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What Can A Thyroid Test Show

The Problems With The Standard Thyroid Panel

How to test your Thyroid at home

If a patient comes to her doctor with a laundry list of hypothyroid symptoms, her doctor will most likely order a standard thyroid panel. However, the standard thyroid panel is problematic for several reasons:

  • The standard thyroid panel usually includes only TSH and T4. There are many factors involved in optimal thyroid function, and TSH and T4 dont tell the whole story. To obtain a clearer picture of a patients thyroid health, a clinician must also assess additional markers such as free T4, free T3, and reverse T3 .
  • The normal ranges for TSH and T4 vary from lab to lab. This inconsistency has the potential to confuse patients and hinder the implementation of effective treatment.
  • The lab ranges for TSH, T4, and other thyroid markers are based on a bell curve of values collected from people who go to labs for testing. Unfortunately, most people who go to labs to have bloodwork done are struggling with health issues. This means that the normal ranges for TSH and T4 are based not on values shown to promote optimal health, but rather on a range of values collected from a sick population. For this reason, it is crucial that we use functional ranges rather than standard ranges when assessing the thyroid status of our patients.
  • Think twice before prescribing thyroid hormone. These five patterns of thyroid dysfunction not only fail to show up on lab work but also tend to respond poorly to conventional thyroid hormone replacement.

    What Causes Thyroid Disease

    Various reasons cause an imbalance of hormone production in your thyroid glands. A few of them can cause hypothyroidism, and others may cause hyperthyroidism.

  • Hypothyroidism: hypothyroidism is when the thyroid glands produce hormones below the normal range. This can be due to two reasons: primary or secondary. Hashimotos disease is an autoimmune disease known as chronic lymphocytic thyroiditis or Hashimotos thyroiditis. It is hereditary, which means either a family member had it, and it is passed down to you. Your immune system consequently attacks and then damages your thyroid, preventing the glands from producing enough substance. On the other hand, the secondary cause is not directly related to the thyroid however, any other disease may interrupt the process of thyroid glands producing enough hormones.
  • 2. Hyperthyroidism: it is when the thyroid glands produce hormones above the normal range. The leading cause of hyperthyroidism is Graves disease, where your glands lose control over the production of hormones. Another cause can be thyroiditis. It is inflammation in your thyroid glands that usually occurs after pregnancy in women. TSH having abnormal secretion and excessive taking of thyroid hormones are other reasons to cause hyperthyroidism.

    Thyroid Disease Symptoms With Normal Thyroid Test Results

    The conventional way of determining thyroid dysfunction is measuring TSH. But with just one thyroid hormone level being checked we miss the chance of complete evaluation of thyroid.

    And thus thyroid dysfunction often goes unnoticed and thats the reason people have suffered for several years before finally someone checks their thyroid completely and discovers the underlying cause of the problem.

    Below I am going to talk about the reasons why are maybe experiencing thyroid disease symptoms with normal thyroid test results. your thyroid tests might be normal but why are you still feeling the symptoms:

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    Why Would I Need These Tests

    The thyroid gland‘s hormones help control some of your body’s metabolic processes, such as heart rate, blood pressure, body temperature and weight. Too much or too little of these hormones can make you ill.

    You might need thyroid tests if:

    • you have symptoms of hyperthyroidism or hypothyroidism
    • you are taking some form of thyroid hormone replacement treatment
    • you are female and being investigated for infertility

    Very rarely, babies are born without a working thyroid gland. For this reason, all Australian newborns are screened for hypothyroidism with a TSH test using a drop of blood taken from a heel prick.

    How Does The Thyroid Gland Function

    How to Properly Test Thyroid Function with Labs ...

    The major thyroid hormone secreted by the thyroid gland is thyroxine, also called T4 because it contains four iodine atoms. To exert its effects, T4 is converted to triiodothyronine by the removal of an iodine atom. This occurs mainly in the liver and in certain tissues where T3 acts, such as in the brain. The amount of T4 produced by the thyroid gland is controlled by another hormone, which is made in the pituitary gland located at the base of the brain, called thyroid stimulating hormone . The amount of TSH that the pituitary sends into the bloodstream depends on the amount of T4 that the pituitary sees. If the pituitary sees very little T4, then it produces more TSH to tell the thyroid gland to produce more T4. Once the T4 in the bloodstream goes above a certain level, the pituitarys production of TSH is shut off. In fact, the thyroid and pituitary act in many ways like a heater and a thermostat. When the heater is off and it becomes cold, the thermostat reads the temperature and turns on the heater. When the heat rises to an appropriate level, the thermostat senses this and turns off the heater. Thus, the thyroid and the pituitary, like a heater and thermostat, turn on and off. This is illustrated in the figure below.

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    How Can A Thyroid Ultrasound Help With Diagnosis

    An ultrasound can give your doctor a lot of valuable information, such as:

    • if a growth is fluid-filled or solid
    • the number of growths
    • where the growths are located
    • whether a growth has distinct boundaries
    • blood flow to the growth

    Ultrasounds can also detect a goiter, a swelling of the thyroid gland.

    What Are Thyroid Blood Tests

    A blood test is done by taking some blood from the vein to test the thyroid hormone levels. The thyroid blood test determines whether you have a thyroid disease if the range is either above or below the normal range. The initial tests that your doctor will usually recommend if you have any symptoms are TSH or T4. The normal range for thyroid is 0.40 4.50 mIU/mL.

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    Which Thyroid Tests To Order

    Comprehensive thyroid testing means testing more than just TSH and T4. TSH and T4 dont tell the whole thyroid story. If you are concerned about less than optimal thyroid function, you can request additional tests to gain clarity.

    Depending on your symptoms and medical history, the following tests can help detect less common thyroid problems and their causes:

    • Thyroid Stimulating Hormone

    Are Normal Values The Same For Everyone

    Low Thyroid Symptoms Despite Blood Tests?

    No. Whats normal for you might not be normal for the person next to you.

    Whats normal for you today will likely not be normal for you in the future.

    Your weight, stress levels, or dietary habits might change you might get pregnant, move countries, and more. These variables and your genes will determine your normal values for any given moment in your life.

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    Mildly Hypothyroid Subclinical Hypothyroid And Hypothyroid Whats The Difference

    Theres a big difference between subclinical, mildly hypothyroid, and hypothyroid. These diagnoses determine the treatment options youll be offered.

    Usually doctors wont prescribe thyroid therapy until a patient is clearly hypothyroid. Symptoms typically become stronger as hypothyroidism intensifies.

    However, even mild hypothyroidism can be aggravating as TSH levels and symptoms increase. Talk to your doctor to determine your personal normal ranges and the best therapy to undertake. Logging your blood test results in the app might help you and your doctor when assessing your health.


    1. Carvalho GA, et al. The clinical use of thyroid function tests, 2013

    2. Wartofsky L, et al. The evidence for a narrower thyrotropin reference range is compelling, 2005

    3. Hollowell JG, et al. Serum TSH, T, and thyroid antibodies in the United States population : National Health and Nutrition Examination Survey , 2002

    4. Dunn JT. Guarding our nations thyroid health, 2002

    5. Hubner U, et al. Continuous age-dependent reference ranges for thyroid hormones in neonates, infants, children and adolescents established using the ADVIA Centaur Analyzer, 2002

    6. Surks MI, et al. Age-specific distribution of serum thyrotropin and antithyroid antibodies in the US population: implications for the prevalence of subclinical hypothyroidism, 2007

    7. Kumar A, et al. Thyroid function tests in pregnancy, 2013

    10. Lewandowsky K. Reference ranges for TSH and thyroid hormones, 2016

    What Do Thyroid Antibodies Tell You

    Three antibodies related to autoimmune thyroid diseases can tell what type of autoimmune disease a person has, and how severe or advanced it might be.

    • Anti-thyroglobulin High levels of TgAb are present in 8 in 10 patients with Hashimotos and in 4 in 10 of people being diagnosed with Graves disease.
    • Anti-thyroperoxidase High levels of TPOAb are found in 9 in 10 patients with Hashimotos and 8 in 10 of patients with Graves disease.
    • Anti-TSH receptor High levels of TRAb are found in 9 in 10 patients with Graves disease and in less than 2 in 10 patients with Hashimotos.

    Its important to note that high levels of either TgAb or TPOAb can be found in 1 in 10 of people without an autoimmune thyroid disease, as well as in 2 in 10 of people that are considered healthy.

    Theres also a small percentage of people with autoimmune diseases who have no antibodies detected.

    TPOAb testing in early pregnancy can predict if a person is at risk of developing postpartum thyroiditis. Postpartum thyroiditis occurs in about 1 in 10 people after giving birth. About 5 in 10 of pregnant people with high TPOAb will develop postpartum thyroiditis .

    TgAb or TPOAb are found in 1 in 10 healthy people, more likely females and elderly people .

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    Why Are Thyroid Blood Tests Necessary

    A thyroid test is essential if certain symptoms show up. The prevailing symptoms may worsen your condition. To diagnose the cause of those symptoms, you will need a thyroid blood test to be done. Thyroid disease can interfere with your day-to-day activities. For example, it becomes difficult to walk or do little chores because of extreme fatigue simply. Once you get done with the thyroid test, either you have the disease or not. If you are diagnosed with thyroid disease, then the symptoms can be managed by consulting the doctor. On the other hand, if your range is normal, then other areas can be investigated.

    The Eight Blood Tests You Need To Assess Thyroid Function

    How to Test Your Thyroid Function at Home

    December 6, 2017 by Megan

    You didnt read that wrong. Thats right. I said the EIGHT blood tests for thyroid function assessment that you need to have run.

    Now hold on, you think. My doctor only runs TWO blood tests for thyroid function TSH and T4. What am I missing??

    Six other blood tests. Thats what youre missing.

    Yes, TSH and T4 are important in the big picture of thyroid health, but without the other 6, MANY thyroid conditions often go undiagnosed. So you could be feeling like crap, wondering whats going on because your thyroid is normal according to your doctor.

    Alright, lets get to it. Here are the EIGHT MOST IMPORTANT blood tests you need to have run in order to assess proper thyroid function.

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    Everything You Need To Know About Thyroid Blood Tests

    The thyroid is a gland that produces certain substances. These substances circulate in your body to do specific functions to regulate your daily activities. The gland is responsible for making hormones if these hormones are imbalanced, it causes thyroid disease. It can ultimately affect the functions of your whole body.

    Hypothyroidism Caused By Elevated Tbg

    Thyroid-binding globulin is the protein that transports thyroid hormone through the blood. When thyroid hormone is bound to TBG, it is inactive and unavailable to tissues. High levels of TBG reduce levels of free thyroid hormone, causing hypothyroid symptoms. 59363-7/abstract” rel=”nofollow”> 13) Patients with this pattern have normal TSH and T4, low T3, high T3 uptake and high TBG.

    Elevated estrogen can raise TBG and cause hypothyroidism. Estrogen may become elevated due to the use of birth control pills and estrogen hormone replacement therapy. The treatment for this pattern is to clear excess estrogen from the body.

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    Lab Tests Of Biopsy Samples

    In some cases, doctors might use molecular tests to look for specific gene changes in the cancer cells. This might be done for different reasons:

    • If FNA biopsy results arent clear, the doctor might order lab tests on the samples to see if there are changes in the BRAF or RET/PTC genes. Finding one of these changes makes thyroid cancer much more likely.
    • For some types of thyroid cancer, molecular tests might be done to see if the cancer cells have changes in certain genes , which could mean that certain targeted drugs might be helpful in treating the cancer.

    These tests can be done on tissue taken during a biopsy or surgery for thyroid cancer. If the biopsy sample is too small and all the molecular tests cant be done, the testing may also be done on blood that is taken from a vein, just like a regular blood draw.

    In People Being Treated For Thyroid Disease

    Thyroid Self Test: 4 Ways to Check your Thyroid at Home

    A high TSH may be found in people being treated for either hypo- or hyperthyroidism.

    With hypothyroidism, a high TSH usually means that the dose of thyroid hormone replacement needs to be increased.

    In some cases, however, the dose is OK, but the medication is not being fully absorbed. For example, many foods and medications can affect the absorption of Synthroid in your system. Learning what to avoid while taking this medication is important for it to work properly.

    With hyperthyroidism, a high TSH usually means that the treatmentbe it surgery, radioactive iodine, or medicationswas so effective in limiting the production of thyroid hormone it caused the person to become hypothyroid.

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    Five Thyroid Patterns That Wont Show Up On Standard Lab Tests

    In medicine, accurate diagnosis is essential for selecting the most effective course of treatment for a patient. Unfortunately, misdiagnosis is commonplace in the management of hypothyroidism. Countless patients with hypothyroid symptoms are dismissed because their lab values dont fit within the narrow diagnostic criteria established by standard thyroid panels others are given prescriptions for thyroid hormone replacement, a blanket approach that fails to address the underlying causes of hypothyroidism. Many of these patients suffer from patterns of thyroid dysfunction that dont show up on standard lab tests and that are unfamiliar to conventional doctors. Read on to learn about the five patterns of thyroid dysfunction that are missed by standard lab tests and how you can successfully correct these patterns and restore thyroid health in your patients.

    What Are The Different Symptoms Of Thyroid Disease

    Hypothyroid symptoms can include:

  • excessive weight loss
  • period flow may decrease
  • A thyroid nodule may not be detected or felt unless it starts to hurt or increase in size. It is sporadic to have such symptoms as only a very few numbers of individuals develop cancerous nodules. However, the cyst can be felt in the throat when the doctor investigates. The cyst may contain blood or fluid.

    To conclude: the symptoms mentioned above may not necessarily happen to you. There are high chances that the symptoms may determine what type of thyroid disease you have. But the doctors cannot diagnose the thyroid type only considering your symptoms. The test is necessary to manage the symptoms.

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    Why A Standard Thyroid Test May Be Wrong

    By: Cat Ebeling, BSN,co-author of the best-sellers: The Fat Burning Kitchen,The Top 101 Foods that Fight Aging& The Diabetes Fix

    You are fatiguedbeyond what a good nights sleep would help, you lack energy, youve gained weight, you feel chilly most of the time, you may even be slightly depressed. You dont even have the energy to follow any kind of fitness program.

    Youve been catching every cold or flu going around, so you go to your physician and he does some blood work. The doctor checks your thyroid, but he tells you, Your TSH is in the normal range, so your thyroid is fine. He sends you home with some vitamins, tells you to get a good nights sleep or even worse, says its all in your head, and offers you an anti-depressant.

    Back to square one? Why DO you feel tired all the time? Even if your physician is telling you your thyroid is normal, it may not be. Unfortunately, most physicians will only do a standard test for thyroid dysfunction which is the TSH test. TSH stands for Thyroid Stimulating Hormone.

    Around 30 million people suffer from thyroid disorders. More than half of those have no idea their poor health and low energy is related to thyroid problems. One in eight women will develop a thyroid disorder at some point in their lives, and the number of people suffering from dysfunctional thyroid is increasing every year. Some studies have suggested that up to 10 percent of women over 60 have diagnosed or un-diagnosed hypothyroidism.

    How To Test For The Five Thyroid Patterns

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    The standard thyroid panel is insufficient for detecting these five patterns of thyroid dysfunction. Additional tests are needed to determine which thyroid pattern is affecting your patient.

    A comprehensive panel of thyroid markers: This panel should include TSH, T3, T4, free T3, and free T4.

    DUTCH test for assessing HPA axis function: This test can help you determine whether chronic stress and high cortisol are causing pituitary dysfunction, under-conversion of T4 to T3, or thyroid hormone resistance.

    Estrogen and testosterone: Measuring these hormones can help you determine whether elevated or decreased TBG, respectively, are the cause of your patients hypothyroidism.

    Fasting blood sugar and hemoglobin A1c, to assess blood sugar imbalances and insulin resistance, which contribute to hypothyroidism caused by pituitary dysfunction.

    Ferritin and serum selenium, to identify deficiencies of iron and selenium.

    Assess gut health: Stool testing, hydrogen breath testing for SIBO, and a urine organic acids profile can be used to identify potential gut infections and dysbiosis contributing to hypothyroidism.

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