Which Thyroid Test Should You Get?
Inside: What Thyroid Tests To Ask For? Various Testing for Thyroid Function and antibodies. Optimal Thyroid Test Result Charts
One of the most common questions that I get asked is that What all tests do I need to get to check my thyroid completely?
It’s so unfortunate that most of the patients that I have seen have not gotten the complete thyroid panel.
Majority of the time the only test they get is TSH. Even though these patients have classical symptoms of thyroid dysfunction but nobody has even thought about doing the complete thyroid panel for them.
The reason is that to date the recommendations in the conventional medicine world are to just order TSH to check for thyroid dysfunction.
But often if we just do one test to check for thyroid dysfunction we miss the opportunity to diagnose several other cases who we can help. Unless you have the correct diagnosis how are you going to improve your symptoms?
And even for people who are taking thyroid medicine the only way their medicine is adjusted is based on this test called TSH. And it’s no surprise that several people who are taking thyroid medicine continue to suffer from symptoms.
It is because often they are under-treated or overrated. Also if we just do one test then we don’t know if levothyroxine is the right medicine for you or we need to change your thyroid medicine.
So because of the above reasons its very important to get a complete thyroid panel so that in-depth testing can be done. And you get the best treatment possible to improve the symptoms.
But now we know that TSH alone is not enough to check for a thyroid condition. Also, the thyroid function test interpretation is different for Conventional and Functional medicine physicians.
Thyroid hormone production is a complicated process.
And thus checking for its dysfunction is not as easy as ordering just one test. There are so many different parameters that affect thyroid gland functioning.
We need to do a comprehensive evaluation which not only includes thyroid hormone levels, but also the antibodies which affect thyroid gland functioning.
This section included tests that measure the functioning of the thyroid gland. Here again, TSH alone is not helpful as that’s not the only thyroid hormone that is produced in your body.
So to completely check your thyroid hormone levels in your body you need to do more detailed testing and it is also important to know thyroid function test normal values.
1. TSH: So TSH levels are the most common thyroid test which is being done.
The TSH range is generally very wide and it is 0.4 – 4.5uIU/ml. But then I feel this range should be between 1.5 – 3 uIU/ml.
2. T4 Levels: You need to get total and free T4 levels checked. T4 is the major hormone that is secreted by your thyroid gland so we need to know whether your thyroid gland is in good shape to produce thyroid hormone or not.
Levothyroxine is a T4 hormone that is given to improve your thyroid disorder. So important to check these levels as this can help to properly dose your levothyroxine medicine.
T4 levels range are generally 0.8 – 1.7 ng/dl. But for me, the optimal value should be more than 1.0 ng/dl.
3. T3 levels: Here we will like to check free T3 levels. T3 is produced from T4 majorly. Your T4 in the body gets converted to T3 and this T3 is the active form of thyroid hormone.
If free T3 is not within normal range then it can signify under treatment of thyroid or it might also mean that you might need to add T3 hormone medicine.
The Free T3 normal range is between 2.0 -4.4 pg/ml. But the optimal range should be around 3 pg/ml
4. Reverse T3: Now reverse T3 is another kind of thyroid hormone which is present in our body. This is an inactive version of the thyroid hormone and there is some concern that actually it interferes with the functioning of the T3 hormone.
If high levels of reverse T3 are present then it can interfere with the proper functioning of the T3 hormone. So that’s the reason to check it also.
The Reverse T3 levels range is between 9-24 ng/dl. So anything more than 20ng/dl is considered high.
Hashimoto’s and Graves are autoimmune diseases and they are often missed if we don’t order the antibody tests.
It is also important because often the antibody level can be detected much earlier than the changes in thyroid hormones.
1. Thyroglobulin antibodies: These are the most common antibodies which are elevated in Hashimoto’s disease. These antibodies are against the thyroglobulin protein in your thyroid gland. These antibodies lead to the destruction of the thyroid gland.
So important to get this antibody checked to make sure that this antibody is not elevated because that will mean you have Hashimoto’s disease.
The optimal thyroid levels for Hashimoto’s disease should be < 4.0 IU/ml
2. Thyroid peroxidase antibody ( TPO antibodies): This is also another set of antibodies that are elevated in autoimmune thyroid disease. They are elevated in 95% of Hashimoto’s disease and 50% of Graves disease.
So another important antibody to get checked so we don’t miss what kind of thyroid disorder that you have.
The optimal thyroid levels for Hashimoto’s disease should be<9 IU/ml
So this is the complete thyroid panel that everyone should get. Below is the thyroid test results chart
|Name of the test||Range as per lab||Optimal thyroid function test normal values|
|TSH||0.4 – 4.5uIU/ml.||1.5 – 3 uIU/ml.|
|T4||0.8 – 1.7 ng/dl.||1.0- 1.7 ng/dl.|
|Free T3||2.0 -4.4 pg/ml||3-4 pg/ml|
|Reverse T3||9-24 ng/dl.||< 20ng/dl|
|Thyroglobulin antibodies||< 4.0 IU/ml||< 4.0 IU/ml|
|Thyroid peroxidase antibodies||<9 IU/ml||<9 IU/ml|
Overall, it is not only important to get complete thyroid testing done, but also important to know thyroid function test normal values. Very often all the tests are not being performed to completely evaluate the thyroid gland, this leads to improper management of thyroid hormone replacement.
Also, optimal thyroid levels for Hashimoto’s should also be known as that’s the only way you know whether your condition is getting better or not.
Dr. Anshul Gupta MD is Board-Certified Family Medicine Physician, with advanced certification in Functional Medicine, Peptide therapy and also Fellowship trained in Integrative Medicine.Continue Reading…
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