A detailed discussion of current symptoms and past medical history will occur during the hour long consultation. Any relevant past labs can be reviewed and interpreted as well as a discussion regarding current medications and supplement dosing. If your visit is in-person, a thyroid physical is done to asses for size, texture and presence of nodules along with an exam of other relevant concerns. Virtual and phone appointments are welcomed, if an in-person appointment can be made in the future, a physical examination will take place.
Testing is an important tool to learn more information and a six-marker panel through Lifelabs is essential when looking at the whole thyroid picture. TSH, T3, T4, reverse T3, anti-thyroglobulin and anti-thyroperoxidase antibodies constitute the advanced thyroid panel. Test results will indicate if Hashimoto’s is present and if so how much inflammation or activity is at this time. The rate of thyroid hormone conversion can be calculated as well as the absolute amounts of active and inactive hormones being made. From this information, a prescriptive plan can be developed along with nutrients and herbs to support wellness. Click here for more details on these markers.
Additional Lifelabs tests ordered often include Vitamin D status, fasting insulin, Day 21 progesterone, iron, B12 levels and Celiac antibodies. This can be done at the same time as the thyroid levels to gather more information.
If obvious other areas are involved, digestive flora testing with a SIBO breath test and microbiology stool test may be ordered. Hormonal imbalances could play a key role and cortisol, estrogen, progesterone and androgens would be tested using saliva or urine analysis. Read about the root causes of Hashimoto's here.
Follow-up thyroid visits Depending on the treatment protocols, those who newly start thyroid medication will re-test TSH in 6 weeks and changes or renewals will test TSH, T3 and T4 in 3 months. Regular monitoring of these 3 markers at 3 month intervals until a stable prescription is written for a year is the best way to ensure optimal thyroid wellness. Once stable, blood monitoring can reduce to 3 times per year, or every 4 months. Symptoms always play an important role when determining appropriate doses, the labs are there to support and give extra clarity.