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  • Writer's pictureCherise Goodrich

How the Thyroid Works & Why You Should Ask for a Full Thyroid Panel

Updated: Jul 26, 2021

The thyroid gland is a vital hormone gland. It plays a major role in your metabolism along with many other functions in the body. When the thyroid is off, it can impact your health in so many ways. Clients will come to me seeking help for symptoms such as: weight loss resistance, fatigue, hair loss, anxiety, depression, joint pain, adult acne, irregular periods, trouble concentration, or a variety of other issues. They will often tell me they had bloodwork done and everything came back “normal.” And one of the first questions I ask is, “Have you had a full thyroid panel recently?”

Often when many of us have our thyroid checked, the docs run a TSH test. TSH stands for "thyroid stimulating hormone." It's actually a hormone that is produced by the pituitary gland in your brain. First, your pituitary gland gets a signal from your hypothalamus which produces TRH, or thyrotropin-releasing hormone. That stimulates the pituitary gland to produce TSH, or thyroid-stimulating hormone. From there, the thyroid gland then produces the hormones T4 and T3. So essentially, the pituitary gland tells your thyroid to produce thyroid hormones and release them into your blood. So while it's related to the thyroid, it's not specifically a thyroid test. Because of that, people can often have a normal (less than 2 is optimal, but normal lab ranges are broader) TSH, but still be struggling with thyroid issues.

It's always best to request a T4 and T3 test as well when having your thyroid checked. These are the thyroid hormones. Your thyroid mainly produces T4; however, T4 also gets converted to T3. T3 is your active form of thyroid hormones, and this conversion happens mostly in your liver and your gut which is why liver and gut health are so important (that's another topic for another day though). It's not uncommon to have a normal TSH, but have your T4 and T3 markers to be off. Optimal levels for T4 are considered to be between 1.0 - 1.4 ng/dL, and optimal levels of T3 are 3.2 - 4.4 pg/mL according to Dr. Westin Childs, an expert on thyroid (

Also, asking for your thyroid antibodies to be checked will help determine if you are struggling with an autoimmune condition related to your thyroid, such as Hashimoto's. Request Thyroid peroxidase (TPO) to be added to your lab panel. TPO is an enzyme that is normally in your thyroid gland. It plays a role in the production of your thyroid hormones (T4 and T3). The TPO test looks for antibodies against TPO. These numbers can start to increase slowly over the years so knowing your levels is important before you are in a full blown autoimmune situation.

In addition, you can request to have your thyroglobulin antibodies (Tg) checked. Thyroglobulin is a protein that binds to T4. Elevated levels may indicate inflammatory conditions related to the thyroid. Again, these numbers can slowly increase over years so finding out your levels can help you monitor your thyroid inflammation and make health changes accordingly.

So now that you know what tests you should get to check on the health of your thyroid, what do you do if your doctor says you only need your TSH and maybe your T4 checked? First of all, know that this is standard practice for most doctors. He or she is doing what is considered “routine” in the conventional medical model. However, it’s your body, and you have a right to request tests. You have a few options here. First, you can ask your doctor specifically for the tests mentioned above. If he or she chooses not to honor that request, you can find a new doctor. Or, you can simply order the tests yourself. Many people don’t realize you have this option. It’s pretty simple actually. There are a few places where you can get this done, but Your Lab Work is a reputable source where you order your lab work and go to a Quest Diagnostics lab for the draw. Results come right back to you and you can share with your doctor if you would like. Feel free to use the following link if this is something you are interested in doing.

I always recommend people get their thyroid thoroughly tested once a year. Many times it takes years before thyroid numbers begin to slowly change, and by testing once a year you can monitor yourself and look for changes. It’s not uncommon for my clients to realize many of their symptoms are tied to an underactive or overactive thyroid and they never knew! Once you are armed with more information about this very important little gland, you can work to make diet and lifestyle changes that support the health of your thyroid.

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