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What thyroid tests should you ask about?

Jillian Foglesong Stabile, MD

Jillian Foglesong Stabile

MD, FAAFP, DABOM

Sipra Medical Reviewer

  • American Board of Family Medicine
  • American Board of Obesity Medicine
  • Wake Forest University School of Medicine
FAAFP, DABOM · Reviewed June 10, 2026 · Educational lab guide
Question 1 of 3
What is prompting you to check?

A worked example

Fatigue, weight gain, and feeling cold, with no previous thyroid test

TSH
the first-line screening test for thyroid function
Free T4
paired with TSH when symptoms are present
Free T3
sometimes added when symptoms are pronounced

The suggestion is which markers are worth discussing. A physician decides what to order and what it means.

Run your own numbers in the tool above.

Chapter 01 · The tests

What a thyroid panel looks at

The thyroid is a small gland that sets your metabolic pace. The first-line test is TSH, the pituitary signal that rises when the thyroid is underactive and falls when it is overactive. When symptoms are present, a clinician often pairs it with Free T4, and sometimes Free T3, to see the actual thyroid hormone levels.1 TSH plus Free T4 covers most situations; the extras are added for a reason.

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Thyroid antibodies (TPO and thyroglobulin) help identify autoimmune thyroid disease, the most common cause of an underactive thyroid, and are often checked when there is a family history or a prior abnormal result. In pregnancy, thyroid needs change and the reference ranges differ by trimester, so testing and timing are handled differently and promptly.
An elevated Free T4 with a TSH that is not suppressed is an unusual pattern. One rare explanation is resistance to thyroid hormone, but a clinician must also consider testing interference and pituitary causes before drawing a conclusion. The pattern needs repeat testing and specialist interpretation; this guide does not diagnose it.2
Chapter 02 · The fine print

What this guide does not do

This is educational. It does not diagnose a thyroid condition, order any test, or tell you that you need treatment. Many symptoms that point toward the thyroid, such as fatigue or weight change, have other causes, and a single TSH can be misleading without the clinical picture. A licensed physician decides which tests are appropriate, interprets them with your history, and recommends next steps. Individual results vary.
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How often should we draw?
One panel, repeated. More draws means you see change instead of a single snapshot. Tap an answer to start your Lab Pass.
If you are pregnant or on thyroid medication, do not wait on a calculator. Reach out to your clinician, who handles testing and dose changes directly. Individual results vary.

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Sources

  1. American Thyroid Association. "Thyroid Function Tests." ATA patient resources, 2024. thyroid.org
  2. American Thyroid Association. "Thyroid hormone resistance and its management." Clinical Thyroidology for Patients. 2012;5(8):9-10. thyroid.org
Educational guide only, not a lab order or a diagnosis. A licensed physician decides which tests are appropriate and interprets them with your history. Individual results vary. Last reviewed June 10, 2026 by Jillian Foglesong Stabile, MD, FAAFP, DABOM. Prices snapshot Educational lab guide.
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