Thyroid Blood Tests (or Panels) need to be thorough and comprehensive. The ability for your body to heal could depend on the outcome of one these tests. Missing or skipping a step could also hinder finding your root cause. The thyroid and all the mechanisms vital for proper function can have many different variables which is why ALL of the following tests are very important. So do your research and be prepared for your doctor’s appointment.
- Complete Thyroid Panel (CTP): includes ALL of the following: TSH, Free T3, Free T4, Total T3, T3 Uptake TPO & TgAb (Hashimoto’s), TSI (Graves) and Reverse T3.
- Complete Blood Count (CBC): Breaks down and tests white and red blood cells.
- Complete Metabolic Panel (CMP): Testing for glucose levels, adrenal function, (very important, especially for me!) gut, kidney and liver function.
- Complete Lipid Panel (CLP): Checks cholesterol triglycerides, Cholesterol/HDL ratio (showing your risk of having a heart attack), HDLs (good cholesterol) and LDLs.
- Vitamin B12 and Folate
- Adrenal Function & Cortisol levels: Saliva testing 24-hour
- Vitamin D
- Sex Hormones: Estradiol, Progesterone, Free Testosterone, DHEA.
- Uric Acid: If not already included in the CMP.
- MTHFR Gene
- FERRITIN (storage iron)
- SERUM IRON if not on the CMP. (the circulating iron)
- TIBC (Total Iron Binding Capacity, aka carrying protein. It should go higher when iron is low)
- Transferrin (ratio of serum iron and TIBC) Iron-binding blood plasma glycoproteins that control the level of free iron in biological fluids.
- Homocysteine: Checks body inflammation.
- C-RP or C-Reactive Protein: Checks for heart inflammation.
- HGB A1C: Better overall indicator of blood sugar levels.
- Iodine: 24-Hour Loading Test
- Sex Hormones
(Estrone, Estradiol, Estriol, TTL Estrogens, Estrogen Quotient, 2-OH Estrone, 16a-OH Estrone, 2/16a Ratio, 4-OH Estrone, 2-Methoxyestrone, 2-Methoxyestradiol, Pregnanediol-progesterone metabolite, DHEA, Testosterone, 5a-Adrostanendiol, 5b-Androstanediol, Androsterone, Etiocholanolone, Pregnanetriol, Cortisone-(E), Cortisol-(F), Tetrahydrocortisone-(THE), Allo-Tetrahydrocortisol-(5a-THF), Tetrahydrocortisol-(THF), 11b-Hydroxyandrosterone, 11b-Hydroxyetiocholanolone, Aldosterone, Allo-Tetrahydrocorticosterone-(5a-THB), Tetrahydrocorticosterone-(THB), 11-Dehydrotetrahydrocorticosterone-(THA)Sodium, Potassium, Sodium/Potassium RatioNeurotransmitters/Brain Chemistry:
(Epinephrine, Norepinephrine, Dopamine, Serotonin, Glycine, Taurine, GABA, Glutamate, PEA, Histamine)Ultrasound of the thyroidFood Sensitivities TestingFunctional Assessment of organs & immune functionVitamin & Mineral StatusIntestinal Yeast (Candida Albicans)
To keep on top of other aspects of your health, consider talking with your doctor about these 10 tests, most of which use blood or urine samples:
- Lipid panel. This test look sat the lipids, or fats, in your blood. People with hypothyroidism may have elevated total and LDL cholesterol levels. Total cholesterol, which includes your good HDL cholesterol, should be below 200 milligrams per deciliter (mg/dL) and LDL cholesterol below 130 mg/dL. If your cholesterol is high when you start thyroid treatment, your doctor might test again after thyroid hormone levels stabilize. “A lot of patients with high cholesterol can have their cholesterol reduced just by treating their thyroid,” says David Borenstein, MD, anintegrative medicine physician in private practice at Manhattan Integrative Medicine in New York City.
- Complete blood count (CBC).“With more severe hypothyroid disease, you are at risk for mild anemia and bleeding problems, and that can have an effect on clotting factors and platelets,” says Dr. Smallridge. A CBC examines five blood components with the following normal ranges:
-Red blood cell count: 3.9-5.69 millions per cubic milliliter
-Hemoglobin: 12.6-16.1 grams/dL
-Hematocrit: 38-47.7 percent
-White blood cell count: 3.3-8.7 thousands per cubic milliliter
-Platelet count: 147-347 thousands per cubic milliliter
- Liver enzyme exam. Liver function tests check on the health of this organ. Not only does the liver play a role in the chemical process that develops thyroid hormones, but untreated hypothyroidism can cause problems in liver function over time.Additionally, sometimes people with hypothyroidism also have liver problems that need attention. The results of a liver panel test can’t diagnose ac ondition, but the pattern of results along with symptoms will help your doctor decide on any next steps. This blood test can look at alanine aminotransferase(ALT), alkaline phosphatase (ALP), bilirubin, albumin, total protein,gamma-glutamyl transferase (GGT), lactate dehydrogenase, and prothrombin time.
- Prolactin test.This hormone stimulates lactation, or breast milk — and people with hypothyroidism often have increased prolactin levels. Normal levels for women who are not pregnant are 0 to 20 nanograms per milliliter (ng/mL) and for men, 0 to 15 ng/mL. Because galactorrhea (spontaneously producing breast milk)improves with thyroid treatment, your doctor might not test for this unless the problem persists.
- Vitamin B12 test. Your doctor may test your levels of B12 and other B vitamins because they playa role in managing thyroid hormones, Dr, Borenstein says. B12 deficiency also can be related to anemia. Reference ranges can vary widely. Talk to your doctor about your lab results.
- Vitamin D check. Early research has shown a correlation between hypothyroidism and vitamin D deficiency. The two conditions could be separate conditions occurring at the same time or contributing to one another — researchers don’t understand the relationship yet. However, your doctor might want to check on your vitamin D levels as well. A 25-hydroxyvitamin D level of 20 nanograms per deciliter or greater is necessary for skeletal health. Some doctors recommend a level of 20-40 nanograms per deciliter, while others recommend 60-70.
- Sodium test. Sodium (salt) is essential to your body’s management of water or fluids. Normal sodium blood test results are 135 to 145 milliequivalents per liter (meq/L), but sodium levels might be lower than normal with hypothyroidism.
- Magnesium check. People with hypothyroidism and certain other deficiencies might also have too little magnesium, an essential mineral. Normal blood test results are 1.8 to3.0 mg/dL.
- C-reactive protein (CRP) test.This test measures inflammation in your body. Most people who are not fighting off an infection or living with an inflammatory condition have low levels of CRP. Increasing levels suggest increased inflammation in your body. An integrative medicine specialist might want to address overall inflammation with changes in diet and lifestyle in addition to thyroid treatment.
- Sleep disorder testing. You might also need sleep testing in addition to lab tests. Sleep apnea and disordered sleep can result from hypothyroidism, says Claudia Cooke, MD, an integrative medicine specialist in private practice in New York City. This is because hypothyroidism can affect the tongue’s mobility, causing it to block breathing at night. A sleep study can help you find out if this is an issue by monitoring your sleep in a sleep lab or at home using portable equipment. This test could be warranted if you’ve had thyroid treatment and your TSH levels are acceptable and stable, yet you wake up tired, feel tired during the day, and your bed partner tells you that you’re snoring considerably.
- Sex Hormones
Results and the ‘Normal’ Range
- What is the normal range at the lab where my test results were processed? (if it isn’t provided)
- What is my TSH test result number?
- What, if any, ‘normal range’ do your follow when diagnosing and managing thyroid issues?
Basal Body Temperature Test
Take a thermometer to bed. Because some people feel analog thermometers are more accurate, if you have one, use it, and shake it down prior to going to sleep. Digital thermometers, however, will work just fine, too. Immediately upon awakening, place it under an armpit. Leave it there for 10 minutes and move as little as possible during that time. A reading below the normal range of 97.8–98.2 indicates lowered metabolic function, which may indicate lowered thyroid function. It should be noted that this test is not definitive and must be used in conjunction with other assessment methods. Men and menopausal women can perform this test any day of the month (Barnes & Galton, 1976, pp. 47–48). Menstruating women should perform it during their periods. Do this test for 5 days to obtain an average reading. 
Important Blood Tests