UNDERSTAND YOUR HYPOTHYROID BLOOD TESTS
DR ANNA ORD (GP WITH HASHIMOTO’S EXPLAINS)
How to understand your hypothyroid blood tests is so important! TSH, T4, T3, Reverse T3, TPO … what are these? What do they mean? What blood tests should you ask for?
When you have hypothyroidism, Hashimoto’s or really any other thyroid conditions, it’s helpful to understand what the ‘thyroid blood tests’ mean and how to interpret them for yourself.
I see in various online forums many people show copies of their blood tests and ask for help to understand them. This can be problematic for a number of reasons (& won’t allow it i my Facebook community… ex-lawyer hat on!).
However, as an empowered patient, it is important to have a general understanding of what thyroid blood tests your doctor should be testing and how to make sense of them for yourself.
Note: Take home a printout of your test results from your doctor and keep them in a folder (like this one available in My Thyroid Box):
In this episode of the Let’s Talk thyroid podcast I talked with Dr Anna Ord who is a General Practitioner in Perth, Australia. Dr Ord was diagnosed with Hashimoto’s about 4 years ago which gives her a very helpful perspective as a doctor on managing thyroid health!
We talked a bit about Dr Ord’s personal thyroid experience (diagnosis, management), how it has impacted the way she investigates thyroid conditions and helps her patients manage theirs too.
Which hypothyroid blood tests to request – including normal & optimal levels
In the conversation with Dr Ord, she goes into each of the blood tests, what they mean and how to understand where your levels ‘fit’ in the normal and optimal ranges. Bear in mind these ranges vary from lab to lab and country to country so these are a guide only.
| Thyroid Function Test | What it’s testing | Normal Range | Optimal Range |
| TSH |
How much the brain (pituitary) is telling the thyroid to produce. * this is the primary test most doctors use to screen for hypothyroidism but it doesn’t tell the whole story. |
0.4-4 | 1-2 |
| T4 |
Level of thyroid storage (inactive) hormone in the blood. * this is the second most common test doctors run but again it’s not the whole story. |
9-19 | 14-18 |
| T3 |
How much active thyroid hormone is in the blood. * many doctors won’t run a T3 test but knowing the levels of active thyroid hormone is really important. |
3-5.5 | around 5 (but optimal ratio T4:T3 is 3:1) |
Optional: Reverse T3 (shows stress response)
Antibodies:
- TPO (Antithyroid peroxidase Antibodies) – this is the more Hashimoto’s specific antibody
- TG (Antithyroglobulin Antibodies) – less specific for Hashimoto’s but 50-60% of Hashimoto’s patients have these present and are usually tested along with the TPO.
*These are usually the last tests a doctor will run although it would be helpful if you have them done so you can pick up any autoimmunity BEFORE destruction to the thyroid gland.
Why won’t my doctor run all the thyroid tests?
Usually this is a combination of the way doctors are taught to screen for thyroid conditions (ie if TSH is in range there is no thyroid problem) and what your health insurance/medical system will cover. This will vary from country to country but in Australia, doctors need to justify to Medicare why they are requesting certain blood tests and so this contributes to why the ‘full’ panel isn’t requested particularly in screening for a thyroid condition. It’s lsightly different once a diagnosis has been made.
Can you order your own blood tests?
YES! There are a few ways to get comprehensive blood tests if your doctor won’t order them.
1. Tell your doctor you’re willing to pay for them privates. They don’t have to justify the request then so will usually agree to you paying for them privately.
2. See a naturopath or other holistic health practitioner that can refer for blood tests (you will have to pay).
3. Order them yourself through a private lab. You will still want to find a doctor to go through them with you (despite this fabulous overview!!) but sometimes just getting the tests is the starting hurdle. I have an affiliate link for the private blood lab, i-screen.com.au here in Australia.
Other things a hypothyroid patient should have tested
As Dr Ord explains in this interview, the thyroid blood tests need to be considered in the context of the individual patient, their history and symptoms.
Nutritional deficiencies for example selenium, iron, zinc and Vitamin D should be tested.
Dr Ord also recommended having a thyroid ultrasound at the beginning of the investigations to see the quality of the thyroid gland itself and to test for nodules.
Thank you Dr Anna Rod! I hope this conversation as helped you to understand your hypothyroid blood tests, a bit more about your thyroid health and how to be better informed patients!
related podcast episodes
If you enjoyed this episode and are looking for similar discussions, check out these episodes:
Meet Dr Anna Ord
Dr Anna Ord MD, FRACGP is a family physician, a General Practitioner with a special interest in nutritional and environmental medicine. She obtained her speciality training with the Royal College of General Practitioners in the UK over a decade ago.
After being diagnosed with Hashimoto’s Thyroiditis 4 years ago, she became determined to discover more about this common autoimmune condition in order to help herself and her patients manage daily symptoms.
She continues to attend courses and workshops to develop her expertise in the filed of nutritional medicine. She recently because an ACNEM Certified Doctor (Australasian College of Nutritional and Environmental Medicine).
Connect with Dr Ord
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