The first step in understanding whats wrong with your Thyroid depends on a Complete or Full Thyroid panel. Most doctors who work with patients suffering from thyroid disease will NEVER run a full thyroid panel. Most of the time you will only get a TSH and Free T4. This doesn’t cut it when it comes to properly managing a thyroid problem. In fact, its is almost impossible in supporting thyroid function with the limited testing done by most doctors.

A full thyroid panel is a specific group of tests that are used in order to evaluate the pattern of thyroid dysfunction but also help diagnose hypo/hyperthyroidism as a result of various thyroid conditions.

1. Thyroid Stimulating Hormone (TSH) is a hormone produced by the pituitary gland which stimulates the Thyroid gland in the production and release of T3 and T4 hormones
2. Total triiodothyronine- total T3
3. Free T3
4. Total thyroxine- total T4
5. Free T4
6. Reverse T3
7. Thyroid antibody test –

In many cases of hypo/hyperthyroidism, the lymphocytes, which are the blood cells created by our immune system and released in the blood circulation with the function to protect our body from any viruses and bacteria by creating their antibodies, now create antibodies against their own thyroid. These antibodies will either stimulate or harm the thyroid gland and its function.

Two main thyroid antibodies are usually found in a case of hypo/hyperthyroidism include thyroid peroxidase and thyroglobulin. The full thyroid panel will help help Dr Hagmeyer understand your Thyroid and what could be some of the root causes behind your symptoms.

A full thyroid panel, although a simple and quite easy to perform the test, can reveal a lot about your thyroid and its function. It is strongly recommended for anybody with a family history involving any thyroid problems such as hypo and hyperthyroidism. Also, those who might have been experiencing any symptoms such as unexplained weight loss/gain, fatigue, weakness, trouble sleeping, tremor in the hands etc., in addition to all women who have just recently entered the period of menopause may want to discuss this test with their doctor in order to determine if their thyroid is functioning properly.

Who Should Get a Full Thyroid Panel ?

We strongly recommend a full thyroid panel,  if you have noticed any of the following Thyroid symptoms or symptoms have not improved after thyroid replacement –

• Persistent Chronic Fatigue
• Unexplained weight gain or loss
• People who have high cholesterol, high triglycerides (hyperlipidemia) or Low HDL (good cholesterol)
• Trouble sleeping
• Tremors
• Dry skin
• Brain Fog
• Infertility
• Family History of Thyroid problems
• Thyroid Problem that does not stabilize (One month your doctor is increasing your medication, the next month lowering it)
• A doctor who refuses to order more than TSH and free T4

People Who Are At The Greatest Risk of Developing a Thyroid Problem

A full thyroid panel is also strongly recommended when we have a family history of thyroid problems, especially thyroid cancer, hyperthyroidism, and hypothyroidism, Graves or Hashimoto’s, Women in or near menopause, pregnant women, and women after birth. As we mentioned previously, the levels of these hormones – TSH, T3, and T4 can be affected by a number of various conditions.

Most Common Conditions That Cause An Abnormality In The Levels of TSH, T3, and T4.

1. Hyperthyroidism – is a term that is used to describe the over activity of the thyroid gland and the excessive production of the thyroid hormones due to which all the functions of the body increase their speed. The usual symptoms are increased heart rate, weight loss, diarrhea, anxiety, weakness, trouble sleeping, and tremors in the hands. What a full thyroid panel in a case of hyperthyroidism would show is low levels of TSH, and high or normal levels of T3 and T4 hormones.

2. Hypothyroidism – Hypothyroidism is a term that is used to define the condition in which your thyroid is not able to produce the needed levels of hormones in order to let your body function properly. It is also known as under active thyroid disease, and surprisingly it is a very common condition. The usual symptoms of hypothyroidism include weight gain, constipation, fatigue, dry skin and menstrual irregularity. In a case of hypothyroidism, what the thyroid panel would show is high levels of TSH, and normal to low levels of T3 and T4 hormones.

3. Pregnancy – During pregnancy, you may experience hypo or hyperthyroidism caused by various causes including Hashimoto’s disease (hypothyroidism) and Graves’ disease (hyperthyroidism) being the most common causes of hypo and hyperthyroidism. Both conditions are systematic, autoimmune diseases which cause the body to attack its own thyroid gland and cause abnormalities in its function to occur.

4. Liver disease – Since the thyroid and the liver are closely connected with their functions, helping each other, it is only natural to expect that when a liver disease is present, there are going to be certain changes in your thyroid function.

5. Menopause – Since many of the usual symptoms that occur as a result of thyroid problems, including dry skin, fatigue, weight loss/gain etc. are the same symptoms that are usually expected for women to experience when they enter menopause, it is strongly recommended to get a full thyroid panel just to eliminate any potential thyroid problem that a woman might experience during that period.

How is a Full Thyroid Panel Performed?

The Phlebotomist will collect blood from a vein in your arm using a needle and then perform the needed laboratory tests as part of the full thyroid panel. Since it is a full thyroid panel that we are talking about, all of the followings will be evaluated:

What Thyroid Markers Are We Checking In A Complete Thyroid Panel

TSH – The most common marker used to asses thyroid function and the most sensitive. This hormone is released by the pituitary when it gets the signal from the hypothalamus. TSH levels increase when T4 levels drop, and TSH decreases when T4 levels are elevated.  Sometimes this is the only marker your doctor will order.

T4 – This is the most prevalent form of thyroid hormone made by the thyroid gland. Levels of T4 in the blood act as the feedback loop for the brain and signal it to stop producing TSH. The vast majority of it is bound to carrier proteins. It is considered metabolically inactive, and must be converted to its active form to be used by cells to regulate metabolism. Typically the only other marker tested other than TSH.

T3 – The active thyroid hormone. If it is not directly made in the thyroid gland, then conversion takes place in the liver, kidney, and GI tract. The majority of T3 is bound to carrier proteins.  Once unbound, T3 acts directly on the cell nucleus to regulate the metabolism of that cell.

Free T4 – This is the unbound version of T4. This marker can be influenced by thyroid hormone replacement, chronic illness, as well as disorders that affect the amount of carrier proteins.

Free T3 – The unbound form of T3. This is the best marker to see what amount of active thyroid hormones are available for the cells. This can be effected by stress, thyroid disorders, and pregnancy.

Reverse T3 – This version of T3 is metabolically inactive. Reverse T3 is only typically produced in cases of extreme stress such as surgery or trauma. Chronic stress can also cause the production of Reverse T3, thereby masking the adrenal issue and looking like a dysfunctional thyroid.

T3 Uptake – This measures the number of sites for T3 to bind to for carrier proteins. These are the sites that allow T3 to be transported throughout the body to be used by cells that need it. This marker is influenced by sex hormones such as testosterone and estrogen.

Thyroxine-Binding Globulin (TBG) – This is the amount of proteins in the blood that carry thyroid hormones to the cells. This marker can be influenced by infections, liver dysfunction, HRT, birth control, steroids, prednisone, aspirin, and pregnancy.

TPO Antibodies – Most common marker elevated with autoimmune thyroid.  90% of thyroid issues are autoimmune related.  This marker is rarely tested since there is no pharmaceutical drug to fix the problem, only lifestyle.

Anti-thyroglobulin Antibodies – Not as commonly elevated with an autoimmune thyroid condition. During thyroid cancer treatment, this marker is routinely evaluated.