Thyroid tests are misunderstood by patients and doctors alike. Here is a run down of the various options for thyroid testing. We typically run the basic thyroid panel and/or thyroid antibodies panel. The less helpful / more specific tests are not that useful and/or reserved for monitoring thyroid cancer, etc.
Basic Thyroid Panel
Thyroid Stimulating Hormone (TSH) – the pituitary hormone released to increase thyroid output from the thyroid gland. Under ideal circumstances, TSH goes up in low thyroid conditions and down (suppressed) in high thyroid conditions. The serum and brain levels of T4 and T3 will both feedback to the brain and pituitary to regulate TSH output.
Free T4 – the portion of T4 that is not protein bound, and thus “free”, which is the bioactive portion of circulating T4
Free T3 – the portion of T3 that is not protein bound, and thus “free”, which is the bioactive portion of circulating T3
Reverse T3 – the chemical mirror image of T3, which will bind to thyroid receptors but not activate them, and if present in excess may cause a low thyroid condition caused Reverse T3 Syndrome
Thyroid Antibodies
Anti-Thyroid Peroxidase (TPO), aka Anti-Microsomal Antibody
- Positive in >80% of Grave’s and Hashimoto’s patients
Anti-Thyroglobulin Antibody (Th Ab)
- Positive in >50% of Grave’s and Hashimoto’s patients
Anti-Thyroid-Stimulating Hormone Receptor (TSHR), aka Anti-Thyroid Stimulating Immunoglobulin (TSI) or Anti-Thyroid Receptor Antibody
- Positive in about 90% of Grave’s and 10% of Hashimoto’s patients
Less helpful / more specific thyroid tests
Total T4
Total T3
T3 resin uptake (T3RU)
Free Thyroxin Index (FTI)
Thyroglobulin – protein made only by thyroid cells. Used to monitor thyroid cancer recurrence
