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Considerations Interpreting a Thyroid Panel

By Dicken Weatherby, ND

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The following are some of the considerations I use when interpreting a thyroid panel:

  1. The thyroid is a complex endocrine gland that works in concert with many other endocrine glands with hormonal mediators. Support the whole system as well as the specific organ or gland.
  2. When addressing any endocrine dysfunction, always support the key essentials to normal function first (nutritional deficiencies, fatty acid metabolism, protein/albumin availability, liver activity, hidden infections etc.).
  3. Liver conjugation problems can significantly impair hormone levels from the thyroid, gonads, or adrenal cortex. Therefore, attention should be paid to optimizing liver function prior to exhausting specific endocrine causes or treatments.
  4. Thyroid hormone activity, along with other hormones, is extremely sensitive to stress and toxins such as halogens, toxic metals, drugs etc., which interfere with the synthesis, transport, and utilization of T-4 (thyroxine) and T-3 (triiodothyronine).
  5. Thyroiditis is the most common thyroid condition, leading to either hypothyroidism (Hashimoto’s and sub-acute thyroiditis) or hyperthyroidism (Grave’s disease). Hypothyroidism due to thyroiditis is the most common. Thyroiditis can present with normal, elevated, or decreased levels of thyroid hormone at any time.
  6. Functional chemistry analysis for thyroid status should consist of TSH, T-3, T-4, T-3 uptake, and free T-3 & T-4 levels. In our opinion these are the most useful tests to order.
  7. Multiple tests found on a thyroid panel taken independently are often misleading and inadequate in determining thyroid status. TSH, FTI, T-3 uptake, T-3, T-4, Free T-3 and T-4 are best analyzed collectively with attention to specific patterns.
  8. FTI (Free thyroxine Index) is a test that is often included in thyroid panels. It is an estimate calculated from total T-4 and T-3 uptake. It is usually proportional to actual free T-4 but is an imperfect measurement as it is quite possible to obtain a normal FTI with an abnormal T-3 uptake or T-4. An increased FTI is usually associated with hyperthyroidism, while a low level is associated with hypothyroidism. Although a part of many panels, this test is not recommended as it has been replaced by more accurate tests, such as free T-3 or thyroxine-binding globulin.

© 2004 Dicken Weatherby, ND


Dr. Dicken Weatherby is a graduate of the National College of Naturopathic Medicine in Portland, Oregon. He is the co-author of the best-selling book "Blood Chemistry and CBC Analysis- Clinical Laboratory Testing from a Functional Perspective". To learn more about Dr. Weatherby's functional diagnosis books and sign up for FREE functional diagnosis tips, tools, and techniques, visit his web site at

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