Tests You Need and Optimal Levels as a Hypothyroid Patient

Click here to listen to a reading of this blog:

As a thyroid patient, the below blood tests are recommended to get the full picture of what’s going on. If you still have symptoms, despite being on thyroid medication, explore these. If you feel well on your thyroid medication, monitor these regularly.

Basically, everyone should monitor their thyroid levels!

You may have to push your doctor or try a few different doctors before you find one who will do them. Alternatively, you could pay for them yourself if this is an option.

Click here for places you can order your own tests from. 

The results you should be aiming for are also shown below on the second half of the page.

Full Thyroid Panel, to include as many of these as possible:


Thyroid Stimulating hormone. It gives an indication of thyroid hormone levels but doesn’t actually measure them as it is a pituitary hormone and not a thyroid hormone. Read more here.

Free T3

A measure of the active thyroid hormone, T3.

There are binding proteins that attach to thyroid hormones to transport through the blood vessels, to cells all over our body. When they reach the cells, only the unbound ‘free’ hormones can actually be used by the cells. Therefore Free T3 levels (and Free T4) are important to monitor. It’s important to be aware that Free T3 and Free T4 are different to Total T3 and Total T4. Make sure you check ‘free’ levels.

Free T4

A measure of the less active thyroid hormone, T4. The body should convert T4 to T3 but doesn’t for a lot of thyroid patients.

Reverse T3

This counteracts the T3 your body is producing, so it is important to test this wherever possible because the three above could potentially be OK, whereas a hidden overproduction of RT3 can cause on-going symptoms because your body is attacking the T3 that is produced.

Thyroid Peroxidase Antibody/ies (TPOAB)

This measures the amount of thyroid attacking antibodies in your blood and is used to identify an autoimmune disease like Hashimoto’s Thyroiditis.

Thyroglobulin Antibodies (TGAB) 

Also used to identify an autoimmune disease like Hashimoto’s.

The Essentials

At the very least, you must have TSH, Free T3 and Free T4 done to get an accurate idea of how you are doing, but also testing Reverse T3 and the two antibody tests are also very important and beneficial.

Other Tests to Explore and results most thyroid information sources state to aim for:

TSH – Below 2 on T4-only medication, often close to 0 (suppressed) on T3 containing thyroid medication.
Free T3 – Upper quarter of the range.
Free T4 – Midrange or a bit higher.
Reverse T3 – Low in range.
Reverse T3 Ratio – Over 20. Measure the ratio between the two by dividing the RT3 into the Free T3.
TpoAB and TgAB – In range (over range means you have Hashimoto’s).
B12 – As close to the top of the range as possible.
Vitamin D3 – 50-80 ng/ml, but as close to the top of the range as possible.
Folate/Follic acid – In the top quarter of the range.
Ferritin – 70-90 ng/ml, being slightly higher for men.
Serum Iron – 110 for women, 130-140 for men.
TIBC – About a quarter above the bottom of the range.
Folate – Top half of the range at least.
Magnesium – Mid-range or higher.
RBC Potassium – Top quarter of the range.
Zinc – Top third of the range.

24 Hour Saliva Cortisol Test –
8am – Top of the range.
Midday  – Upper quarter of the range.
4-5pm – Midrange.
11pm – Midnight – At the very bottom of the range.

DHEA – Above mid-range.

You can click on the hyperlinks in the above post to learn more and see references to information given.

If you found this article helpful please take a moment to share this post on social media so we can help other Thyroid Warriors get better and spread awareness.

Written by Rachel, The Invisible Hypothyroidism

Sign up to The Invisible Hypothyroidism's newsletter

You'll get an easy to digest, relevant round up of thyroid news, advice and support to get you feeling better, once every two weeks.

Don’t stay feeling rubbish. Get better.
Get real, helpful advice directly from another thyroid patient. Me!

Give my Facebook page a like, follow me on Instagram, Twitter, Pinterest, Google+.

Join My Facebook Support Group for patients

Join My Facebook Support Group for patients Thyroid Family: Hypothyroidism Advice & Support Group

Hypothyroid patients' other halves can join my seperate group called Loved Ones Of Those With Hypothyroidism - Support & Advice Group

Rachel Hill, Thyroid Patient Expert and Advocate, blogger and author, has Six 2018 WEGO Health Award Nominations. She is a highly ranked writer appearing in the Top Hypothyroidism Websites and Top Thyroid Websites 2018, with relevant qualifications and certificates in Diet and Nutrition, whilst also currently studying  Life Coaching, Motivational Speaking, Reflexology and more. She has worked with The National Academy of Hypothyroidism, The BBC, The Mighty, Dr. Hedberg, Thyroid UK and ThyroidChange, to name just a few. She is well recognised as a trusted and useful contributor to the thyroid community.

6 thoughts on “Tests You Need and Optimal Levels as a Hypothyroid Patient

  1. I want to sign up for your newsletter.This is the only place that respond with a place to give up my email. Hope you will add me to your list from here. Others links did not take me anywhere.

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.