Here is the full list of recommended lab work for assessing possible thyroid, adrenal, and hormonal health issues compiled from Stop the Thyroid Madness and other sources. First it’s important to understand the TSH test commonly to diagnose Hypothyroidism can be unreliable. Learn more about how the TSH lab test can be unreliable. Second learn how to diagnose hypothyroidism without TSH.
Thanks to our friends at TrueHealthLabs.com, you are now able to order our recommended lab tests yourself.
TSH is not to diagnose hypothyroidism unless its in the high range. TSH is for diagnosis of hypopituitary. Or as a way to measure to understand a relative range for yourself.
Free T3 is the workhorse of all thyroid hormones. Free T3 measures the free, unbound levels of triiodothyronine in your bloodstream. Free T3 is considered more accurate than Total T3. Free T3 is typically elevated in hyperthyroidism, and lowered in hypothyroidism. (2)
Free T4 measures the free, unbound thyroxine levels in your bloodstream. Free T4 is typically elevated in hyperthyroidism, and lowered in hypothyroidism. (3)
Reverse T3 (RT3)
Resistance to thyroid hormone (RT3) refers to people that don’t respond properly to thyroid hormone supplementation (such as natural desiccated thyroid medicine like Naturthroid or Erfa), and continue to have hypothyroid symptoms and normal blood test results. Learn more about RT3.
The RT3 test must be done at the same time as the Free T3 in order to calculate the ratio with the results and measurements. According to Thyroid-Rt3.com, divide Free T3 by reverse T3. The amount should be 20 or greater. If it’s less then that you have a RT3 problem. If it’s vastly smaller or larger you may have to move the decimal point to get the units right.
Thyroglobulin Antibodies / Antithyroglobulin Antibodies
According to About.com (4), testing for thyroglobulin antibodies (also called antithyroglobulin antibodies) is common. If you have already been diagnosed with Graves’ disease, having high levels of thyroglobulin antibodies means that you are more likely to eventually become hypothyroid. Thyroglobulin antibodies are positive in about 60 percent of Hashimoto’s patients and 30 percent of Graves’ patients.
According to Stop the Thyroid Madness (5), there are four iron tests worth getting which are Ferritin, % Saturation, TIBC and Serum Iron (aka, Iron, or total iron). A high ferritin can also point to inflammation. Up to five days off iron supplements is necessary to see what your body is holding onto.
Iodine Loading Test
Iodine deficiency is the chief cause of Hypothyroidism. Iodine is an important nutrient for thyroid and whole body health. Learn more about iodine.
As explained in The Iodine Crisis by Lynne Farrow, the 24 Hour Iodine Loading test is helpful in assessing a patient’s iodine sufficiency. The Iodine Doctors find that any test result showing saturation lower than 90% suggests a patient is a candidate for iodine supplementation (7). For 24 Hour Iodine Loading test kits try Hakala Labs. And visit the Iodine Literate Practitioners Directory.
Adrenal Cortisol levels
Take the 24-hour Saliva Test, not the blood test. According to Dr. James L. Wilson, the Saliva hormone test is the best single lab test available for detecting Adrenal Fatigue and has advantages over other lab tests in determining adrenal hormone levels. This test costs around $125 and is often not covered by insurance. Patients can order the test for themselves. For a list of labs and doctors familiar with this testing visit AdrenalFatigue.org. To order the saliva test click here.
Magnesium and Potassium, plus Calcium, Sodium, Glucose, etc
According to Stop the Thyroid Madness, all the latter are part of the Comprehensive Metabolic Profile–CMP blood test–as well. You can also ask for the RBC (Red Blood Cell) versions of Mag. and Pot, which measures cellular levels. Stop taking these mineral supplements for several days before the test for best accuracy.
B-12 and Folate
B-12 deficiency is common in patients with hypothyroidism (8), by as much as 40%.
Vitamin D3 (25-hydroxyvitamin D lab test…)
According to Richard Shames, MD, Vitamin D is so crucial to thyroid function that its status has now been elevated by researchers to co-hormone. We now know that the variability of thyroid to work or not work in your body is dependent upon the presence of Vitamin D, making it not just of benefit, but absolutely essential.
The typical normal range for Vitamin D levels is from around 30 to 100. Keep in mind in mind that just being in the low end of normal range will not do an adequate job for someone with an underactive thyroid person. Thyroid patients need to be “replete” — and that means alevel of at least 50 – 60 level, or greater. (9).
Frequently there is a connection, or related condition with hypothyroidism and sex hormones. Its worth testing progesterone, estrogen, testosterone, etc.