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.
Thyroid Stimulating Hormone Testing
Thyroid Stimulating Hormone is produced in a part of your brain called the pituitary gland. The job of TSH is to tell the thyroid gland that its time to get busy producing more thyroid hormone. When the healthy thyroid gets this chemical message, it produces two hormones: triiodothyronine and thyroxine ,
The normal range for TSH is somewhat controversial. Most labs consider the upper range to be between 4 and 5 mU/L. However, many experts even in conventional endocrinology believe that the upper end of normal is actually more like 2.5-3 mU/L. This is based on the fact that when Americans without any hypothyroid symptoms have this testing done, that is the most usual upper range.
Many integrative and functional medicine doctors find that their patients feel their best at an upper limit of 1.5-2 mU/L.
My patient was one of these people. At a TSH of 4 she was really at the upper limit of normal, over the preferred upper limit according to some docs, and well over the 1-2 mU/L upper range! This controversy and discrepancy of opinion over the normal upper range for TSH is one of the most common reasons that women get under-diagnosed for hypothyroidism and suffer with unnecessary symptoms that can seriously interfere with health and quality of life.
Does High TSH Mean Hypothyroidism?
How To Order Your Lab Tests
If your doctor is ordering thyroid labs for you, be sure to request a copy so that you can see them for yourself and ensure that they are interpreted correctly.
Additionally, I have included self-order options for most of the labs discussed, in case your current doctor wont order the labs for you.
The self-order options are discounted panels that I set up with Ulta Labs and can be ordered almost anywhere in the U.S. . You will receive a lab order that can be taken to your local lab, and the results will be sent to you electronically.
You can order each individual test that I recommend below, or you can order the entire discounted panel here.
In many cases, you can self-order the labs and then send the receipts for reimbursement to your insurance.
Now, lets take a look at each thyroid test and what they mean for your thyroid health.
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Talking With Your Medical Provider
As a doctor, I can tell you that in medical school we are taught that doctors know best. But this is often not the case. You are your bodys best expert. After all, you live with you all the time! And you have a right to ask for basic hypothyroid testing and receive it. Were not talking about tens of thousands of dollars in MRIs and CT scans here were talking about modest amounts of blood work.
That said, do discuss your symptoms with your doctor because theres a lot of hype in the natural medicine and natural products world, and your doctor is possibly just trying to protect your from the opposite problem getting OVER-diagnosed or misdiagnosed with a thyroid problem and believe me, Ive also had many patients who were put on thyroid medications by integrative practitioners when these meds were not needed.
If you are unable, however, to have an honest conversation with your doctor, if you feel your doctor is not listening or is condescending, then thats another issue. You should be able to have mutually respectful conversations with your care provider, to get the answers you are seeking, and to be able to explore your concerns. If you can’t, then figure out whether the obstacle is in your being unable to speak up because of a perceived power differential or whether your doctor is just not communicating respectfully. And make the change!
What Is Being Tested
Thyroid function tests are used to check for a number of thyroid problems. The tests measure the amount of different hormones including thyroid stimulating hormone , thyroxine , and triiodothyronine . Other tests on the thyroid include various antibodies related to thyroid tissue.
TSH is produced by the pituitary gland in the brain. TSH is carried in the blood to the thyroid gland, which sits at the front of the neck. From there, TSH influences how much T4 and T3 are released into the blood.
TSH, T3 and T4 levels can all be tested in the blood. Your doctor will probably test TSH first, then T3 and T4 if TSH is abnormal. Tests can also be used to measure antibodies to diagnose autoimmune thyroid disease.
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When You Should Get Your Thyroid Checked
Because the thyroid impacts so many processes in the body, thyroid tests are pretty routine. But despite the wide array of symptoms that can be caused by a thyroid issue, these tests arent helpful in diagnosing every possible condition. By familiarizing yourself with the symptoms that could be caused by an overactive or underactive thyroid, youll know when the tests are actually necessary.
You should ask for thyroid testing if you experience the following:
- Depression and/or Anxiety. Mood changes and anxiety are common symptoms of thyroid disorders, and your thyroid function should be considered before making a mental health diagnosis.
- Problems Gaining or Losing Weight. If youre experiencing unexplained weight gain or loss despite making no changes to your activity level and caloric intake, you may be experiencing a thyroid-related hormone imbalance.
- Bowel or Menstrual Irregularities. Thyroid issues can cause both irregular bowel movements and irregular menstrual cycles. If these are changing unexpectedly, you might want to consider thyroid testing.
- Fatigue. Thyroid hormones can have a significant impact on energy levels and should be one of the first sites of investigation if you are experiencing ongoing fatigue.
Thyroid Function Test Results Explained
The thyroid usually changes slowly. It hardly ever quickly changes to being overactive or underactive: it usually takes a few weeks at least, or even a few months. If you have a thyroid function test that shows something is wrong, it’s usually worth repeating it in 3-6 weeks. That is because there’s always the chance that your thyroid gland could have gone back to normal by itself.
The second thing to bear in mind about thyroid function tests is that medications, and even herbal remedies or vitamin supplements, can affect the accuracy of thyroid results.
For these two reasons it’s always recommended to have a thyroid function test if it is recommended to you by a doctor, rather than having it done privately or without a doctor suggesting it.
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Side Effects And Aftercare
A blood draw is a routine, minimally invasive procedure and doesnt have many side effects.
During the days immediately after the blood draw, you may notice slight bruising or soreness at the area where the needle was inserted. Placing an ice pack on the affected site or taking an over-the-counter pain reliever can help ease your discomfort.
If you experience a great deal of pain, or if the area around the puncture becomes red and swollen, follow up with your doctor immediately. These could be signs of an infection.
When Is It Ordered
A thyroid panel may be ordered when you have signs and symptoms that suggest underactive thyroid or overactive thyroid due to a thyroid disorder.
Signs and symptoms of an underactive thyroid may include:
- Trouble tolerating heat
- Sometimes more frequent bowel movements
- Some uncommon problems that can affect the eyes: puffiness around the eyes, dryness, irritation, excessive tearing, light sensitivity, blurry double vision
- In some cases, bulging of the eyes
- Less frequent or lighter menstrual periods in women
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The Best Home Thyroid Tests Of 2022
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Testing for health conditions at home is becoming increasingly popular. Before buying an at-home thyroid test, a person should consider which hormones the test detects, how much it costs, and how quickly the results arrive.
This article looks at a range of home thyroid tests a person can consider and looks into whether home thyroid tests work. It also discusses some of the most frequently asked questions about home thyroid tests.
What Should I Do To Prepare For A Thyroid Function Test
Thyroid function tests usually require very little preparation.
You don’t need to fast before the blood test. And it doesn’t matter if you have taken your thyroid medicine just before the blood test.
Tell your doctor if you are taking any medication, as some medicines can alter the test results and how they are interpreted.
It is also important to mention if you have had any X-ray tests that have used a special contrast dye, as this may contain iodine which can affect the results. Levels of thyroid chemicals also change in pregnancy, so tell your doctor if you are pregnant when the test is taken.
Note: all newborn children have their thyroid function tested as part of the heel prick test which is offered to all babies and undertaken when they are 5 days old. See the separate leaflet called Newborn Baby Screening Tests for more information.
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What Tests Do Doctors Use If I Have A Thyroid Nodule
If your health care professional finds a nodule or lump in your neck during a physical exam or on thyroid imaging tests, you may have a fine needle aspiration biopsy to see if the lump is cancerous or noncancerous.
For this test, you will lie on an exam table and slightly bend your neck backward. A technician will clean your neck with an antiseptic and may use medicine to numb the area. An endocrinologist who treats people with endocrine gland problems like thyroid disease, or a specially trained radiologist, will place a needle through the skin and use ultrasound to guide the needle to the nodule. Small samples of tissue from the nodule will be sent to a lab for testing. This procedure usually takes less than 30 minutes. Your health care professional will talk with you about the test result when it is available.
Drawing Blood For Thyroid Function Tests
Before you get a blood draw to check your thyroid levels, talk with your doctor about any medications youre taking. Also let them know if youre pregnant. Certain medications and being pregnant may influence your test results.
A blood draw, also known as venipuncture, is a procedure performed at a lab or a doctors office. When you arrive for the test, youll be asked to sit in a comfortable chair or lie down on a cot or gurney. If youre wearing long sleeves, youll be asked to roll up one sleeve or to remove your arm from the sleeve.
A healthcare professional, like a technician or nurse, will tie a band of rubber tightly around your upper arm to make the veins swell with blood. Once the healthcare professional has found an appropriate vein, theyll insert a needle under the skin and into the vein.
You may feel a sharp prick when the needle punctures your skin. The healthcare professional will collect your blood in test tubes and send it to a laboratory for analysis.
When the healthcare professional has gathered the amount of blood needed for the tests, theyll withdraw the needle and place pressure on the puncture wound until the bleeding stops. They will then place a small bandage over the wound.
You should be able to return to your typical daily activities immediately.
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What To Do With Your Thyroid Test Results
After testing, your practitioner should have a fairly good idea of what might be going on with your thyroidif anything is wrong at all. In most cases, thyroid tests come back completely normal. This is good news! While thyroid problems are well-studied and often simple to resolve, its always better not to have a chronic hormone imbalance. If your results are normal, your practitioner can move on to other tests that could help determine what is causing your symptoms.
If you are diagnosed with an underperforming thyroid, there are a number of treatment options available. You may choose to receive conventional medications directly from your primary care physician or whichever practitioner ordered your thyroid tests. These medications come in standard doses and supplement the hormone levels in your body to bring you back into balance. If conventional medications dont work for you, you may want to seek out a practitioner who can prescribe custom compounded thyroid medications. Your hormone practitioner should ideally also provide nutrition and lifestyle guidance to help you address your symptoms and promote overall hormone health.
Regardless of your diagnosis and treatment choices, proper thyroid testing is the first step forward on your journey toward better health and a renewed sense of wellness.
What Is Your Thyroid
The thyroid gland is located at the base of your neck. Its part of the endocrine system and is responsible for regulating hormones throughout your body to help you sleep, give you energy, and help you stay warm.
The main hormones it produces are thyroxine and triiodothyronine , which control how your cells use energy. Your thyroid gland regulates your metabolism through the release of these hormones.
Hypothyroidism occurs when the thyroid doesnt make enough T4, T3, or both. Its the most common thyroid condition, affecting 5% of the population worldwide, with another 5% who have the condition but havent been diagnosed.
In hyperthyroidism, the opposite occurs. The thyroid becomes too active and makes too much of the thyroid hormones.
Testing your thyroid levels at home is convenient and accurate when done correctly, and with the range of home test kits to choose from, you may find one that you like.
Read on to find out what thyroid tests are available and if theyre right for you.
Anyone can get their thyroid checked. However, certain populations can be at higher risk for thyroid disorders, including:
- people born with a uterus
- people with autoimmune disorders, including type 1 diabetes
- people with a history of thyroid disorders
- people who smoke
- people with a family history of thyroid disorders
You may want to undergo testing if youre showing any symptoms of hypothyroidism or hyperthyroidism.
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The Thyroid Screening Test
The thyroid stimulating hormone, or TSH test, is used as a screening test for thyroid disease, as well as a test for monitoring the correct dose of medication needed for an individual.
This is an important test that I recommend getting every time you check your thyroid function.
TSH is a pituitary hormone that responds to low/high amounts of circulating thyroid hormone. If youre new to thyroid lab testing, it may seem counterintuitive, but an elevated TSH means that you do not have enough thyroid hormone on board and that you are hypothyroid. This is because the TSH hormone senses low thyroid levels and is released when there is a lack of it, in an effort to signal the body to make more.
In advanced cases of Hashimotos and primary hypothyroidism, this lab test will be elevated. In the case of Graves disease and hyperthyroidism, TSH levels will be low. People with Hashimotos and mild or central hypothyroidism may have a normal reading on this test.
If youve been a thyroid patient for a while, youre probably thinking to yourself, Well, of course, doesnt everyone know that? and I have to warn you Ive unfortunately seen physicians who have mistakenly thought that a low TSH meant one had an underactive thyroid, and a high TSH, an overactive thyroid putting their patients in really dangerous situations by under- or overmedicating them!
Most conventional practitioners will stop further thyroid testing when they determine the TSH is normal .
Recommended test: TSH
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.
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You Need To Be Your Own Advocate Dont Expect To Have All The Labs Done Right Away
Most doctors will not automatically test you for the below labs even though they are standard and insurance would pay for them .
Most doctors just order the TSH and Total T4 which I explained above, are useless. It is therefore paramount that you print out and take the checklist with you to the doctors office and insist on getting the full panel. Explain your symptoms and share with your doctor why TSH alone is not good enough. Back up your claim with a medical source and you can use Dr Izabella Wentzs book to do so.
If the doctor refuses, move on and find a doctor who would. They do exist.
Reason #: T3 Hormone Is King
T3, also known as triiodothyronine, is the hormone that our body cells have receptors for. This means that for you to have beautiful hair, healthy nails, optimal gut health, a sharp mind and good mood, you need a sufficient amount of the T3 hormone, not T4.
Interestingly, the T3 hormone is produced from T4 by a metabolic conversion that happens in the gut and the liver. Can you see now how you could have a sufficient T4 hormone but if your T3 is low, you will still be feeling like a zombie?
Oh, and by the way, Synthroid is a synthetic version of T4 this means that you still need to convert it to T3 to feel good.
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