Thyroid Lab Tests
Dr. Anish Musa
Dr. Anish MusaMay 27, 2021

Overview

Standard protocols in India generally use TSH to screen for the presence of thyroid disease. Many doctors may check for Total T3 and Total T4. But this is not a complete profile of the thyroid panel and does not give a complete picture of thyroid function. Many doctors are prescribing the medication based on the TSH value only. That's why even after taking the medication, 75% of patients still report persistent symptoms like Fatigue, Weight, Hairfall, Pain. Hence, our first step at Jeevam Health is to perform a complete profile, without cutting any corners.

GOALS

  1. Identify the comprehensive functioning of the thyroid gland
  2. Diagnose the underlying cause for thyroid dysfunction

About Thyroid Biomarkers

TSH, Total T3 & Total T4:

TSH levels are an indicator of the level of activity of the thyroid gland. When the thyroid gland is not functioning optimally, T3 and T4 levels in the bloodstream are below normal levels. When this message is conveyed to the brain, it increases the stimulation to the thyroid gland. This results in an increase in levels of TSH, which will mediate this action. Hence, a level of TSH higher than normal indicates hypothyroidism.

Thyroid Anitbodies

There are certain people who have thyroid problems but their TSH test, T3 levels, and T4 levels are all normal. That is because the disease process acts beyond these test measures. Such a person may have elevated antibody levels. This may occur in the early stages of the disease. Thyroid antibody (B cells) levels are not associated with the severity of disease or symptoms. T-cell aggression determines the severity. TSH levels can fluctuate as the autoimmune expression waxes and wanes. This is why it’s important to test TPO and Tg antibodies in addition to TSH. There are two main antibodies implicated in the causation of hypothyroidism. These are:

  • Anti-thyroid peroxidase (anti-TPO)
  • Thyroglobulin Antibodies (TgAb)

Free T3 & Free T4

T3 circulates in the bloodstream, both bound and not bound to protein. The free (unbound) T3 is the only form that is able to enter and affect the body tissues. A total T3 test measures all the T3 in your body. This includes the inactive bound form as well. Free T3 is a crucial test which only measures the amount of T3 which performs essential functions. The conversion of T4 to T3 can also be affected by various factors such as:

  • Imbalance in the gut microbiome
  • Stress
  • Improper liver function
  • Extreme calorie restriction

List of Lab Request:

  • Thyroid Function:
    • TSH
    • Total T4,
    • Total T3
    • Free T4,
    • Free T3
    • Anti-thyroid peroxidase (anti-TPO),
    • Thyroglobulin Antibodies (TgAb)
  • Nutrition Profile:
    • Vitamin D
    • Iron panel with ferritin
    • Vitamin B12
  • Inflammation:
    • HS CRP
  • Complete blood count (CBC) with ESR
  • Cardiometabolic:
    • Fasting glucose
    • Haemoglobin A1c
    • Fasting Insulin
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