My TSH was normal. Why test more?
TSH is a useful screening test, but it is one number. Free T4, free T3 and thyroid antibodies add information about how the gland is working and whether autoimmune thyroid disease is present.
• Tired, foggy, not yourself / Thyroid
Thyroid
Many people are told their thyroid is "normal" based on a TSH result alone, and are never told what else can be measured.
TSH is a reasonable place to start. It is not the whole picture, and it doesn't tell you whether autoimmune thyroid disease is developing.
What this can be
More than one possible cause.
Symptoms people link to the thyroid, such as fatigue, weight change, feeling cold, hair thinning and low mood, can come from the thyroid or from something that looks like it.
Underactive thyroid
Hypothyroidism slows metabolism and energy.
Overactive thyroid
Hyperthyroidism can cause a racing heart, weight loss and anxiety.
Autoimmune thyroid disease
Hashimoto's or Graves' disease, often visible in antibodies first.
Iron deficiency
Low ferritin causes fatigue and hair loss that overlap with thyroid symptoms.
Low vitamin D
Common, and linked with fatigue and low mood.
Metabolic or sleep problems
Blood sugar, kidney and sleep issues can feel similar.
What we measure
The specific tests we run.
This is the panel we order.
TSH
The pituitary's signal to the thyroid; the standard screening test.
Free T4
The main hormone the thyroid makes.
Free T3
The active form of thyroid hormone.
TPO antibodies
A marker of autoimmune thyroid disease.
Thyroglobulin antibodies
A second marker of autoimmune thyroid disease.
Ferritin
Your iron stores.
Vitamin D
A common deficiency with overlapping symptoms.
Metabolic panel
Kidney function, electrolytes and fasting glucose.
Being honest
What we don't chase.
We do not use reverse T3 to make dosing decisions. And we do not treat a lab number in someone who feels well.
Antibodies tell us about autoimmune thyroid disease even when TSH is still normal. That is useful to know, and it is a reason to monitor over time rather than a reason to start medication.
What happens next
Options, depending on what we find.
We go over your results with you. If thyroid hormone is low and you have symptoms, treatment is an option. If antibodies are positive but function is normal, we set a schedule to recheck. If something else explains how you feel, we address that instead.
What it costs
Published pricing.
Initial evaluation
$250
Self-pay
Follow-up visit
$150
Self-pay
We accept PPO plans from Aetna, AmeriHealth, Horizon and UnitedHealthcare, plus Medicare. HMO plans are not accepted. Lab and treatment costs depend on what is ordered.
See full pricing →Frequently asked
Common questions.
What do thyroid antibodies mean if my TSH is normal?
Positive TPO or thyroglobulin antibodies point to autoimmune thyroid disease, such as Hashimoto's, even before TSH changes. That is a reason to monitor over time, not a reason on its own to start medication.
Do you test reverse T3?
We do not use reverse T3 to make dosing decisions. The evidence does not support it as a guide for treatment.
Will you treat a lab number if I feel fine?
No. We don't treat a lab result in someone who feels well. Treatment decisions are based on symptoms, history and the full picture of results together.
Why do you check ferritin and vitamin D too?
Low iron stores and low vitamin D cause symptoms that overlap with thyroid disease, such as fatigue and hair thinning, and they are common alongside it.
Does insurance cover thyroid testing?
Medically necessary labs can be sent to Quest or Labcorp and billed to insurance. We accept PPO plans from Aetna, AmeriHealth, Horizon and UnitedHealthcare, plus Medicare.
• 6 N Mississippi Ave, Atlantic City
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