Nutrition

Why you need to ask for a full thyroid panel

September 8, 2020

Many people may be walking around with poor thyroid health. Unfortunately, not all health care practitioners will run basic thyroid testing let alone a full thyroid panel. I encourage clients to go for the full thyroid panel because it can provide more information.

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Why you need to ask for a full thyroid panel


Many people may be walking around with poor thyroid health. Unfortunately, not all health care practitioners will run basic thyroid testing let alone a full thyroid panel. I encourage clients to go for the full thyroid panel because it can provide more information.

So, when you go to the doctor and ask for thyroid testing, you are likely going to be given a blood test for your Thyroid Stimulating Hormone (TSH) 

Another thing I like to point out is to of course have your tests examined by your medical doctor but also consider having it looked at by a nutritionist or naturopathic doctor. This is because medical doctors use bigger ranges than natural health care practitioners. Natural or functional practitioners like to see the optimal TSH range around 1-2 or as high as 2.5 whereas conventional doctors may go up to 5.0. That number is quite high and may be indicative of more serious health issues such as hypothyroidism (1).

So you can tell some important information from TSH levels so why do you need more? This is because you need to know how your body converts T4 to T3.

What does a full panel include?

  • TSH
  • Total and Free T4
  • Total and Free T3
  • Reverse T3
  • Anti-TPO
  • Anti-thyroglobulin

How do these hormones work?

The pituitary gland, which is located in the brain, communicates with TSH so if “thyroid hormone levels are too, it releases more TSH…” (2). The thyroid gets this push from the pituitary gland by TSH and starts to produce large amounts of T4 (thyroxine) and less T3 (Triiodothyronine) and “..T4 is eventually converted into T3, the “active” form that is taken up by receptors in body cells” (2).

Many people like to use the thermostat analogy to explain how your thyroid works, such as this one:

“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” (3).

How do you read these tests?

Be sure to speak to a health care professional. As mentioned before medical doctors follow conventional ranges whereas naturopathic doctors follow functional test ranges. If you are suspected to have hypothyroidism “…TSH levels become very high way before T4 levels fall below normal” (2).

  • High TSH – thyroid gland not making enough thyroid hormone (hypothyroidism)
  • Low TSH – thyroid is producing too much thyroid hormone (hyperthyroidism)
  • High TSH and low free T4 – indicates hypothyroidism
  • Low TSH and low free T4 -indicates hypothyroidism
  • Low TSH and high free T4 – indicates hyperthyroidism
  • High T3 – indicates hypothyroidism
  • Reverse T3 – can be hard to determine in individuals who are relatively healthy

T3 tests are typically helpful in how severe hypothyroidism is and it’s also important to now that elevated T3 generally indicates hypothyroidism (3). However, individuals who get a pull panel may have normal T3 levels, with high TSH and low Free T4 but still have a severe form of hypothyroidism (3).

Antibodies Anti-TPO and Anti-thyroglobulin

These two antibodies are also included in a full thyroid panel. It’s important because: “…many patients with hypothyroidism or hyperthyroidism, lymphocytes react against the thyroid (thyroid autoimmunity) and make antibodies against thyroid cell proteins” (3).

Positive anti-thyroid peroxidase and/or anti-thyroglobulin antibodies in someone with hypothyroidism may indicate Hashimoto’s thyroiditis (3).

You have your results, now what?

It’s important to take a personalized approach as everyone is different. Reach out to a health care professional to make sure you understand your bloodwork and to take the necessary next steps.

Sources:

  1. https://drbrighten.com/complete-thyroid-labs/
  2. https://www.health.harvard.edu/womens-health/do-you-need-a-thyroid-test
  3. https://www.thyroid.org/thyroid-function-tests/
  4. https://kresserinstitute.com/why-your-normal-thyroid-lab-results-may-not-be-normal/

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