5 Thyroid Tests Every Thyroid Patient Needs
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Wondering what thyroid tests you need?
Do you feel like something might be wrong with your thyroid, but your thyroid blood work says you're fine? If your doctor only ordered the TSH test, you might need more information to know what is really going on.
More and more, people are being diagnosed with thyroid issues, but some people have thyroid issues without knowing it. It's important to know what's wrong with you so you can know what to do.
To that end, it's crucial to know what thyroid blood work to have your doctor order so you can get the medical care that you need.
Thyroid disease is rampant these days and since the thyroid is affected and is affected by many things, including the food you eat and your adrenal glands, it's important to get informed about this important gland as much as possible.
My Struggle with Thyroid Disease
I've struggled with hypothyroidism for years. I started noticing severe fatigue, dry skin, weight gain, and joint pain when I was just 22 years old.
I wasn't old enough to be feeling that bad. I went to the doctor on a few occasions and described my symptoms telling her I just didn't feel well.
She blew me off and told me I was perfectly healthy.
Long story short, I was able to begrudgingly get my doctor to run a TSH test. (This is the standard test pretty much all doctors run to test thyroid function. I didn't have any idea what it was at that point.)
Two days later I received a call.
Low thyroid levels. Supposedly I had hypothyroidism.
The plan? Start synthroid (that was the first problem, but more on that later).
I started my meds and waited 6 weeks.
I still felt bad.
We tweaked my meds. Waited 6 more weeks.
I still felt bad.
Round and round we went until my search for information (and a new doctor) began.
(Before we get started, I want to let you know that I am not a doctor or any sort of medical professional. All of this information I have gleaned from my own research and should not be used for any sort of diagnostic purposes. Use common sense, do your own research, and talk to your doctor before making any changes to your diet, supplements, or exercise routine.)
TSH: Just the Beginning of the Story
In this search for information, I've learned that the standard TSH test that most doctors rely upon for both diagnosis and treatment does not give a complete picture of what is going on with your thyroid.
You see, TSH, which stands for thyroid stimulating hormone, is actually a test of what the pituitary gland is doing.
That's right, it isn't even testing any of your thyroid hormones.
In theory, when your body does not have enough thyroid hormone, your pituitary gland should be releasing TSH to signal to your thyroid that you need to make more (sort of like a wake up call for your thyroid). Those with elevated TSH levels should theoretically have low thyroid levels and those with low TSH levels should have enough (or too much) thyroid.
So, what's the problem? It seems pretty cut and dry, right?
Wrong.
There are many many reasons why doctors should not diagnose or treat a thyroid patient based on TSH levels.
Some people simply have a malfunctioning pituitary gland and this is why it is not producing TSH. Unfortunately, it is beyond the scope of this post to go into all of the reasons as to why TSH is not an effective marker.
You can read countless stories of hypothyroid patients who were not diagnosed for years and years because of doctors who simply tested TSH, didn't consider other symptoms, and didn't do further testing.
In theory, the TSH test tells a lot.
But, in reality it might not be all that you need.
What Thyroid Blood Work Do You Need?
So, if TSH isn't the best lab test for diagnosing and treating thyroid disorders, what is?
First, I want to confirm—in case you haven't already guessed—there is no test that can substitute for a doctor who will listen to how you feel.
You need to be seeing a doctor who will listen to you and will place great value in your symptoms when diagnosing and treating you.
Below are the tests that might be essential for anyone who is struggling with thyroid problems or believes they may be struggling with thyroid problems.
Thyroid Blood Work Checklist
Following is a list of blood tests that you can ask your doctor to run. This list of thyroid blood tests will give your doctor and you more perspective of what exactly is going on with your body, and hopefully will put you on the road to better health.
Free T4
T4 and T3 are the two main thyroid hormones. But, T4 is the less active hormone. Your body converts much of your T4 into the more active T3 inside the cells of your body. With the T4 (and T3) test you can check both free and total levels.
You might want to ask your doctor to check your free levels. Why might this be important? Because free T4 is the T4 that is not bound to proteins in your blood. If you know that number, you will know the amount of T4 that is available to be used and converted to T3.
Free T3
This is the more active form of the thyroid hormone. If you don't have enough of this you're going to feel lousy. This is what should, in my opinion, be considered the gold-standard of thyroid function! Free T3 is primarily responsible for increasing your metabolism.
Anti-Thyroid Antibodies
The tests you specifically want to ask for here are TPO and TgAb. These tests will tell you if your body may be attacking your thyroid. The reason that doesn't sound so good is because it isn't good. If these levels are elevated, chances are you have Hashimoto's thyroiditis. Hashimoto's is a type of autoimmune thyroid disease, meaning your immune system is mounting an attack against your thyroid.
It is important to identify if your thyroid disorder is autoimmune in nature because if it is, there are a number of implications. One thing that's important for individuals with autoimmune diseases is to be on a diet that is anti-inflammatory which often means at a minimum cutting out highly inflammatory foods like wheat and sugar. I know, total bummer. But nothing new from what you've read on this blog before?
Cholesterol Panel
Though not as important as the above tests, I believe a cholesterol panel is good to have when going in for your tests as well. Often times people who do not have optimal thyroid levels also have elevated cholesterol. Your body is not able to properly metabolize cholesterol without adequate thyroid hormone. If your levels are elevated, this is just another clue that will help you figure out what is going on.
Don't worry too much about cholesterol levels until after you have your thyroid levels regulated. Figure out what your thyroid is doing and then check back to see what your cholesterol is doing. To get the most accurate idea of what is going on with your cholesterol be sure to request the NMR cholesterol panel.
Vitamin D
Though many people could benefit from other tests as well, the last test I believe is truly essential for anyone suspecting or treating thyroid disorders is Vitamin D. Vitamin D is a hormone that plays an important role in your immune system function.
Many individuals who struggle with hypothyroidism also have low levels of D. It is particularly important that those with autoimmune diseases have optimal D levels. If you do have low D levels, it's important to begin to work on this right away.
What to Do About Thyroid Problems
If you have thyroid problems, after getting proper testing here are a few more suggestions for getting your health on track. Please, of course, review all of these (after the first one) with your physician prior to making any changes.
Find a good doctor
Find one who will not only complete the appropriate tests, but will also medicate you appropriately and listen to you. Some people suggest finding a doctor who is comfortable using natural desiccated thyroid hormones (as opposed to synthroid or levothyroxine).
The doctor should be determining medication based off of the above tests as well as how you feel.
Cut out gluten
You might wish to talk with your doctor about removing gluten from your diet. Gluten is highly implicated in autoimmune thyroid disease.
Some sources that that 90% of thyroid disorders are autoimmune in nature.
Optimize Vitamin D levels
It has been said that apparently you need to have good adrenal health before increasing vitamin D so please be careful and don't self-prescribe. Vitamin D also can reduce Mg so you need to be careful about that as well.
Change Your Diet
Read this list of 5 Foods that Can Wreck Your Thyroid and see if you should eliminate some of those from your diet.
Testing Options
You can have tests ordered by your physician, but there are also some other options. UltaLabs is one option and Everlywell is another. You can get 12% off at Everlywell by entering the code EVERLY in the shopping cart.
{From Adrienne: This is a seriously important post. I have been doing a lot of digging into thyroid research recently, for reasons which I will share soon. So many people have issues with their thyroid and they don't know where to go or what to do. If you haven't already, please stay tuned to make sure you get this information. It's crucial. You can subscribe to my site by grabbing this Essential Oils free book here.
In the meantime, I would highly recommend the following books. I am not saying this is the advice you should follow (i.e. this isn't medical advice), but it is very very interesting and was very helpful to me.
Hashimoto's Thyroiditis: Finding and Treating the Root Cause
I've met the author of this book, Izabella Wentz, in person and while I never agree with everyone on everything, she really is a wealth of information. This book is a great thorough resource for those wanting to gain knowledge and action points to address Hashimoto's and start on the road to feeling better.
Trisha Gilkerson is a homeschooling mom to four crazy boys. She blogs with her awesome hubby Luke at Intoxicated on Life where they talk about faith, homeschooling, and health. They’ve authored the Write Through the Bible curriculum and family Bible Studies and have recently released their first healthy living book – Weeding Out Wheat: A Simple Faith Based Guide.
Before any Medication is prescribed in my Home Country Germany , Doctors do an ultra scan of the Thyroid gland and all the above mention tests+ testing for adrenal and para thyroid gland. Also ,if you a woman ,their asked if you go through Meno pause
are on Birth Control or any other Medication or Herbal Supplements, smoke,Alcohol, Stress or Drugs,because all that can influence your Thyroid.
If you Tests turn out positive their put you on Medication or what most choose on Herbal Supplements, You also will meet a Nutritionist you will help you to put together a healthy Diet.
I was diagnosed 4 years ago with Hypothyroid, while working in the US. According to the Physician ,my Levels where above the normal and just prescribed me the Standard Meds. I refused and told him , no other tests? Not necessary, he replied.
I took leave from work and flew home. Well I was right , my Doctor, she is also a Doc for Alternative Medicine run all the Blood work and scan my Glands and turned out that my Thyroid and para Thyroid ,adrenal working fine, Cholesterol ok, Vitamin D enough. I suffer from a severe Hormonal Inbalance due to Menopause . I took a Herbal Supplement until this year, I am post Menopause now and feeling better than ever.
I am back the US for about 6 month but in any case of getting sick again I prefer to fly home
I am glad those in Germany are doing more thorough tests. I think the hormonal imbalances can cause so much. Take good care. I hope that otherwise your time in the US is a good one. I enjoyed my time in Germany in my college years. It was brief but lovely.
Sorry for the previous “wordy” post – I think it was relevant 🙂 Could you give me the email and contact information of the woman you are working with please? Thanks in advance!
No problem at all :). I was using the author of this post: https://wholenewmom.com/health-concerns/thyroid-disease-hypothyroid-what-causes-hypothyroidism/
Now I am working with Meghan: https://meghanbirt.com/ (but I think she’s not taking new clients at present as she is expecting) and I just started with a homeopath. I’m really intrigued by homeopathy. I hope to update you all when I’m further down the road with it but so far I am very pleased.
Hi Adrienne! Thank you for your blog! I immediately noticed that you “repeatedly and consistently” state that you are not a physician, (you are NOT bashing physicians) you are simply sharing your personal experiences and continued struggles (as well as victories) as you strive to manage your chronic thyroid issues. So, THANK YOU! I’m concerned about a few of the nay-sayers that have posted insinuating otherwise? Please continue to disregard their outbursts your posts are ESSENTIAL! I’ve experienced severe “menopausal” migraines for nearly 8 years. With progressively worsening symptoms I recognized that these symptoms were very likely linked to my adrenals and thyroid more so than simply ‘menopausal’ in nature. I recently convinced my MD to take blood work in hopes that a referral to an Endocrinologist would soon follow. I received a voicemail informing me of my “High Cholesterol and critically low Vitamin D levels” accompanied by his advice to begin taking a Vitamin D supplement immediately and to begin exercising a minimum of 5 times weekly for an hour to hour and a half. I have multiple physical symptoms of Cushing’s and/or other sub-conditions that tie into adrenal exhaustion, excessive cortisol production and hypothyroidism; bilateral hyper pigmentation, atrophy, full face, catabolic indentation (atrophy) of muscle tissue in both lower arms with an identical pattern. Needles to say, I have a long road ahead of me in an attempt to find an accurate diagnosis and proper treatment. However, your insightful posts are already a huge game changer for me! I will require further testing of the Free T3 and Free T4 right away and I will not blindly begin the Vitamin D supplementation without further adrenal investigation. I’m hopeful that my symptoms are those of pseudo-Cushing’s Syndrome based on the most prominent physical symptoms appearing during a period of severe stress (excessive cortisol production) as I supported my oldest daughter through a Cancer diagnosis along with Chemotherapy and Radiation treatment while simultaneously supporting my youngest daughter as she endured a sports injury resulting in Foramenol Stenosis of her C5 and C6 vertebrae (extremely lucky there is no paralysis) and continuous attempts to alleviate her excruciating pain. Needless to say, ALL aspects of our life have a direct affect on our health. I’m truly thankful for your blog and my divine appointment while scrolling this morning! Please continue to share your insight – you’ve simplified SO MUCH for me – now I know how to start at the beginning and create the proper dialogue for my diagnosis and treatment! THANK YOU
Hi there. Thanks for your kind words! What a blessing. That is a lot of exercise! 1 hour every day? B/c of the cholesterol?
I have heard that Vitamin D lowers Mg so I currently take D with Mg and Vitamin K. I should do a post soon on Mg Oil. Take care!
I have all the symptoms of a low thyroid.
No energy joint pain dry skin losing hair.
My test results show its like one point off.
Is that enough to make me feel bad? My doctor said it’s normal but I know something is wrong. I also have elevated cholesterol.
I’m so sorry – the book about thyroid in this post might be of help to you. There are all kinds of things that can be involved. I am working w/ 2 practitioners long distance and doing better. https://wholenewmom.com/whole-new-budget/deals/free-kindle-books-crucial-thyroid-summit-healthy-living-deals-6714/
Hi,
I am glad you could know what was happening with your thyroid, I had hyperthyroidism when I was 16 and went through alot of doctora before they woukd make an accurate diagnosis…just one homeopathic doctor got it right, I got cured with homeopathic medicine,Having a gland disbalance can affect a lot your life, I hope more people can turnto homeopatic medicine because it works
So glad to hear you are doing so much better. I have not done much w/ homeopathic medicine, but hope to learn more. Thanks!
Should I stop taking my medication and just change up my diet? i buy generic synthroid online, otherwise I couldn’t afford it. I even use a half off code 50%off. If I could just fix it with my diet that would be great I’m really broke. I take generic synthroid from Canada Pharmacy Rx.
Hi there. I could never recommend your going off your meds. I am not a doctor and can’t medically advise, but I will say that I am healing just with diet and supplement and lifestyle changes. I think I would try to work w/ your doctor on this if possible. This post might be of interest: https://wholenewmom.com/health-concerns/thyroid-disease-hashimotos-blood-test/ My first practitioner told me first to go off gluten / soy / corn / eggs / dairy. Then we went from there. Again – not medical advice – this is what she told me to do.
I’m so glad I ran across your post. I have recently started undergoing blood work and a thyroid sono with my PCP. Still awaiting an appointment with an endocrinologist so I can find out more. I am so confused because my blood shows hyperthyroidism yet the results of the sono show signs of Hashi’s. I’m still learning what each of them entails and it’s hard to know what my next steps should be because they are both opposites. Hopefully I can get in to see the Dr very soon so she can tell me what exactly it is I’m dealing with and what sort of treatment I should undergo. You’ve helped me know a few questions I should ask thought. Thanks again. =)
I am so glad it helped. Did you get blood work run for TPO and TGAb? Those show the antibodies. I hope you are OK.
I would like advice on the results of my recent lab work. I have Hashimoto.
My sense of well-being tells me something is wrong, and I need to listen. From reading this post I believe my Free T4 is too low in the range ( .92 Range .82- 1.77), And my Free T3 is also low (3.0. Range 2.0 – 4.4) . Would like feedback, I think I need an increase in my dosage. Currently on Armour 90mg. I
My TSH is .633 Range. .450-4.50
Ferritin. 147. Range 15- 150
Vitamin B12. 741. Range 211-946
Vitamin D. 38.0. Range 30.0- 100
Reverse T3. 9.0. (L). Range 9.2- 24.1
I am sorry, but this is outside of the scope of my knowledge. I actually really couldn’t medically advise here, but additionally I don’t know how to interpret thyroid labs well at all. I will say that this book is one of the books most people refer to when they “know” something is wrong and don’t know what to do about it. https://amzn.to/1LMvhzN That’s an affiliate link. Take care and I hope to study up on this stuff more. I also really feel that the autoimmune paleo diet is something to look at. It made a huge difference for me. I believe I have one of the cookbooks mentioned in this post. https://wholenewmom.com/whole-new-budget/cant-miss-black-friday-healthy-living-deals-why-my-husband-didnt-want-me-to-write-this-post/
Reverse T3 was not mentioned in this article. One of the most important thyroid tests. Please can you edit the article so that it is thorough so it may help more people? I was misdiagnosed for more than 10 years because my doc wouldn’t do that test and I didn’t know about it to request it.
I took a test on the women’s healthcare site and I received a 65 what does that number mean?
I’m not sure what site you mean and we can’t medically diagnose….perhaps someone at that site can help? Thanks!