I've heard that the 'full thyroid panel' is a useless dinosaur and that a TSH test is sufficient but I've also heard that a full thyroid panel is necessary to determine any subclinical, suboptimal deficiency cases.
The so-called "full panel" usually consists of TSH, T4, T3 uptake, and FT index. This panel is outdated and not at all revealing.
TSH alone will tell you nothing, because TSH can lag behind low thyroid hormone production by months and/or years.
The tests that will reveal most cases of hypoT are the TSH, free T4, free T3, and anti-thyroid (TPO and Tg) antibodies. If either or both the free hormones are below the middle of the lab range, no matter where the TSH value, there is a problem. Even if the TSH is mildly elevated (meaning above 2, but below the upper limit), and the free Ts are solidly mid-range, but anti-thyroid antibodies and symptoms are present, the most enlightened doctors will begin treatment. That's because the ABs indicate Hashimoto's disease, and the gland is doomed to failure anyway.
You can see, TSH is NOT the be-all and end-all test. Thyroid disease should be open to interpretation, but stubborn doctors continue to insist it isn't. Darn shame.
>That's because the ABs indicate Hashimoto's disease, and the gland is doomed to failure anyway.
Well I'm pushing 60 and been this way virtually all my life so if it was going to fail it would have done so by now.
Hashimoto's isn't the only cause of hypothyroidism.
Are you working with a doctor on this? If you've only seen one, and he says TSH is sufficient, he's wrong. If he did the "dinosaur" panel, he still doesn't know much about thyroid, and you'll be better off getting another opinion or two.
So... talk to us. Tell us what's going on with you.
I too have been dealing with a doctor who believes that TSH is the only test that is done for thyroid testing. He did test me Free T's only because I asked for them. I also mentioned thyroid antibodies testing and he said no such thing existed. My TSH has been rising slowly starting at 0.67, 0.9 and now at 1.07 (range 0.3-5.0) my Free T4 was 9.2 (range 9.1-23.8) and Free T3 was 4.6 (range 2.5-5.7) and my doctor insists that there is nothing thyroid here so he will not send me to an Endo. I am just tired of not feeling like my old self which hasn't been for along time. So any advice would also be appreciated in how I can get my doc to see my way. See here in Canada you can not get into another doctor without a referral. So any info or advice would be greatly appreciated. Thanks and God Bless.
I've personally tested the theory. I bought myself 5 TSH tests and wrote my symptoms down. In the course of a week or two my TSH was between 5.5, which is almost normal, to over 15.5 which is pretty hypothyroid yet my symtoms remained the same. So, for a fact, TSH tells you nothing more than the fact that there is probably a thyroid problem without providing a cause or a way to treat it. Free T3 and Free T4 IS the gold standard.