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What thyroid labs to ask for in order to manage your thyroid and Hashimoto’s disease?

Posted on by Magdalena

So, you just got back your “thyroid labs” and all they say is: TSH and Total T4. Your doctor might have even told you that “you do not have a thyroid problem” even though you are ticking every symptom of hypothyroidism (I’ve posted the Symptoms List here).

If you are lucky, the doctor would have also tested you for Total T3.

If you are really lucky, the doctor would have ordered the Free T4 and maybe Free T3.

Why is it important to know if you want to manage your thyroid health?

For a few reasons.

Reason #1: The TSH Controversy.

TSH alone is not enough to manage your thyroid condition. There is a big push from the thyroid advocacy world against the blindness of doctors of using TSH to treat thyroid patients.

There are a few reasons for that. Firstly, the range used by conventional doctors is 0.5 – 5.0 whereby functional and integrative practitioners would want to see a healthy person to have their TSH in the 1-2 range.

You see, I also had a perfect TSH of 1.6 to 1.8 even when my body was completely shutting down. This is due to reason #2, see below.

Reason #2: T3 hormone is king. 

T3, also known as triiodothyronine, is the hormone that our body cells have receptors for. This means that for you to have beautiful hair, healthy nails, optimal gut health, sharp mind and good mood, you need a sufficient amount of the T3 hormone, not T4.

Interestingly, the T3 hormone is produced from T4 by a metabolic conversion that happens in the gut and the liver. Can you see now how you could have a sufficient T4 hormone but if your T3 is low, you will still be feeling like a zombie?

Oh, and by the way, Synthroid is a synthetic version of T4 – this means that you still need to convert it to T3 to feel good.

Reason #3: Free and not Total. 

Another problematic issue is that most doctors do not test for the “free” version of the T4 and T3 hormone. “Free” means unbound to a protein molecule and available for the body receptors to use so you can function properly.

Can you see now how useless and even dangerously misleading it is to have your TSH and Total T4 tested and nothing else?

But, there is more.

~ T4 to T3 Conversion Issues ~ 

There is a list of vitamins and minerals that are key in converting T4 to T3 (including Synthroid). Vitamin and mineral deficiencies are very common in most people today. This is due to a combination of reasons – poor soil conditions of the food we grow, poor diet but also highly compromised gut health.

When we experience poor digestive health even supplements can’t help as the gut lining is just not absorbing the goodness of the food we are eating.

~ The Overlooked Autoimmune Component ~ 

Remember that 90% of thyroid conditions in developed countries are due to an autoimmune condition, such as Hashimoto’s. This means one basic thing: it’s our immune system primarily that is in trouble, not our thyroid.

How do you confirm having Hashimoto’s? By testing for the level of your TPO (thyroperoxidase) and TGB (thyroglobulin) antibodies.

To sum it all up what is absolutely key and essential in managing your thyroid condition, I’ve put together a list of Labs that every thyroid patient should ask their doctor to test for. If the doc refuses, move on and find a doctor who would.

Download a copy of the Thyroid Lab Checklist here.

Bring it to your doctor, it will feel empowering to be in the know. If your doctor dismisses you, find one that will do the complete tests.


~~ From Triggers to Solutions ~~

Given the frustration I sense from the emails I receive every day, I got inspired to run a Free Online Workshop on January 14th called Mastering Hashimoto’s”.

It will be a FREE and highly interactive workshop which will help you plot your SYMPTOMS to a HEALTH MAP and understand what were/are your TRIGGERS that activated your autoimmune condition(s) and how to address them proactively.

I created a number of tools I recommend printing out and bringing to the online workshop on January 14th.



Other tools you are getting before the workshop:

Symptoms List 

Labs Checklist 

Vision Board 

You need to register to get dial-in details.

It’s true that once you have Hashimoto’s you have it forever – this includes me. But, you can get to a place of remission, be symptoms-free and live a full life.

I hope to see you there!



P.S. Most of us have a friend who struggles with weight, fatigue or hair loss even though their doctor told them that they have no thyroid problem. If you have such friends, send them this email, together with the Symptoms List and the Labs Checklist.

Too many people are flying under the radar, this is killing me to see. You can change someone’s life with this information.