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What Is Included In A Complete Thyroid Panel

Symptoms Of Low Thyroid That Require A Complete Thyroid Panel

What Lab Tests are in a Comprehensive Thyroid Panel?

July 6, 2018//;;by;Dr Hagmeyer

Hey everybody Dr Hagmeyer here and todays video is on the 12 Signs Of An Under-Active Thyroid. Maybe you have been suspecting a thyroid problems for a while and you went to your doctor complaining of low thyroid symptoms- only for your doctor or the nurse to call you and tell you that your thyroid is completely fine.

Is it possible to have a thyroid problem with normal thyroid testing. This is tricky question and a question I am asked daily. So lets dive into these symptoms a little bit and then I will let you know what you want to do if you can related to more than three of these symptoms.

How Is The Test Used

A thyroid panel may be used to evaluate thyroid function and/or help diagnose thyroid disorders.

Typically, the preferred initial test for thyroid disorders is a TSH test. If the TSH level is abnormal, it will usually be followed up with a test for free T4. Sometimes a total T3 or free T3 will also be performed. Often, the laboratory will do this follow-up testing automatically. This is known as reflex testing and it saves the healthcare practitioner time from having to wait for the results of the initial test and then requesting additional testing to confirm or clarify a diagnosis. Reflex tests are typically performed on the original sample that was submitted when the initial test was requested.

As an alternative, a thyroid panel may be requested by your healthcare practitioner. This means that all three tests will be performed at the same time to get a more complete initial picture of thyroid function.

Keeping Tabs On Your Thyroid Health With A Thyroid Panel

If youve been concerned that your symptoms such as fatigue, weight gain, or hair loss are coming from a thyroid problem, running a thyroid panel is one of the first steps to take to learn more.

A thyroid panel is simply a collection of thyroid blood tests. Leaving a thyroid imbalance uncorrected can have health consequences, and a thyroid panel is the primary tool you can use to guide your diagnosis and treatment.

There are a few different schools of thought about thyroid panels. Some doctors will only look at your thyroid stimulating hormone , while others will run a complete and complex thyroid panel to monitor different markers. But which approach is best?;

In this article, well cover what a thyroid panel is and which markers are most important to monitor. Well also discuss when you would want to run a thyroid panel, what it tells you, and what to do with your thyroid panel results.

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Sexually Transmitted Disease Tests

Many sexually transmitted diseases can be diagnosed using a blood sample. These tests are often combined with urine samples or swabs of infected tissue for more accurate diagnoses.

The following STDs can be diagnosed with blood tests:

Blood tests arent always accurate right after contracting an infection. For an HIV infection, for example, you may need to wait at least a month before a blood test can detect the virus.

Is There Anything Else I Should Know


In the past, panels of tests were more common. More recently, however, the practice has been to order, where possible, one initial or screening test and then follow up with additional testing, if needed, to reduce the number of unnecessary tests. With thyroid testing, one strategy is to screen with a TSH test and then order additional tests if the results are abnormal or if clinical suspicions warrant.

Your thyroid hormone test results can be affected by:

  • Increases, decreases, and changes in the proteins that bind T4 and T3
  • Pregnancy

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How To Test For Thyroid Problems At Home

How to check your thyroid hormones at home?

The Everlywell at-home thyroid test can tell you if your thyroid hormone levels suggest hypothyroidism. This test requires only a few drops of blood as a sample. After getting your online test results, you can easily see your levels of thyroid-stimulating hormone , free T3 and T4, and TPO antibodies. High TSH and/or low T3 and T4 can indicate hypothyroidism.

You can also take our thyroid test at home to check your hormones for indications of hyperthyroidism. Hyperthyroidism means your thyroid gland is overactive: it√Ęs producing too many hormones. Low levels of TSH and/or high T3 and T4 can suggest hyperthyroidism.

What Is The Thyroid Gland

The thyroid gland is a butterfly-shaped endocrine gland that is normally located in the lower front of the neck. The thyroids job is to make thyroid hormones, which are secreted into the blood and then carried to every tissue in the body. Thyroid hormones help the body use energy, stay warm and keep the brain, heart, muscles, and other organs working as they should.

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Does Cmp Include Thyroid


The Comprehensive Metabolic Panel measures blood sugar levels, electrolyte and fluid balance, kidney function, and liver function. The CMP aids in determining how the liver and kidneys are functioning and where glucose, calcium, protein, sodium, potassium, and chloride levels stand.

One may also ask, what is the difference between CMP and BMP? The CMP is an expanded version of the basic metabolic panel , which does not include liver tests. A CMP can be ordered as part of a routine physical examination, or may be used to monitor a patient with a chronic disease, such as diabetes mellitus or hypertension.

Similarly, you may ask, is prealbumin included in CMP?

A variety of prescription and over-the-counter drugs can affect the results of the components of the CMP. The CMP is made up of 14 tests; the basic metabolic panel is a subset of those and has 8 tests. It does not include the liver and protein tests.

Does CMP include CBC?

A CBC also helps your health professional diagnose conditions, such as infection, anemia, and several other disorders. Comprehensive Metabolic Panel with eGFR is a group of 14 laboratory tests ordered to give information about the current status of your liver, kidneys, and electrolyte and acid/base balance.

Do You Know Your Thyroid Numbers

What tests does a full thyroid panel consist of?

If you read our other post about thyroid health, you now know a lot about this important organ, including what it is, what it does, symptoms and possible causes of thyroid issues, and how diet can play a role in managing thyroid health.

We now want to talk more about the medical aspect to thyroid health your lab values. Labs are the best way to know the details of whats going on with your thyroid, but you have to have the right information. So were diving into what exactly a full thyroid panel is, and why you may need one.

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What Imaging Tests Do Doctors Use To Diagnose And Find The Cause Of Thyroid Disease

Your health care professional may order one or more imaging tests to diagnose and find the cause of thyroid disease. A trained technician usually does these tests in your doctors office, outpatient center, or hospital. A radiologist, a doctor who specializes in medical imaging, reviews the images and sends a report for your health care professional to discuss with you.

What Is Reverse T3

Reverse T3 is a biologically inactive form of T3. Normally, when T4 is converted to T3 in the body, a certain percentage of the T3 is in the form of RT3. When the body is under stress, such as during a serious illness, thyroid hormone levels may be outside of normal ranges even though there is no thyroid disease present. RT3 may be elevated in non-thyroidal conditions, particularly the stress of illness. It is generally recommended that thyroid testing be avoided in hospitalized patients or deferred until after a person has recovered from an acute illness. Use of the RT3 test remains controversial, and it is not widely requested.

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What Blood Tests Do Doctors Use To Check Thyroid Function

Doctors may order one or more blood tests to check your thyroid function. Tests may include thyroid stimulating hormone , T4, T3, and thyroid antibody tests.

For these tests, a health care professional will draw blood from your arm and send it to a lab for testing. Your doctor will talk to you about your test results.

What Each Lab Means

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  • TSH: High TSH levels mean the thyroid gland is not making enough of this hormone , while low levels mean it is making too much . However, it should always be checked within a larger context of thyroid labs.;
  • Free T4:;High free T4 can indicate an overactive thyroid while low levels can indicate underactive thyroid function .
  • Free T3: High free T3 also indicates overactive thyroid. Low levels may mean that your body isnt converting T4 into T3 very well and may indicate hypothyroidism even if TSH and free T4 are within the normal range.
  • Reverse T3: High reverse T3 may mean that not enough free T4 is being converted into free T3, and can cause symptoms of hypothyroid even if TSH and T4 are normal. Chronic stress and high cortisol levels can raise reverse T3.
  • Thyroid antibodies:;High levels of either lab indicate that the immune system is attacking the thyroid and can be a basis for diagnosing an autoimmune condition.

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What Are Normal Thyroid Hormone Levels

The thyroid itself is regulated by another gland that is located in the brain, called the pituitary. In turn, the pituitary is regulated in part by the thyroid and by another gland called the hypothalamus.

The hypothalamus releases a hormone called thyrotropin releasing hormone , which sends a signal to the pituitary to release thyroid stimulating hormone . In turn, TSH sends a signal to the thyroid to release thyroid hormones. If a disruption occurs at any of these levels, a defect in thyroid hormone production may result in a deficiency of thyroid hormone .

Hypothalamus – TRH

Thyroid – T4 and T3

The rate of thyroid hormone production is controlled by the pituitary gland. If there is an insufficient amount of thyroid hormone circulating in the body to allow for normal functioning, the release of TSH is increased by the pituitary gland in an attempt to stimulate more thyroid hormone production. In contrast, when there is an excessive amount of circulating thyroid hormone, TSH levels fall as the pituitary attempts to decrease the production of thyroid hormone.

  • In persons with hypothyroidism , there is a continuously decreased level of circulating thyroid hormones.
  • In persons with hyperthyroidism , there is a continuously elevated level of circulating thyroid hormones.

What More Should I Know About Thyroid Blood Tests

Ranges noted here are approximate; your providers may differ slightly. Its important that you remember abnormal readings do not necessarily mean a thyroid disorder is present, as each test can be affected by a variety of factors.

No preparation is required for these tests. They can be taken any time of day without fasting.

Last reviewed by a Cleveland Clinic medical professional on 12/27/2019.


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Support Gut Health To Improve Thyroid Function

Thyroid-like symptoms or a poor response to thyroid medication may be due to an imbalance in your gut. Gut imbalances like IBS [14

  • Follow an anti-inflammatory diet, such as the paleo diet.
  • Take quality probiotic supplements to restore balance to your gut ecosystem.
  • Reduce stress and prioritize good sleep.
  • For a more comprehensive discussion of how to optimize your gut health, check out my book, Healthy Gut, Healthy You.

    What To Ask Your Doctor To Test:

    What’s a Complete Thyroid Panel?

    Complete Thyroid Panel:;TSH,;Free T4,;Free T3,;Reverse T3,;TPO Antibodies,;Anti-TGB Antibodies

    Vitamins and minerals: These are key in converting T4 hormone to T3 : Ferritin, vitamin D and B12 at the very least.

    Sugar levels: glucose ,;HA1C and insulin.

    Lipid Panel: Total cholesterol, LDL, HDL triglycerides.

    If you want a printed copy of the above labs, grab a copy of the Thyroid Lab Checklist here.

    Bring it to your doctor, it will feel empowering to be in the know. If your doctor dismisses you, find one that will do the complete tests.

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    What Is Being Tested

    A thyroid panel is a group of tests that may be ordered together to help evaluate thyroid gland function and to help diagnose thyroid disorders. The tests included in a thyroid panel measure the level of thyroid hormones in the blood.

    A thyroid panel usually includes tests for:

  • Free T3 or total T3
  • Although rarely used these days, sometimes a T3 resin uptake test is included. T3RU and T4 can be used to calculate a free thyroxine index . This is another method for evaluating thyroid function. It corrects for changes in certain proteins that can affect total T4 levels.

    The thyroid is a small butterfly-shaped organ that lies flat across the windpipe at the base of the neck that produces thyroid hormones, primarily T4 and some T3. These hormones travel throughout the body and regulate the metabolism by telling the cells in the body how fast to use energy and produce proteins. Most of the hormone produced by the thyroid is T4. This hormone is relatively inactive, but it is converted into the much more active T3 in the liver and other tissues.

    Almost all of the T3 and T4 circulating in the blood is bound to protein. The small portions that are not bound are called “free” and are the biologically active forms of the hormones. Lab tests can measure the amount of free T3 or free T4 or the total T3 or total T4 in the blood.

    The body has an elaborate feedback system to control the amount of T4 and T3 in the blood.

    Why Should I Do Wellness Testing

    Dogs are very good at masking illness and disease that may be present. If a disease can be detected early on, before a pet shows signs of illness, then steps can often be taken to manage or correct the problem before permanent damage occurs. Wellness testing is particularly important in senior dogs, since there is a greater chance that an older animal will develop disease or have an ongoing but stable condition that needs to be monitored.

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    What To Do With Your Thyroid Paneltest Results

    In many cases, your out-of-balance thyroid panel results dont require any action. A significant number of subclinical hypothyroidism cases or elevated thyroid antibodies return to normal on their own without treatment [12

    But even if your thyroid panel reveals you have a thyroid disorder, theres no reason to despair. Thyroid conditions can and do respond well to treatment.

    At a very high level, treating thyroid disease involves a three-step approach:

  • Take standard thyroid medication to bring thyroid hormone levels up to a normal range.
  • Use gut-healing therapies to resolve symptoms.
  • Retest thyroid hormone levels and adjust medications as needed.
  • Lets further discuss how you can use this approach to improve your thyroid function.

    Reason #5: The T4 To T3 Conversion Issues

    Basic Thyroid Panel

    There is a list of vitamins and minerals that are key in converting T4 to T3. Vitamin and mineral deficiencies are very common in most people today. This is due to a combination of reasons poor soil conditions of the food we grow, poor diet but also the highly compromised absorption ability of our gut.

    When we experience poor digestive health even supplements cant help as the gut lining is just not absorbing the goodness of the food we are eating.

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    The Five Thyroid Patterns

    Thyroid physiology is complex and regulated by input from multiple endocrine glands, the immune system, the gut, and many cell-signaling molecules. Malfunctions in any one of these components can cause hypothyroid symptoms. However, these malfunctions are not revealed by a standard thyroid panel. Patients with hypothyroid symptoms but normal TSH and T4 according to the standard thyroid panel may be told that nothing is wrong with their thyroid glands and sent on their way. Some are handed prescriptions for thyroid hormone replacement. This one-size-fits-all approach to managing hypothyroidism ignores the multitude of factors that influence thyroid function and may even worsen symptoms in some patients. At best, it does our patients a disservice, and at worst it could be considered sheer negligence.

    T3 Resin Uptake Results

    A T3 resin uptake, also known as a T3RU, is a blood test that measures the binding capacity of a hormone called thyroxin-binding globulin . If your T3 level is elevated, your TBG binding capacity should be low.

    Abnormally low levels of TBG often indicate a problem with the kidneys or with the body not getting enough protein. Abnormally high levels of TBG suggest high levels of estrogen in the body. High estrogen levels may be caused by pregnancy, eating estrogen-rich foods, obesity, or hormone replacement therapy.

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    Does Your Thyroid Panel Include These Markers If Not

  • TSH,
  • Reverse T3,
  • TPO antibodies and TGB antibodies-
  • The T3 and Reverse T3 markers are used to look at the T3/Reverse T3 ratio and the last two markers help in identifying an autoimmune disease called Hashimotos which incidentally accounts for the majority of hypothyroid cases in the US.

    If you dont have these Thyroid biomarkers or your doctor wont run a Complete Thyroid Panel you can purchase a complete Panel and consult here

    If you have a free T3 and Reverse T3 levels you can go to my website watch a video that explains how to calculate your ratio.

    So there you have it folks- hope you found todays video helpful I hope it sheds some light on why your levels might seem normal range despite having symptoms.

    I hope you understand why its so important to have more than a TSH and T4 test done.

    If you are looking for more information in understanding your thyroid lab values I put together a free guide titled 5 patterns of thyroid disease that dont show up on standard blood testing If you want to see that I will put a link in the description- click on the link and you can download your free copy.

    If you want to order a complete Thyroid Panel and consultation with me use the link here


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