormone imbalances) find the help that they need. Download more free resources on this page. Hormone Testing for Women: 12 Common Lab Tests and What They Mean Medical research shows that hormonal imbalances affect nearly 50% of women . Note that this approach will take a significant amount of time (probably 1 hour at a minimum with your physician). In some cases, late-stage Hashimoto's and autoimmune thyroiditis may result in "burn out" of the thyroid gland due to thyroid damage and a decline in thyroid antibodies. Free T3 represents the amount of circulating T3 in your blood that is FREE and ACTIVE to do the work of thyroid hormone in the body and at the cellular level. They should also be coupled together with a complete physical exam and comprehensive history (your Doctor should do these as well). Foods to Avoid if you have Thyroid Problems: The Complete List of Thyroid Lab Tests to Ask For, #5. Learn about medical tests, including what the tests are used for, why a doctor may order a test, how a test will feel, and what the results may mean. Reverse T3 is a measure of what I like to call an anti-thyroid metabolite that is often present in the blood. Free T3 may be perhaps the most important measure of thyroid function in the serum. It's particularly helpful when the patient is using T3 containing medications such as NDT or Cytomel/Liothyronine. The goal here is to understand that thyroid function is more complex than the standard TSH and free T4 testing that you probably have received in the past. Blood tests are used to figure out numerous medical conditions. Basic Metabolic Panel. This discussion will begin with some general comments about approaches to ordering clinical laboratory tests, followed by real-world examples to illustrate these approaches. How often should I get my thyroid tested? Following the reverse T3 can also be used during thyroid hormone replacement therapy. The reason for this has to do with suppression of thyroid hormone production from the thyroid gland when using T3 containing medications. It can also act as a proxy to help determine if you are absorbing thyroid medication taken by mouth. I go through great lengths to help my users better understand their health; however, the content you see here is not a substitute for medical advice. The world of thyroid lab testing can potentially be a confusing place! There are some services that allow you to order your own tests online without a physician. What to Look for in a Thyroid Doctor to Start Feeling Better, Hormone Testing: How to Test your Sex Hormones, Thyroid & More. Also known as a blood chemistry, chemistry panel, or basic metabolic panel, this test looks at the levels of... CBC. Try to seek out physicians who are up to date on the current medical literature and are able to adequately order and interpret your thyroid lab tests. Sit down and dig into these posts. You do not have to check each thyroid test every time you get your labs drawn. So while the TSH is definitely a useful test it should be ordered in addition to other thyroid lab tests that we will discuss below. 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