Thyroid Lab Work- Why your doctor probably won’t order the right labs & what to ask for instead

Welcome back to our thyroid disease series.  Last time, we looked at what the thyroid is and some of its functions within our bodies.  Today let’s talk a bit about thyroid lab work and the process for getting a proper diagnosis.

Many patients with thyroid disease report that it took them 5+ doctors to *finally* obtain a diagnosis.  Even then, it’s not uncommon for thyroid patients to have to request their own labs. They then have to do legwork & research on their own or with an alternative care provider. Only then do people finally figure out what thyroid disease they have, why they developed it, and the best course of treatment.

What are the labs doctors will look at for diagnosing thyroid disease?

The TSH (thyroid stimulating hormone) lab is the most common drawn thyroid lab.  Unfortunately, this lab is inconsistent and doesn’t give a whole lot of information regarding why the thyroid is out of balance.  This lab can vary greatly based on your stress levels, how the last couple of days have been, and even how you slept the night before.  This is often the only thyroid lab practitioners will draw and it really doesn’t tell us anything except a tiny snapshot of that exact moment in time.

It can take footwork for thyroid patients to get a comprehensive picture of what’s going on.  There is a lot of information out there to help people understand optimal values vs “normal”, and how to interpret the labs.   A functional medicine doctor, naturopath or another holistic healthcare provider may also be able to help, depending on the laws in your state.

Patients that are treated with only TSH results often find their symptoms don’t diminish or have an increase in symptoms sometimes.  

TSH can change throughout the day, with the person’s body temperature, and even based on their stress levels. Plus, there’s a lot of debate about the TSH range.  “Normal” is considered under 5 by most doctors. However, many thyroid disease experts are advocating for the range to be under 2, as most people feel best with a TSH under 2.

When looking at any lab work, it’s helpful to research the “optimal” levels vs the “normal” levels.  Many women test “normal” but are still treated until they get into “optimal” range and report a significant decrease in symptoms.  

It’s useful to have additional lab work drawn.  This helps to give an indication of what part of the thyroid is imbalanced, if the thyroid disease is autoimmune or not, and how balanced some of the other minerals & hormone levels that influence thyroid health are.  

Additional labs to ask for  are:

• TPOAb & TgAb are thyroid antibody tests which will help determine if the thyroid problem is autoimmune or not.

• Free T3, Reverse T3 & Free T4, Total T3 Triiodothyronine, – these are thyroid hormone labs which help give a better picture of what area of the thyroid is out of balance.

• Iron, Vitamin D, Magnesium, Selenium, Potassium, Cortisol, B12, and other vitamin  & mineral levels depending on symptoms.

• Many practitioners also suggest testing sex hormones, gene mutations, parasite testing, adrenal levels, mold toxicity, food allergies,  and a comprehensive stool test.

Adrenal fatigue and thyroid problems often go together, so don’t be surprised if testing includes adrenal and thyroid labs.  Pituitary dysfunction also occurs alongside thyroid issues often. Testing the pituitary can be incredibly helpful in uncovering the root cause of illness.

Comprehensive lab work can be extremely beneficial in diagnosing and treating thyroid disease.  

Many thyroid patients order their own labs through online clinics and do a lot of the legwork themselves.  There’s a good number of resources online to help find a comprehensive practitioner that can help.

Join me next time to learn more about some of the causes of thyroid disease.

This information is for educational purposes only. It is not intended to diagnose, treat, or cure any health issues.  A healthcare practitioner should always be consulted if you have concerns about your health.