Thyroid Labs

These thyroid labs will give a complete picture of your thyroid. The last 2 tests are the least important, but I feel they are still very important. The only reason why I measure which ones are least important is because your ordering provider may not want to run them unless they see an anamoly within the first 4 tests.

TSH: Thyroid Stimulating Hormone. Produced by the pituitary gland. This is the most common test for thyroid, and usually the only one a provider may order. This is not a reliable test alone to determine thyroid function or whether or not the cells are using the thyroid that is being produced.

T4-FREE: This is they thyroid hormone that is produced in greater amounts by the thyroid gland in response to the TSH signal. This is sometimes referred to as the “storage” thyroid hormone in the body. It is not the form that the cells “actively use” for metabolism, sleep, menstrual regularity, and more.

T3-FREE: This hormone is produced in less significant amounts in the thyroid and is referred to as the “active” form. When T4 is produced, it is transferred to other tissues and converted into T3. Small amounts of T4 are also converted into “reverse T3”. Reverse T3 also can bind to thyroid receptor sites on the cell, acting as a buffer, to ensure that not “too much” T3 is attaching to receptor sites, thus marking “hyperthyroidism” – too much active thyroid.

TPO: Thyroid peroxidase antibodies. These are produced when a person’s immune system mistakenly targets components of the thyroid gland or thyroid proteins, leading to chronic inflammation of the thyroid (thyroiditis), tissue damage, and/or disruption of thyroid function. If thyroid antibodies are found in the blood, at ANY level, it is an indication of Hashimoto’s Thyroiditis – an autoimmune disorder.

T3-Uptake: Reflects available binding sites for T3 to attach and be utilized.

Reverse T3: Reverse T3 and T3 compete for receptor sites on cells. This is described as “antagonists” of each other. If your thyroid receptor sites have reverse T3 blocking them up, then T3 cannot bind to your cells. The T3 floats around in the blood, looking like you have normal levels, but since it’s not binding to the cells, it cannot perform its functions within the body.

Note: The creation of thyroid hormone is dependent upon the body’s reserves of iodine and healthy fats. The conversion of T4 to T3 involves the use of Selenium and Zinc by the body. Nutritionally, it is important to review the intake of foods and supplements that can aid this conversion. Sometimes one or many of these labs will appear within the normal range, but it is important to look at all of them together for a complete picture.

Ordering Your Own Labs

You can order labs yourself.
If you order labs yourself, you will not be able to bill insurance for them. But many labs are affordable, and there are many reasons why you may want to order your labs yourself:
a) There is always the chance that your insurance may not cover a lab.
b) The cost/wait of an office visit to your doctor may not be worth taking the chance to see if they will order the labs for you.
c) You may not want your doctor/insurance company knowing that you ran a particular lab. This was more true in the days of preexisting conditions, but some situations still may apply for privacy reasons.

There are 2 main lab companies that I use, depending on what I need done. The main difference is that one of these lab companies will actually perform a “procedure” and the other ONLY will do a blood draw.

Step 1: Find a local lab near you.

Direct Labs: Direct Labs partners with Quest Laboratories, solely. Direct Labs will only order for blood draws. You are able to order all of your labs yourself online using this site. I really like their test “kits” which are a discounted bundle of tests that generally should be run together to form a complete picture (Women’s Hormones).

LabCorp: Lab Corp is a little different. Lab Corp locations differ by service and while all of them offer a blood draw for many labs, certain locations perform other services such as hair sampling, a breath test, or even a wellness check that involves weighing you. They are more than just a blood draw facility. But there are 2 different ways you can get your testing done.

LabCorp Tests: LabCorp itself has a huge menu! But for these tests – you do need a physician to write the lab. And they will attempt to bill your insurance. If the lab is not covered by insurance, then you pay for it. But this can be a handy resource during certain times when your doctor isn’t sure where to get the lab done, but you do.
I’ll give you an example: If I suspect a client has SIBO, I advise 2 different breath tests. Usually doctors will “refer” their patients to a GI Specialist to get this test ordered. But they can order it themselves, and LabCorp facilities do breath tests. In this instance, we can ask the ordering provider “Hey, can you just write me a lab for this through LabCorp? There’s one right around the corner from me, and they do breath testing. I just need the order sent, and I’ll show up and handle the rest with my insurance card, that way I don’t have to see another doctor”. That usually works! It’s less paperwork for you both. And with immediate results, you can schedule your follow-up with your doctor (and me).
LabCorp also has specific allergen testing. If you suspect you are allergic to wheat, whey, or even watermelon, they have that test available for your doctor to order. No need to refer you to an allergist (yet). This saves your health plan money.

Pixel by LabCorp: This is just like Direct Labs. You can order certain labs yourself. Most of these are very affordable. Pixel has a very limited catalog, however.

Step 2: Order your labs from Direct Labs or Pixel. This is a lot like shopping for anything online. You select what you want and then you “checkout”. Direct Labs lets you walk into Quest Labs with your order anytime. Usually the Pixel by LabCorp requests that you schedule an appointment ahead of time.

If you know you need some blood work performed, but don’t know what to order – make an appointment with me, and I’ll help you. For certain blood labs, it matters “when” you get the blood drawn and I can help you with that, also.