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10 Must Have Thyroid Tests

Thyroid Testing is by far the most asked question I get asked every day. This is where the magic lies, this is where the keys to our thyroid health are kept. Without all the appropriate tests you will never begin to figure out what is going on with your thyroid. So what thyroid testing do we need to get a full picture of our health?

1. TSH – Thyroid Stimulating Hormone

This is seen as the gold standard for doctors when testing anything to do with the thyroid. It is like a messenger standing at your door knocking hard and saying “you need more thyroid hormone”. The more messengers at your door (so the higher your TSH level) then the more you need thyroid hormone (hypothyroid). The fewer messengers at your door (so the lower your TSH level) means you have too much hormone already (hyperthyroid).

2. Free T4 – Thyroxine

This is the hormone the thyroid makes. This is the base from which the active hormone is made. If we have too much of this in the blood it may indicate that the thyroid is making too much, or it is not converting into the activated form.

3. Free T3 – Triiodothyronine

This is what T4 needs to be converted into for the body to be able to use it. This is the hormone that actually makes us feel normal. If we have too much T3 circulating in the blood, this could indicate that it is not getting into the cells where it needs to be. If we have too little, then the body may be struggling to convert from T4 to T3.

4. Reverse T3

We naturally produce a little RT3 however if we are under stress (physical, mental or emotional) then in its wisdom, our body will produce a lot of this. The body is really clever and if there is a lot of stress floating around then it thinks if all bodily functions are shut down to the minimum amount of running then the body will be safe from whatever perpetuated that stress. Unfortunately, our body is unaware that we humans are under stress seemingly all the time. This blood test will show you how much RT3 is in the blood which will be blocking the T3 from getting into the cells.

5. TPO Ab – Thyroid Peroxidase Antibodies

This test will tell you if your thyroid is being attacked by your immune system. This means that you have an autoimmune disease which is either Graves's Disease (Hyperthyroidism) or Hashimoto’s Disease (Hypothyroidism).

6. TGB Ab – Thyroglobulin Antibodies

Another test for autoimmune disease. This will also tell you if your thyroid is immune-based, so Graves or Hashimoto’s.


You can see that it is like a jigsaw puzzle to put together. But this is why it is vital you always get a copy of your own blood tests. They are yours – you are entitled to have them, you just need to ask. If your practitioner questions why you suddenly want copies of your tests, just tell them you are finally going to take an interest in your own health and this is part of that.
As you learn more about your own illness, you will find yourself referring back to your tests time and time again to understand what is happening.


If your doctor says that these tests are not warranted and will not run them don’t get your knickers in a knot! There could be a couple of reasons for this. Here in Australia, Medicare will not cover all of these tests without a really good reason (for example your practitioner is struggling to get your TSH in range). Medicare will only cover the TSH, to begin with. So in this case, you could suggest to the doctor that you are happy to pay for the tests yourself. Generally, then they will have no problems writing the path slip for you.


This is not some weird conspiracy where they are trying to stop you from knowing too much about your health, I promise. The thing is, your practitioner will not “treat” you any differently even with that information. What I mean by this is that they still only have thyroid replacement to give you or drugs to calm down your thyroid, whichever your case is. So running extra, costly tests will not change what they can do for you. And after all, they are in business too, they answer to bosses also, so if they can save the money on a test that will not change the outcome from their point of view, they will. The reason you need to know this, however, is because it changes how YOU treat yourself.

Many Naturopaths can run blood tests now and are more in tune with the need for running all of these tests. So finding a good Natural practitioner would be a great addition to your own team. This DOES NOT replace your doctor, however, there is a time and a place for both.

There are also companies that allow you to write your own tests and pay for it yourself, so if money isn’t too much of an issue, or getting well is worth the cost to you, this pricier option may be worth it to you.


There are other tests that can help you to get a good understanding of your particular presentation of this disease and therefore give you a clearer way forward to helping yourself heal or at least feel better. They are not vital, however, I have found through experience with myself and with clients that the more information you have on hand about your body, the more success you will achieve.

7. Liver Studies

Because your liver is responsible for 70% of the conversion of inactive thyroid hormone to active thyroid hormone, it is good to know the health of this vital organ. Even just being overweight for a long period of time can cause a fatty liver which is the first stage towards liver cirrhosis. You don’t have to be a heavy drinker anymore to have your liver fail on you, so having this set of tests done once a year is really wise.

8. Sugar Studies

Unfortunately, Thyroid people tend to have higher levels of insulin which can then lead you down the road of diabetes and metabolic syndrome. Having a fasting glucose, fasting insulin, and also a long term sugar test called an HbA1c. Once a year for these if you are doing ok, if not your doctor will request more often.

9. Lipid Studies

Lipid studies mean cholesterol numbers. Again, thyroid disease causes an increase in cholesterol so this is another test that needs to be checked yearly if it is in a decent range, more often if it is not. Thyroid disease puts a person at 70% higher risk of strokes, so knowing what your blood is doing and if you are heading down the road of cardiovascular disease is a good way to prevent the worst.

10. Hair Mineral Analysis Test

This test will tell you how many minerals you have in your “store cupboard” and how many toxic metals you have in your “junk room” so to speak. The test will tell you more accurately about your zinc, iron, B12, and potassium levels (plus many more) along with your mercury, aluminum, lead, cadmium, and arsenic levels (plus more). If you have somebody that can interpret this test well, it can show you why you may be suffering from allergies, depression, anxiety and will also tell you if you are on the road to thyroid disease, even if you are not there yet.

And if you want to get O.T.T about it…

I actually have a spreadsheet that goes over 5 years with all of my regular blood tests on it (not just the thyroid tests) so that I can compare my progress over the years. It also has on there things like pap smears and colonoscopies (I have to have one every 3 years due to colon cancer in the family), but you could also add your dental appointments, mammograms, or whatever else you have to have regularly.

But as I said, I am a little Over The Top about being organized, so you don’t have to go to this trouble. I would suggest though at the very least you have a Binder that you put all of your tests and health info in so that you always know where to find it all. With our foggy brains we need all the help we can get to find stuff, and doing little things like this will lessen the load which lessens the stress which lowers the RT3 which improves our thyroid! Phew! Who knew buying a binder could help our thyroid???


One last word! I know thyroid testing is a pain, I know it is inconvenient and at times costly. For me, I am well aware due to my deflating veins that I will likely walk out of the lab with more than one hole in my arm! But as the old saying goes – forewarned is forearmed!

If you were running a business you wouldn’t ignore the financials because it was inconvenient. You wouldn’t avoid doing the books in case the results were not good. You must always know ahead of time what is happening so that you can course-correct if it is going in the wrong direction. So please – don’t put them off. Get into a habit, like the end of the financial year or something. Or your birthday, what a great gift to give yourself every year – an overhaul and check up on where your health is at! You are worth the effort!


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