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Thyroid Lab Guide
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Thyroid Lab Guide
Welcome from Modern Thyroid Clinic, where your journey to wellness begins with a compassionate team who’s taken the same journey you are on. Hi, I’m McCall McPherson, and I intimately understand your struggle. I, too, was a patient grappling with debilitating fatigue and confusion. My personal quest to reclaim my own health turned into a mission, conceived from the urgent need to address the countless hours I, and other patients, have lost in search of answers for their hypothyroid symptoms. We’re not just a clinic; we’re a movement, tirelessly working to train clinicians and help our patients in groundbreaking methods to broaden our reach, ensuring no one has to endure the uncertainty of unresolved thyroid issues. Visit us, join our community, and reclaim the vibrant life you deserve.
Introduction
More than any other question at Modern Thyroid Clinic, I get asked two things:
- What labs do I need to get to properly assess my thyroid?
- What are the ranges they should be in?
Labs You Need
A proper workup for hypothyroidism include the following labs:
- TSH
- TSH
- Free T4
- Free T3
- Reverse T3
Normal Isn't Optimal
I get into this deeper in our thyroid course but, in short, regular lab ranges have expanded over the years and are simply way too wide. As a result, individuals can suffer for years (or decades) with thyroid symptoms before drifting outside of most lab’s “normal” ranges. So the lab ranges you’ll find here are within optimal (not ‘normal’) ranges, developed after analyzing hundreds of thousand of pieces of data, and may be very different than the ones you’ll see on your commercial lab report. Some practitioners who are not specialists in thyroid care over rely on the reference ranges commercial labs use - leading some doctors to tell you your results are “normal”. But within these ranges, people thrive and are truly able to get their lives back. Let’s dig in .
Labs You Need
A proper workup for hypothyroidism include the following labs:
- Regardless if you are on medication, have or haven’t been diagnosed with hypothyroidism, your TSH should always be close to 1 and less than 2. Some people’s symptoms don’t resolve until it’s less than 1.
- It’s important to note, TSH does not truly dictate your thyroid status, especially if you are on a T4 based medication like levothyroxine, Synthroid, Tirosint, Unithroid, et al. These medications disrupt the feedback mechanism of communication to your brain, rendering the TSH completely invalid.
- Remember, the only job of the TSH is to tell your brain how hard it needs to work. Alone, it’s simply not a good gauge to your thyroid status.
Free T4 - Your Inactive Hormone
Free T4:
- Greater than 0.90 but less than 1.2.
- When Free T4 creeps above 1.2, it starts to signify a conversion problem, meaning you aren’t converting the Free T4 to Free T3.
Free T3 - The Good Stuff
- I like my patients’ Free T3 to hang around 3.6 - 4.2 for the better part of the day. This often means they peak a little bit higher.
- This is the most important thyroid lab ordered. It is what dictates the true status of thyroid function. If your doctor is telling you that your thyroid looks fine, but has not ordered Free T3, you certainly need a deeper look before ruling out a thyroid problem.
- This lab value is influenced by the time of day you take your medicine if you are on desiccated thyroid - things like Armour, NP thyroid, etc., or on Cytomel (lithyronine).
Reverse T3 - Inhibition
- Ideally below 15, usually around 8 - 12. The lower your Free T3, the lower Reverse T3 needs to be, as it is a competing enzyme that interferes with Free T3 absorption.
- This can often be elevated in people on T4-based medications (see list above). This creates the need for a reduction in Free T4 to reduce Reverse T3.
- Less isn’t always better, 8 should be the lower end of this hormone.
In Closing
Thank you. Becoming better educated is the fastest way to recovery and managing your thyroid symptoms.
Patients like you, who are reading and learning how their thyroid works, are leading the thyroid revolution.
Spread the word that #ThereIsNoReasonToStillHaveThyroidSymptoms
