Diagnostics

Comprehensive Thyroid Testing

A single TSH is the most common thyroid test — and the reason so many people are told they're 'normal' while still feeling awful. Here's the full panel we run, and what each marker tells us.

  • Standard testTSH only
  • Our panelTSH, Free T4, Free T3, Reverse T3, antibodies
  • WhyTSH is a signal, not the active hormone
  • Interpreted withYour symptoms, not just the range

Why TSH alone isn't enough

TSH is a pituitary hormone that tells the thyroid to work harder or ease off. It's a useful screen, but it's an indirect signal — not a measurement of how much active hormone is actually reaching your cells. People with the same TSH can feel completely different, and early autoimmune disease can be well underway while TSH still reads 'normal.'

What a complete thyroid panel includes

A thorough evaluation looks at the whole system:

  • TSH — the pituitary signal and starting point.
  • Free T4 — the storage hormone your body converts to the active form.
  • Free T3 — the active hormone that actually drives your metabolism.
  • Reverse T3 — an inactive form that can rise under stress or illness and blunt T3's effect.
  • TPO & thyroglobulin antibodies — markers of Hashimoto's autoimmune activity.

Together these reveal not just whether you're hypothyroid, but why, and whether you convert T4 to T3 well — which guides treatment choice.

Reading labs against the patient, not just the range

Reference ranges describe a broad population, not your optimal. A result at the edge of 'normal' paired with classic symptoms tells a very different story than the same number in someone who feels great. We interpret your panel alongside your symptoms and history — and use it to decide between levothyroxine, T3/T4 combination, or desiccated thyroid.

Frequently Asked Questions

What thyroid tests should I ask for?
Beyond TSH, a complete picture includes Free T4, Free T3, Reverse T3, and TPO/thyroglobulin antibodies. We order the full panel by default rather than testing TSH in isolation.
My TSH is normal — do I still need the full panel?
If you have symptoms or a family history, yes. Antibodies and Free T3 can flag a problem that a normal TSH hides, especially early in autoimmune thyroid disease.
Do I need to fast or time the test?
We'll give you specific guidance, including how to time the draw relative to any thyroid medication and the time of day, since both can affect results.
Can I get tested by telehealth?
Yes. We send orders to a lab near you, then review the results with you by video — anywhere in California, plus in person in Chatsworth and Santa Barbara.
What is Reverse T3 and why test it?
Reverse T3 is an inactive form of thyroid hormone that can rise during stress, illness, or dieting and reduce the impact of your active T3. It helps explain symptoms when other labs look borderline.
How often should thyroid levels be rechecked?
After a dose change, typically in 6–8 weeks; once stable, periodically. Antibodies are followed over a longer horizon to monitor autoimmune activity.

Clinical references: American Thyroid Association · Endocrine Society

Related Thyroid Care

Get the
Whole Picture.

Stop guessing from a single number. A comprehensive thyroid panel — interpreted against how you feel — is the fastest way to answers. Book a consultation to get started.

Available across California via telehealth · in-person in Chatsworth & Santa Barbara.

Medically reviewed by Carolyn Pampalone, MSN, FNP-BC · Last reviewed October 2026