In a perfect world, you would be able to go to your thyroid doctor and they would willing to order all of the right thyroid lab tests and that would be the end of it.
Your insurance would pay for the cost of the lab tests, your doctor would be able to interpret all of the results, and you’d be able to get on the right thyroid medication or treatment.
Unfortunately, that’s not the world we live in right now (hopefully, that changes!).
Even with all of the information available to us, there are still plenty of doctors that refuse to order tests outside of the TSH and free T4.
This leaves a lot of thyroid patients in a conundrum:
Do they stick with a doctor who isn’t willing to work with them?
Do they try to find a new doctor or…
Do they order their own thyroid lab tests?
For patients in this situation, ordering their own lab tests seems like an easy solution.
It may sound tempting or appealing to order your own lab tests but I’m here to tell you that it doesn’t always make sense.
In fact, I think in the majority of cases it’s not worth it and will only result in less money in your bank account.
Before you get upset, hear me out!
I’m not saying that ordering your own lab tests doesn’t have merit, but I don’t think it should be your first choice.
Let me explain why:
Reasons You May Not Want To Order Your Own Thyroid Lab Tests:
The order-your-own lab test industry is exploding in recent years (1) and for good reason.
It allows pretty much anyone to have a better look inside their own body and who doesn’t want to do that?
When you look at the numbers, more people than ever are evaluating their own blood tests for things like hormones, electrolytes, blood sugar, and more.
And, as I mentioned, this is a great thing.
The only problem is that these lab tests don’t always come with an instruction manual.
For something simple like interpreting blood sugar, that isn’t a problem.
But when it comes to evaluating and understanding hormones, it’s another story entirely.
That doesn’t mean you shouldn’t order your own thyroid lab tests, that’s not what I am saying at all.
What I am saying, though, is that before you run out and order them just because you can, make sure that ordering them will provide you with some benefit.
Because if they don’t, you will just end up with a bunch of numbers on a piece of paper (digital or physical) and in the same situation as when you started.
What I’d like to do is lay out some ground rules for when it makes sense to order your own thyroid lab tests and when it doesn’t.
Let’s start with the reasons why you may not want to:
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#1. It’s Expensive and Insurance Won’t Cover Them
The first has to do with cost.
One of the biggest drawbacks to ordering your own thyroid lab tests is that you will be responsible for 100% of the bill.
These tests are not crazy expensive, but they can also start to stack up once you realize that you will probably need more than just your thyroid tested.
Here’s what I mean:
Take for instance the thyroid antibody test combo from Let’s Get Checked.
This thyroid lab test combo contains the following:
- Thyroid Stimulating Hormone
- Free Thyroxine
- Free Triiodothyronine
- Thyroglobulin Antibodies
- Thyroid Peroxidase Antibodies
The total cost for this panel is $119 without any discounts.
The cost of $119 will be affordable for many people but it will be out of reach for some.
But let’s assume for a minute that that price isn’t an issue for you personally and that you could easily afford a couple of hundred dollars in thyroid lab tests every few months.
There’s still one big problem:
If you are serious about treating your thyroid, you are probably going to need more than just your thyroid evaluated.
When you go to your doctor, do they really ever just order your thyroid lab tests?
Not usually, in addition to your thyroid lab tests, they also need to check for other things such as your blood count, your blood chemistry, other hormones, nutrient deficiencies, blood sugar, cholesterol, and so on.
While it may be affordable to just check your thyroid, it starts to get a little out of hand when you add everything together.
You can see the cost of various panels that you’d want to get tested with your thyroid below:
- Vitamin D – $89
- Cortisol – $99
- CRP – $89
- Cholesterol Test Panel – $89
This doesn’t even represent a comprehensive testing profile for thyroid patients, but even with just a few added tests the total runs up to $485 and it gets there quickly.
In reality, if you were really wanting to test your thyroid and get a solid look at other factors that may be contributing to your symptoms, here’s what you’d want to get:
- Thyroid hormone panel – TSH, free T3, free T4, total T3, thyroglobulin antibodies, thyroid peroxidase antibodies, and reverse T3
- Inflammatory Panel – ESR and CRP
- Complete blood count
- Comprehensive metabolic panel
- Vitamin D – 25 hydroxy vitamin D
- Magnesium
- Cortisol
- Sex hormone-binding globulin
- Free and total testosterone
- Vitamin B12
- Iron study panel – Ferritin, serum iron, percent saturation
What’s interesting is that many of these tests are not even available for self-ordering so I can’t even give you an estimated cost, but I would guess it would probably be close to $2,000 or more.
Many people may be able to afford a couple of hundred dollars worth of self-testing but not many will be able to afford $2,000 or more.
This doesn’t mean there aren’t a time and place for self-ordering your own thyroid lab tests but it does mean that it doesn’t make sense for many thyroid patients.
I think it makes the most sense to always try and get your doctor to order as many tests as possible.
Whatever you aren’t able to get, you can then order from a self-order lab company as needed or a la carte.
As long as your doctor is coding your lab test requisition form correctly you shouldn’t have to pay anything out of pocket if you are going the insurance route.
#2. Who Will Interpret The Results?
Another huge problem has to do with the issue of interpretation.
Let me show you what I mean:
Imagine a scenario in which you are a thyroid patient taking 75mcg of levothyroxine and not feeling very well so you want to order your own thyroid lab tests.
You get the panel I mentioned above because it has most of the thyroid markers you need:
- TSH, free T3, free T4, thyroid peroxidase, and thyroglobulin antibodies (the panel I mentioned above)
Now imagine you get your results back and they look like this:
- TSH – 0.65 with a reference range of 0.5 to 5.0 mIU/L
- Free T4 – 1.3 with a reference range of 1.4 to 1.77 ng/dL
- Free T3 – 0.9 with a reference range of 2.0 to 4.4 pg/mL
- Thyroid peroxidase – 60 with a reference range of 0 to 34 IU/mL
- Thyroglobulin Antibody – 3 with a reference range of 0.0 to 0.9 IU/mL
The question is, what do you do next?
Do you increase your dose of levothyroxine? Do you switch to another medication? Do you add some T3 to your levothyroxine? Do you need more lab tests to make the picture clearer?
If you have a lot of experience in interpreting your own thyroid lab tests then this may not seem like a problem but if this is your first time, this information might as well be in another language.
You might think you don’t have to worry because your doctor can help you interpret them but that’s not the case either.
The reason your doctor didn’t order them was most likely because they didn’t understand their importance or their value which is why they weren’t ordered in the first place!
It’s highly unlikely that your doctor will be able to help you which means you will most likely have to go to some other place such as an online forum or Facebook group.
Even though there are plenty of knowledgeable thyroid patient advocates out there, I still would be hesitant to take the advice of a random person on the internet because they bear no responsibility for the outcome of your actions.
When a doctor orders a test, he/she is responsible for the interpretation of that lab test and what it means for the patient.
For this reason, doctors won’t order things that they don’t understand.
The problem of interpretation can be solved and isn’t a problem for everyone but it should at least be considered before you order your own lab tests.
#3. One Set Of Lab Tests Doesn’t Tell You Much
Finally, one last reason to be hesitant has to do with the need for follow-up lab tests.
It’s very rare that a thyroid patient can figure out exactly what type and dose of thyroid medication they need with one set of thyroid labs.
Instead, it usually requires consistent lab testing over months (6-12 on average) to get everything dialed in.
You will test, make adjustments to your medication, test again, make adjustments as necessary, test again, make adjustments, test again, and so on.
When insurance is covering these lab tests, the testing process is relatively painless aside from some frustration.
But if you are footing the bill, you may want to cut corners, extend how the time between your lab tests, or even cut out certain lab tests to lower the price.
This sort of behavior defeats the purpose of ordering your lab tests which is to finally take control of your thyroid symptoms.
Again, this isn’t an insurmountable problem, but you should be aware of what to expect before you jump in.
When It Makes Sense to Pay Out of Pocket:
So far I’ve been critical of self-ordering your own thyroid lab tests so it’s only fair to give some examples of when it makes sense to go ahead and pull the trigger.
#1. You Don’t Have any Thyroid Literate Doctors Near You
If you’ve exhausted all other options and you live in a place where it’s pretty much impossible to find someone to help you then ordering your own thyroid lab tests makes a lot of sense.
It’s better to do something than nothing, even if trying to do it yourself isn’t the best option.
Before you throw in the towel, though, make sure you have truly exhausted all of your options.
This means looking at different types of doctors including specialists like ob/gyns, oncologists, and psychiatrists in addition to the conventional options like endocrinologists and family practice doctors.
Ideally, you would want to look for someone that practices integrative, functional, or anti-aging medicine, but these doctors tend to be more difficult to find and are much more expensive since they don’t take insurance.
#2. You Don’t Have Insurance
As I mentioned above, one of the biggest drawbacks is the cost!
But if you don’t have insurance anyway, then you’re most likely going to have to pay out of pocket so you might as well go with the most convenient option.
If that means ordering your own thyroid lab tests then go with that option.
In the past, it has almost always been a cheaper option to go with online lab testing companies like Let’s Get Checked and Everywell as opposed to the bigger lab companies like Lab Corp.
But recently, the gap between these types of companies has closed, so go with whichever option is cheapest.
#3. You Want to go the All-Natural Route and Your Practitioner Can’t Order Them
Even though my recommendation for thyroid management is to go see a doctor, there are plenty of people who have had success in seeing different types of practitioners.
I typically will recommend seeing doctors (MDs and DOs) because they can prescribe thyroid medication but if that isn’t important to you, or if you don’t need it, or if you are trying to actively avoid it, then other practitioners may work better for you.
Practitioners like chiropractors, health coaches, nutritionists, and naturopaths may be able to actively help you manage your thyroid without the need for medication.
It’s not always possible to avoid the need for thyroid medication, but there are definitely situations in which it’s not necessary or in which you may be able to wean yourself off of it.
These types of practitioners may be able to help you order and better understand your thyroid lab test results.
And because insurance will generally not cover lab tests that are ordered by these types of practitioners, it doesn’t really matter where you get them from.
Outside of MDs and DOs, these types of practitioners are not able to make diagnoses based on the results of your lab tests, but they can help walk you through your own results which can provide you with a lot of helpful information.
If you do decide to go down this route, make sure you find someone that has a lot of experience specifically in helping thyroid patients.
#4. You are a Thyroid Veteran and Have a Lot of Experience Looking at and Evaluating Thyroid Lab Tests
There are plenty of thyroid patients out there that are true veterans.
They understand thyroid lab tests, they know when it makes sense to order what tests, they understand what the results mean, and so on.
If you are one of these veterans then you can forget pretty much everything I’ve said to this point because it doesn’t matter all that much.
With the right knowledge, it’s possible to completely manage your thyroid on your own.
Getting to this point can take a long time, though, and a lot of trial and error.
It should ultimately be the goal of everyone reading this to make it to thyroid veteran status, but don’t get discouraged if you aren’t there.
Keep on reading and keep on learning and you will eventually get there.
Ways to Get Your Own Thyroid Lab Tests:
If after reading all of this information you want to proceed to order your own thyroid lab tests, here are a few options:
- Let’s Get Checked – Let’s Get Checked has a thyroid antibody test that includes TSH, free T3, free T4, thyroglobulin antibodies, and thyroid peroxidase antibodies for around $120.
- Everlywell – Everylwell has a thyroid test option that includes TSH, free T3, free T4, and thyroid peroxidase antibodies for around $120. If you are
- Lab Corp – Lab Corp has a thyroid health blood test that includes TSH and free T4 for $89.
- Quest diagnostics – Has a TSH-only lab test that is available for around $49.
- Paloma Health – Paloma Health has a thyroid biomarker lab test that includes TSH, free T4, free T3, and thyroid peroxidase antibodies.
As you can see, the pricing between all 5 options is fairly close so the best option will largely depend on what you need.
I would recommend sticking with whatever option you choose long term just so that it’s easier to keep track of your results.
By the way, I have no affiliation with any of these companies and don’t receive any compensation for recommending them, I’m just providing you with options should you choose to use them.
Final Thoughts
It can be frustrating to feel like you’re unable to get the tests that you want or need for your thyroid from your doctor.
One potential solution is to order your own thyroid lab tests.
Before you do, I would recommend doing your best to get your current doctor to order them so that they are covered by insurance and so that you have someone to help you interpret the results.
If you are all out of options then there are several situations in which ordering them yourself may be the best option.
Now I want to hear from you:
Have you ordered your own thyroid lab tests before?
Is your doctor willing to order all of the tests that you need or want?
Have you had issues in the past getting all of the right tests?
Have you used any of the on-demand lab testing companies listed above? If so, which one? How was your experience?
Leave your questions or comments below!
