Check the Thyroid Problems factsheet out here.
You can purchase all Thyroid Tests now on the shop here.
Thyroid Testing Summary
You would think thyroid testing would be easy, but you’d be wrong! Why do they never test everything you want to know, honestly, it drives me spare! Certainly, please do not go by your mainstream medical test results – they are woefully inadequate, sadly, and will not help you much. Just measuring TSH and T4 is not giving you the whole picture at all.
FDX Thyroid Ultra
This is a fantastic and very comprehensive thyroid test, which matches most of the markers recommended by STTM (Stop The Thyroid Madness). You can read about it here: https://functionaldx.com/product/fdx-22/. It includes hormones, cardiovascular and inflammation levels, sugar and lipid management, enzyme production, vitamin and mineral status, alongside thyroid function. Also: Parathyroid hormone, TSH receptor Auto-antibodies, Thyroid binding globulin, free T3: reverse T3 ratio, Selenium, Copper and Zinc Serum levels and Epstein Barr Auto-antibodies.
FDX, Functional Diagnostics Lab, offers some really brilliant detailed panels with fantastic reports. The tests give optimal ranges of nutrients but also a shed-load more interpretation using the lab results as indicators and predictors of problems instead of just giving you a baffling set of numbers. Samples returned to the lab by courier, which is included. Blood needs to be centrifuged so please check you have a local phlebotomist who can do that before ordering. Test instructions are here. And here’s a leaflet about the report you get. Blood draw locations can be found here and I have put loads more on the FAQ here. Note: ALL tube labels must be labelled with the client’s full details. Minimum requirements are full name and DOB. Results are usually back to me within 3 weeks and I will email them to you with some thoughts if appropriate.
Just make sure you do FDX tests within 90 days or they can charge an admin fee and they charge cancellation fees after 45 days of up to the full price, so only order if you are going to do it within the timeframe and not change your mind!
I’ve also listed the FDX Thyroid Check + as a cut down version of the main profile – still great as a good look at thyroid health and would be useful for checking progress, rather than having to do the full test again, and it doesn’t need centrifuging.
Any questions, please don’t contact FDX direct; they will only deal with practitioners. You can see their FAQ here.
Don’t forget: you will need to budget for phlebotomy services.
Alternatives
I’ve used the Genova Thyroid Plus successfully for patients for many years as a really good baseline thyroid check that is still a million times better than standard testing! I like it because it looks for the usual TSH, free T4, free T3 etc, but also gives an idea of how much inactive reverse T3 you are making, shows up conversion problems that might be related to selenium or iodine deficiency (surprisingly common this latter one, measures the main autoimmune antibodies. With all that info, you can make a start on seeing what is going wrong, what further investigations might be useful and how to treat effectively. You can order that here or direct using my code A42RS.
Genetic Thyroid Testing
It can be very useful to check for any SNPs or weaknesses on your thyroid genetics, especially if you are not getting well with usual treatments. For this, use the Lifecode Gx Thyroid test. With Lifecode, you can order one report, or several. The first is £399 and you can add-on other reports and each report added costs £150. You can see the different Lifecode Gx reports here, the test instructions here and sample reports here. There is also an introductory brochure here. Please put in comments which reports you want, thanks.
Iodine and Halides Testing
More often than not, I find that people are making enough thyroid hormone but not converting it properly into the active hormone T3, or they are converting too much of it into the inactive hormone Reverse T3. These conversions are utterly dependent upon iodine and selenium levels. With iodine issues, the most suspect pattern is if T4 is low with normal or high T3. You can test for iodine itself but it is more effective to test loading levels eg. using the Urine Halides Loading test, where you can see if the iodine is OK, but also if levels of bromine and flourine are blocking the iodine. You can order that here, or direct from the lab using that link.
For selenium, you need to check whole blood levels. You can do that using the Genova Elemental Analysis test, which cleverly uses all the right forms of blood sample for the various minerals. You can order that here or direct using my code A42RS. See the collection instructions here and all the other nutrient tests they do. It’s actually better to do a nutrient test for most minerals rather than just selenium as others have a bearing on thyroid health too, especially magnesium – must be red blood cell, not serum, which is misleading. (Note, selenium and magnesium, plus other nutrients are included in the FDX Thyroid Ultra above, so you don’t need both).
Hormone Testing
Hormones are all interlinked and affect each other greatly, so it can be a good idea to check those, especially if you are not getting well. Check the Men’s Health and Women’s Health pages where I’ve listed hormone tests for you too.
Testing Tips….
Many people will test whilst they are on long-term thyroid meds eg. thyroxine to see how they are on it/is it enough etc? If you are on something like Armour, again you can test on it – just take your usual dose after the blood draw – or, if you are stopping either (with your health professional’s assent, of course), then the lab advises you would need to wait 90-100 days for it to come out of your system and get a clear result.
Iodine and Halides Loading tips…
Shipping
The lab will then drop-ship it to the US lab for you.
How do I do the test?
You take a urine sample when you get up in the morning, put it in the ‘Pre’ vial, label that and then take your loading dose of 50mg of Iodoral; that’s all 4 tablets together (unless your health professional advises otherwise, of course). From then on, you collect your urine every time you go for the next 24 hours or until you fill the 4 litre jug. You then shake the jug to mix the urine up a bit, write down the total volume of urine collected in the post section on the form (should be max 4000ml obviously but might be under that), then take a sample and put it in the ‘post’ vial, labelling it correctly. Ignore the Excess volume bit of the form; it’s just confusing and you don’t need it. You then package your samples up, following the instructions and packaging given in your kit. Make sure your form is filled in completely – especially the pre and post urine volume amounts which are crucial otherwise they can’t calculate your results properly – and put it with the samples (otherwise it will be rejected) and Bob’s your Uncle.
Will I get iodine tablets in the kit?
Yes, 4 x 12.5mg Iodoral tablets for the challenge test are included with your kit.
What if I collect more than 4000ml of urine over the 24 hours?
It does say to stop at 4000ml so you just fill the jug up to the fill line and then discard the rest.
Do I have to avoid anything?
With this test, you need to avoid any iodine supplements and iodine rich foods like seafood, kelp, fish (see the instructions in the kit) for 48 hours before the test. You don’t need to stop any other supplements but I often say if unsure stop all supplements for 48 hours to be sure.
I am on thyroxine/Armour, can I still do the test?
The lab advises that thyroxine and other thyroid boosters like Armour should not interfere with results but you need to be careful of over-stimulating your thyroid and be led by your health professional. If you have autoimmune thyroiditis or hyperthyroidism, for example, taking the iodine could cause a thyroid storm so do please talk to your health professional to be safe. I have never known it, but that’s what the lab advises. If taking the test, it is best to take the loading dose well away from your thyroxine or Armour.
I am on other meds, can I still do the test?
Probably. Here is a list of interactions of meds with iodine. Check with your health professional – and often a local pharmacist can be very helpful.
I urinate a lot, will I have to drink less on the day of the test?
There is an option to take a representative sample of your urine anyway. You measure the total volume first and write that on the form. I would trial a normal day and measure what you usually pass and cut down if it is beyond the reference range given on the test instructions.
I see the test measures creatinine. I do a lot of exercise which I read raises creatinine. Does this matter?
The creatinine is only used as a baseline to measure urine concentration levels so they can calculate the retention levels etc. Exercise, raised or low creatinine levels serve no diagnostic purpose here and therefore won’t affect your results.
Does the urine sample have to be frozen?
No, not even if sending from Europe.
Do I have to take the loading dose with food?
It’s always best to take supplements with food so I would have it with a bit of a snack, although it doesn’t matter for your test results.
I have heard that I could have a Symporter transport problem with iodine. Can you test for that?
We don’t do an actual Symporter test as it is very unwieldy to do and hard to get done in the UK. However, we do know that one of the main causes of a symporter issue is high halides, so do the Halides Loading test first and, if those are high, you have your answer. If the halides are low, you’ve ruled that cause out, but there are others including genetic defects, goitrogens, some pesticides and oxidative stress, to name a few. There is useful, if pretty technical, factsheet here for you on Symporter transport testing and treatment.