Thyroid Testing


A critical part of detecting and diagnosing thyroid disease is the clinical evaluation conducted by a trained practitioner. As part of a thorough clinical evaluation, your practitioner typically should do the following:

-Feel (also known as “palpating”) your neck.
-Listen to your thyroid using a stethoscope.
-Test your reflexes.
-Check your heart rate, rhythm and blood pressure.
-Measure your weight.
-Measure body temperature.
-Examine your face.
-Examine your eyes.
-Observe the general quantity and quality of your hair.
-Examine your skin.
-Examine your nails and hands.
-Review other clinical signs


The blood tests that may be done as part of a thyroid diagnosis include the following:

-Thyroid Stimulating Hormone (TSH) Test
-Total T4/ Total Thyroxine
-Free T4 / Free Thyroxine
-Total T3 / Total Triiodothyronine
-Free T3 / Free Triiodothyronine
-Thyroglobulin/Thyroid Binding Globulin/TBG
-T3 Resin Uptake (T3RU)
-Reverse T3
-Thyroid Peroxidase Antibodies (TPOAb) / Antithyroid Peroxidase Antibodies
-Antithyroid Microsomal Antibodies / Antimicrosomal Antibodies
-Thyroglobulin Antibodies / Antithyroglobulin Antibodies
-Thyroid Receptor Antibodies (TRAb)
-Thyroid-Stimulating Immunoglobulins (TSI)


A number of imaging tests are performed for diagnosis of various thyroid conditions. These tests include:

-Nuclear Scan / Radioactive Iodine Uptake (RAI-U) – which can tell whether a person has Graves’ disease, toxic multinodular goiter, or thyroiditis.
-CT Scan – to help detect and diagnose a goiter, or larger thyroid nodules.
-MRI / Magnetic Resonance Imaging – to evaluate the size and shape of the thyroid
-Thyroid Ultrasound – to evaluate nodules, lumps and enlargement of your gland. Ultrasound can tell whether a nodule is a fluid-filled cyst, or a mass of solid tissue.


A needle biopsy, also known as fine needle aspiration (FNA) is used to help evaluate lumps or cold nodules. In a needle biopsy, a thin needle is inserted directly into the lump, some cells are withdrawn and they are evaluated for cancer. (Some practitioners use ultrasound while conducting a biopsy in order to ensure that the needle goes into the right position.) Cancer can be definitively diagnosed about 75 percent of the time from FNA. Evaluation of biopsy results can also show cells indicative of Hashimoto’s thyroiditis.


Some patients need to be highly involved in their thyroid diagnosis and care, which is where self-tests and the ability to order your own tests can be a critical tool for an empowered patient. Among the options for patients include:

-The Thyroid Neck Check – A check you can perform yourself.
-Biosafe’s Fingerstick TSH Blood Test Blood Tests, including Anti-Thyroid Antibodies (Thyroglobulin Antibodies and Thyroid Peroxidase Antibodies), Thyroid panel I (T3 -Uptake, T4 Total, T7, and TSH), Thyroid Panel II (Free T3, Free T4, and TSH), TSI/TSH (Thyroid Stimulating Immunoglobulin and TSH), and TSH alone.
-ZRT Laboratory’s Saliva and Bloodspot Testing, including TSH, Free T4, Free T3, and Thyroid Peroxidase (TPO) Antibody.
-Diagnostechs Saliva Testing, including TSH, Free T4, Free T3, and antimicrosomal antibodies.