Thyroid Testing Necessary?

[stellaluna]

My naturopath has ordered $150 worth of thyroid tests. I’m Canadian, so if a physician ordered these, they would be covered by public health (but they would not order these as my TSH has been in range lately). My naturopath has been concerned as my TSH has been on the high end of normal lately and I have had some odd thyroid numbers way back (although potentially related to eating disorder). I’m just not sure if it’s overkill. I don’t want to spend $150 on these if it won’t bring me much benefit.

The tests ordered:

• FT3
• FT4
• Reverse T3
• TSH
• TPO

My previous results:

Date:	TSH (mIU/L)	FT4 (pmol/L)	FT3 (pmol/L)
Nov 2016	2.16
May 2020	1.03	9.0 L
Jul 2020	9.09 H	13.0	4.3
Oct 2020	2.02
Nov 2020	1.63	12.2	3.6
Feb 2021	3.94	13.9
Jun 2021	2.63
Jul 2021	2.74
Dec 2021	2.03
Apr 2022	2.06
May 2022	1.37
Jun 2023	1.67
Nov 2023	1.56
Dec 2024	3.85
Mar 2025	3.33

I do have an appointment with my internist coming up so I could ask him what he thinks but I don’t want to come across as overly anxious or anything so i just want to get a sense of what might be appropriate first

 

[Zebra]

Hi, @stellaluna

Smart of you to track it your results!

I want to share something with you, and if you already know this, please ignore me!

I check in with an endocrinologist once or twice a year. And what I've learned from my endocrinologist is that these test results are more meaningful, and more reliable, if the blood samples are drawn at the same time of day and under the same circumstances, every single time you go in for thyroid testing.

So, for me, that means, fasting (water only) in the AM, usually between 7am and 9am, over the span of 10 years now.

For someone else, it could be going to the lab at 1pm, after lunch, every single time. Whatever works best for that person.

I wanted to mention that because this is something primary care doctors definitely DO NOT know, and I'm not sure if naturpaths know better.

Just wanted to share with you because you are clearly tracking your results, and any deviations (up or down) are more reliable if the testing is performed at the same time and under the same circumstances, every single time.

 

[pamojja]

Are you on thyroid medications?

The high TSH - thyroid stimulating hormone (and therefore strictly speaking not a thyroid hormone) otherwise was a natural result of too low real thyroid hormone, freeT4 and freeT3 in 2020.

On the other hand, supplemental biotin allegedly can falsify thyroid hormone tests. I've got pretty consistent low freeT3 syndrome. So I save money by testing freeT3 hormone only.

My latest lowest freeT3 of 1.9 pg/ml should make me concerned, though. But with 3.6, as in your case 5 years ago, I wouldn't worry and save money.