Knowing Which Thyroid Tests to Ask For Can Help You Get the Right Diagnosis

by Charlotte

When you visit your health care practitioner seeking help for persistent symptoms like unexplained weight changes, fatigue, anxiety, or low mood, they will likely recommend getting a full panel of blood tests. These results help identify or rule out a multitude of medical issues that might be causing your symptoms. Overall, blood tests are a safe and inexpensive first step in treatment for a vast number of conditions.

Thyroid tests are commonly called for under these circumstances. When your thyroid is underperforming or hyperactive, you could experience a wide range of symptoms that don’t resolve on their own. Rather than trying to address these symptoms in isolation, identifying the hormonal imbalance that lies at their root is essential to getting the right treatment and protecting your health.

While most health care practitioners will automatically prescribe thyroid testing if it seems useful for diagnosis, it’s also a good idea to be ready to ask for specific tests. Knowing which thyroid hormone tests to ask for will help you get an accurate diagnosis and allow you to make the best treatment choices based on all the available facts.

When You Should Get Your Thyroid Checked

Because the thyroid impacts so many processes in the body, thyroid tests are pretty routine. But despite the wide array of symptoms that can be caused by a thyroid issue, these tests aren’t helpful in diagnosing every possible condition. By familiarizing yourself with the symptoms that could be caused by an overactive or underactive thyroid, you’ll know when the tests are actually necessary.

You should ask for thyroid testing if you experience the following:

  • Depression and/or Anxiety. Mood changes and anxiety are common symptoms of thyroid disorders, and your thyroid function should be considered before making a mental health diagnosis.
  • Problems Gaining or Losing Weight. If you’re experiencing unexplained weight gain or loss despite making no changes to your activity level and caloric intake, you may be experiencing a thyroid-related hormone imbalance.
  • Bowel or Menstrual Irregularities. Thyroid issues can cause both irregular bowel movements and irregular menstrual cycles. If these are changing unexpectedly, you might want to consider thyroid testing.
  • Fatigue. Thyroid hormones can have a significant impact on energy levels and should be one of the first sites of investigation if you are experiencing ongoing fatigue.

Thyroid dysfunction can also cause temperature sensitivities (to heat or cold), muscle aches, jitters, brain fog, dry skin, and hair loss, among other symptoms. If you’re experiencing these or any of the symptoms above, you’ll want to get your thyroid levels assessed before seeking further treatment.

The Four Most Important Thyroid Tests to Ask For

There is no single test that will tell you everything you need to know about your thyroid. Rather, there are a number of tests that provide insight into different aspects of thyroid function. Which will be the best tests for you will depend on your individual symptoms and whether hypothyroidism or hyperthyroidism is suspected.

The four most important types of thyroid tests are:

  • TSH Test. TSH is a hormone produced by the pituitary gland that instructs your thyroid to produce hormones. If you have too much TSH, your body could be trying to activate your thyroid to compensate for low thyroid hormone levels. If you have too little, your thyroid might be overproducing hormones and suppressing TSH secretion. This is the broadest test that might indicate some kind of thyroid problem and is typically administered any time a thyroid issue is suspected. While the TSH test alone doesn’t result in a diagnosis, it is a necessary first step to understand thyroid function.
  • Free T4 Test. The primary hormone released by your thyroid is called thyroxine, also known as T4. Free T4 testing provides a greater level of insight than TSH testing alone and is necessary to determine whether or not your thyroid is producing healthy hormone levels. Typically, high free T4 levels suggest hyperthyroidism while low free T4 levels typically point to hypothyroidism.
  • Free T3 Test. In order for thyroid hormones to fully impact the body, they must be converted from T4 to triiodothyronine, also known as T3. Due to an overproduction of T4, people with thyroid conditions like hyperthyroidism or Graves’ disease typically also have high T3 levels. Conversely, those with low T4 levels will have correspondingly low T3 levels. However, it is also possible to have normal T4 levels and low T3 levels, suggesting a problem with the conversion process. T3 testing can, therefore, be an important part of overall thyroid evaluation and may help elucidate symptoms that are not explained by TSH and T4 tests alone.
  • Thyroid Antibody Tests. Certain autoimmune disorders cause your immune system to attack the thyroid. Your body responds to this attack by producing antibodies, resulting in either thyroid overactivity or underperformance. Thyroid antibody tests can be critical to understanding the cause of thyroid dysfunction and are used to diagnose both Graves’ disease and Hashimoto’s disease, the two most common autoimmune disorders impacting the thyroid.

What to Do With Your Thyroid Test Results

After testing, your practitioner should have a fairly good idea of what might be going on with your thyroid—if anything is wrong at all. In most cases, thyroid tests come back completely normal. This is good news! While thyroid problems are well-studied and often simple to resolve, it’s always better not to have a chronic hormone imbalance. If your results are normal, your practitioner can move on to other tests that could help determine what is causing your symptoms.

If you are diagnosed with an underperforming thyroid, there are a number of treatment options available. You may choose to receive conventional medications directly from your primary care physician or whichever practitioner ordered your thyroid tests. These medications come in standard doses and supplement the hormone levels in your body to bring you back into balance. If conventional medications don’t work for you, you may want to seek out a practitioner who can prescribe custom compounded thyroid medications. Your hormone practitioner should ideally also provide nutrition and lifestyle guidance to help you address your symptoms and promote overall hormone health.

If you are diagnosed with an overactive thyroid, you also have a range of treatment options that can help you find durable symptom relief and protect your long-term health. Whether you choose to manage your thyroid hormone levels with medications, receive radioactive iodine treatment, have surgical intervention, or try to address underlying health issues impacting thyroid function, partnering with a practitioner who specializes in treating hormone-related health conditions will be essential to achieving the best outcomes.

Regardless of your diagnosis and treatment choices, proper thyroid testing is the first step forward on your journey toward better health and a renewed sense of wellness.

BodyLogicMD is a nationwide network of top health practitioners who specialize in hormone health. The practitioners in the BodyLogicMD network offer extensive in-house hormone testing services to fully understand your thyroid function and comprehensive treatment to address your symptoms. If you’re looking for a hormone specialist who can prescribe personalized hormone therapy in tandem with nutrition and lifestyle counseling for a fully integrated treatment plan, consider partnering with BodyLogicMD. Contact a local practitioner today to start your journey toward a more balanced life. Or take the BodyLogicMD Hormone Balance Quiz to boost your understanding of how hormones like T3 and T4 impact your health.

Disclaimer: These statements have not been evaluated by the Food and Drug Administration. All content on this website is for informational purposes only. The content is not intended to diagnose, treat, cure or prevent diseases.


  • Charlotte

    Charlotte is a patient care coordinator specializing in bioidentical hormone replacement therapy. She is committed to helping patients who struggle with the symptoms of hormonal change and imbalance explore their treatment options and develop effective strategies to optimize wellness.