Thyroid Health.PNG

THYROID PANEL

  • Thyroid stimulating hormone (TSH)

  • Free T4

  • Free T3

  • Anti TPO

  • Anti TSH Receptor Abs

  • Reverse T3

  • Urinary Iodine and Bromide

TESTING STRATEGY

TSH, fT4, fT3 are the standard tools to identify classical hyper/hypothyroidism. Autoantibodies to the TSH receptor can inhibit or activate the thyroid resulting in abnormal (usually increased) release of T4 from the thyroid (Grave’s Disease). Autoantibodies to thyroid peroxidase, an intracellular enzyme are associated with the cell death of thyroid cells resulting in hypothyroidism. Abnormal thyroid markers without auto-antibodies development can be consistent with thyroiditis or thyroid cancer.

Reverse T3 is often increased during illness and several other stress, inflammatory related conditions. It is a tool used by some to determine the cause of non-thyroid hypothyroidism.

Urinary Iodine is useful to identify possible dietary insufficiency. Bromide is thought by some to be a possible inhibitor of thyroid function and is included in the panel. More research is needed in this area.

TREATMENTS

The involvement of an endocrinologist in the treatment of any form of thyroid disease is recommended. Treatments vary according to the condition including hormone replacement, radioactive iodine treatments etc. A number of researchers have shown associations between gut dysbiosis and thyroid disease. Treatments aimed at improving intestinal permeability and inflammation may be useful in the prevention of thyroiditis and Grave’s disease. 

MONITORING

In patients with identified disorders repeat testing of the entire panel is recommended every 2-3 months.

ADDITIONAL TESTING

  1. Gut Health Panel

  2. Cardiovascular Panel