Did you know that there were decades of successful treatment for hypothyroid that involved nothing more than dosing you by symptoms? The TSH lab didn’t even come into existence until the mid-1970′s.
Today, the tables have completely turned. We now live in a lab-obsessed society, where most doctors completely ignore your thyroid symptoms and make your man-made lab results with the dubious ranges the holy grail of diagnosis. And diagnosis and treatment based solely on falling in a so-called “normal range” is a consistent failure, leaving millions of patient either undiagnosed, or undertreated.
Even worse, when labs are used, the majority of doctors are only doing the TSH (thyroid stimulating hormone) and total T4 to diagnose or treat you, neither which give an accurate clue to your hypothyroid condition. Additionally, ranges are made as if from God Almighty. They are not.
So…when you visit your doctor, symptoms should be the conductor of the orchestra. Then use the right labwork, and knowledge of where results should fall, for more knowledge. Below are those patients recommend you insist to your doctor that you want, or take with you when you visit your doc.
- TSH But this lab is only for diagnosis of hypopituitary, NOT to diagnose or dose your hypo by.
- Free T4 and Free T3 (note the word “free”–important since it measures what is unbound and available.)
- Reverse T3–to be done at the same time you do the Free T3. Then calculate your ratio with the results and measurements.
- Thyroid Antibodies (anti-TPO and TgAb. YOU NEED BOTH.)
- Four iron labs, which include Ferritin, % Saturation, TIBC and serum iron
- Adrenal Cortisol levels (but we strongly recommend saliva tests, not the one time blood test your doctor will do. One result does not tell the whole story. See below, because you don’t need a prescription)
- B-12 and Folate
- Magnesium and Potassium, plus Calcium, Sodium, Glucose (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.) For potassium, make sure the rubber tourniquet is not left on more than 60 seconds, says this study. Also note that the Buccal Mg lab test is finally available and seems to be more correlated to cardiac health than RBC Mg,but is expensive and not always easy to get.)
- Vitamin D3 (25-hydroxyvitamin D lab test…)
- …plus others your doctor may recommend.
***CLICK HERE TO READ HOW TO INTERPRET YOUR LAB RESULTS in order to be knowledge in the doctor’s office.Below are lab facilities you can use without a prescription: saliva, blood, or both. The top three work with Stop the Thyroid Madness recommended labwork. Saliva is highly recommended to test cortisol, but blood for the others. Many of us stopped using saliva for sex hormones, as we have found them to be strange. Some require a prescription for RT3, sadly, so definitely talk to your doctor about it if you have reason to believe it may be a problem.
NOTE: if you want the lab page to open in a new tab, RIGHT CLICK the link and choose “Open Link in New Window or Tab”
LAB WORK packages designed specifically for readers of Stop the Thyroid Madness. Use the discount code STTM10 which will give you 10% off the already low prices! STTM Thyroid and Adrenal Lab Packages You can choose just saliva for cortisol, or use LabCorp facilities around the US for blood draws. NOTE: the price went up for the “Adrenal Hormones Saliva Testing Kit from ZRT labs (Dirunal Cortisol and DHEA-S)”, from $170.00 to $ $265.00. But there is GOOD NEWS: STTM’ers can keep the price of $170.00 by placing a PHONE ORDER for the saliva at 1-800-929-2044. The customer will need to mention STTM.
LAB WORK packages designed specifically for readers of Stop the Thyroid Madness -STTM Thyroid and Adrenal Lab Packages You can choose just saliva for cortisol (which is six times in a 24 hour period), or use LabCorp facilities around the US for blood draws. My Med Lab designs a special area on the website just for YOUR lab results, making it all very personalized. I can highly recommend them.
LAB WORK designed specifically for readers of Stop the Thyroid Madness. IMPORTANT NOTE about using this page: you will need to use scroll down bar just to the right of the red “Add to Cart” to view all labs they offer. No saliva for cortisol. http://www.directlabs.com/Default.aspx?alias=www.directlabs.com/sttm
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Those without STTM-directed labs include:
- LAB WORK from ZRT LABORATORIES Saliva and a blood prick test…or one or the other. Adrenal Function Test for cortisol. The blood spot test kit uses a finger prick and several tests can be done from a single sample. They state it’s on par with serum needle blood draw tests, though you can do this right in your own home. THIS IS ALSO A PLUS SINCE SALIVA CAN FAIL TO DETECT THYROID ANTIBODIES. One downfall: it’s at least $100 more expensive than saliva. http://www.salivatest.com/
- LAB WORK from Vitamin Research Products Saliva Test kits including iodine, adrenals. They can do New York residents.
- LAB WORK from Canary Club. This website is not a lab, but offers saliva for cortisol, plus more. Saliva for antibodies or female hormones not recommended by many patients. Shows screwy results. (Canary Club used to offer Diagnos, Tech, but as of late March 2009, they are removed. Probably a good thing, since some patients were finding results through Diagnos Tech which did NOT match their symptoms or other saliva results.)
- Finland: Test kits from Genova diagnostics via MDD Terveyspalvelut: http://www.mdd.fi/
- Germany: Saliva testing and helpful facility http://www.hormonselbsthilfe.de/
- United Kingdom Labwork from Lab21: Click on Chemical Biochemistry to find Saliva: http://www.lab21.com/healthcare/index.php#
- United Kingdom Labwork from Red Apple Clinic. Thyroid, Adrenals, and others. (thanks to Crunchie for this info). www.redappleclinic.co.uk
- Australian Labwork from Healthscope (used to be Analytical Reference Laboratories (ARL) http://www.healthscopepathology.com.au/.. in Melbourne , Victoria.. Australia.Phone, 1300 453 688. you can phone them to find a Doctor or Naturopath who uses their Tests.
NOTE: several labs above provide you with the term “Cortisol Burden” and a number. Cortisol Burden is the combined value of all 4 saliva cortisol readings for the awake period of that particular day. It can tell you if you are making more or less than the average.
ABOUT RANGES: Each lab facility can have different ranges, so it’s important to evaluate YOUR results by the ranges provided by the lab facility you used. But, we especially like the free T3 represented on this page, since the free T3 range is especially wide!! Dr. Domissee of Arizona remembers using a lab that also had a range more like this one, and we hope to see a return of this. The current free T3 ranges are often far too narrow!
***CLICK HERE TO READ HOW TO INTERPRET YOUR LAB RESULTS in order to be knowledge in the doctor’s office.
TSH: This is the abbreviation for Thyroid Stimulating Hormone, and is also known as thyrotropin. It’s produced and stored in the Pituitary gland, and is released to stimulate your thyroid to release more hormones. When your TSH rises high, it means your thyroid isn’t doing it’s job, and the TSH is saying “Produce! Produce!” On the other side of the coin, when the TSH goes low, it can mean your thyroid is overproducing, called hyperthyroid. But remember: there’s a huge different between the REAL TSH in your body, and the TSH lab test. Patients have consistently found the TSH lab to be a lousy measure, and more specifically because of a questionable “normal” range, causing a patient to go for years without diagnosis. Additionally, the TSH often lags behind what is really going on, or it can be affected by factors including hypopituitary, acute stress, extreme illness, or the first trimester of pregnancy, etc. Additionally, you can have a very low TSH during a one time lab test, yet have an untested high TSH a few days later. That fluctuation is indicative of Hashimoto’s or an attack of the thyroid, causing swings between hypo and hyper. And once you start on treatment, patients have noted that when they are kept within the range–even at the lower end–they continue to have symptoms! It is totally useless? No. A low TSH lab test in the presence of a low free T3 and symptoms to match hypothyroid can point to hypopituitary. This condition means your pituitary fails to send a message via the TSH to your thyroid to produce. Causes can range from a tumor on the pituitary gland, to severe head trauma, to radiation, surgery or infection. Go here to read more.
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ARE YOU A SMOKER??? There is evidence that those who smoke have a lower TSH than those who don’t. That can be a disaster in our TSH-obsessed society, and your diagnosis of hypothyroid can wane. So there is wisdom in refraining from smoking the day of your lab blood draw. To see a research study on smoking and your TSH, go here.
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Free T4: T4 is the storage form of thyroid hormone, called levothyroxine or l-thyroxine, and it’s “main” purpose is to convert to the active hormone T3. There are two llabs: one will simply say T4, and the other will say free T4. If you only have the T4, aka the total T4, you are measuring both bound and unbound T4, and it fails to tell you what is free and useable. The free T4, on the other hand, shows the latter. Make it clear to your doctor that you want the FREE.
Free T3: T3 is the active thyroid hormone, also called triiodothyronine, and can be the most important lab you will do. Same as above, you need to specifically request the free T3 to reveal what is unbound and available. You can have a so-called normal TSH, but if your free T3 is low in the range, that is a strong sign of your hypothyroid status. Though most of the T3 in your body is produced by the conversion of T4 to T3, there is also a direct release of T3 from the thyroid. T3 is the active hormone which is responsible for your overall good health, metabolism, immune strength, etc. A good level of T3 is what prevents chronic low grade depression, high cholesterol, dry skin and hair….the list is endless. When patients are raising their Armour, their optimal dose is most often the amount that gets their free T3 at the top of the range, if not slightly over in some patients, with no hyper. The free T4 is often mid-range, and the TSH is most often suppressed. The latter does NOT equate to having osteoporosis or heart problems, as many uninformed doctors will rotely state. Instead, patients have reported their bone density IMPROVED, as did some heart issues.
ANTIBODIES: Antibodies are proteins produced by your immune system in response to a problem. If your labs come back above-range for thyroid antibodies, you can have an autoimmune thyroid disease, also called thyroiditis or Hashimoto’s, which means your thyroid is being attacked. There are two forms–one set targeting your thyroid peroxidase (an enzyme that is important in the production of your thyroid hormones) and the other targeting your thyroglobulin (a protein carrier for your thyroid hormones). It is not uncommon for one to be in range, and the other to far out of range. The latter fact is why you need BOTH tested. Make sure you are taking Selenium, since studies show it can help reduce the TPO antibodies. I have not yet found research as to if it can lower the thyroglobin antibodies. Even with the presence of antibodies, you can initially have a so-called “normal” TSH and the lack of symptoms. But down the line, you WILL get symptoms of the attack, which can include vacillating between hypo and hyper, and eventually becoming a raging hypo. So, it’s important to “tackle the attack”, and patients have found great success when they are willing to dose high enough with Armour. Armour, when raised high enough, appears to remove the signal that creates the attack.
IMPORTANT: if your labs show that you have antibodies, all labwork has to be thrown out the window when it comes to using them for diagnosis. Why? Because antibodies mean an attack is going on, and an attack means you will swing between hypo and hyper. One lab will look hyper, and the unknowing doc will tell you to decrease your Armour…when in reality, you need to INCREASE your Armour to eventually STOP the attack. With antibodies present, you have to dose by the elimination of symptoms, NOT labs. A large goiter or thyroid gland can accompany some cases of Hashimotos. Or, you can feel a discomfort when you swallow, and a tightness around the neck area. Elevated thyroid antibodies have been linked to a wide array of non-thyroid diseases including chronic inflammatory bowel disease and diabetes.
ADDITIONAL LABS TO CONSIDER: Many thyroid patients have benefited from getting other labwork, including DHEA, testosterone, progesterone, estrogen. The creator of this site found her testosterone to be quite low, even though she had no symptoms of it. Her doctor helped her start supplementation and she found the surprise result of the complete removal of low back pain upon waking. Other female patients with low sex drives found that the testosterone supplementation renewed their drives. We are seeing more labs being done for Vit. D, as well as other minerals. Highly recommended. *To read a good article on Saliva vs. Blood tests, go here.
*Click HERE to see OPTIMAL LAB VALUES…i.e. what your lab results mean and where you want to be.
