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!
Do you have a list of drs who can help?
I feel like you tell us the drawbacks of both case scenarios as far as testing but what else can we do?
Hi Teresa,
Sort of, there really isn’t a good list of doctors that practice the right way but you can use this resource to help you find someone local: https://www.restartmed.com/how-to-find-a-doctor-to-treat-your-thyroid/
I started Armour Thyroid about a year ago and now my TSH and T3 are normal, but T4 is low.
Also, my hair started to fall out but that might be menopause related? Still retaining water and abdominal weight. Temperature running hot all the time, but skin cool to the touch.
My Doctor (internist) doesn’t known why this is happening and is not adjusting the medication. Previously, I went to an endocrinologist who wouldn’t prescribe Armour Thyroid so can’t go back to her.
Have no where to turn at this point.
Any ideas on what is going on?
An OB/GYN ordered my meds; however, I am on my last refill. I am hoping to find someone more qualified to take my case. Denver, CO is 45 minutes away–no problem. Most of them require a referral which I cannot get! HELP!
Hi Christine,
I don’t know anyone in that area but you can use this resource to help you find someone: https://www.restartmed.com/how-to-find-a-doctor-to-treat-your-thyroid/
I did just order a self test. I’ve been diagnosed with a hypothyroidism and have seen five doctors since the initial issue which prompted a visit. Still working on getting the med levels right, but had to push for the TPO test to find out exactly what the issue is: hypothyroidism or Hashimoto’s. It will be another six weeks before I can get it from the doctor. The frustration was that I went to my gp because my eye doctor found uveitis and said get a physical to see if I have an underlying autoimmune situation. Six months later with four sets of blood work, an eye doctor, an allergist, a rheumatologist and a gp, the home test confirmed my tpo levels.
Now I have a nutrition plan to go along with my meds. This article on Foods to Avoid you wrote is going to be quite helpful. Thank you for writing these articles. I appreciate it.
Hi Joanne,
Do you live in the United States or another country? I’m surprised it’s taken so long to get such a simple test.
In the US. They were concentrating on getting my TSH numbers under control, not the cause. Thank you again.
Hi Joanne,
Gotcha! In that case, it’s probably time to find a new set of doctors! You can use this resource to help: https://www.restartmed.com/how-to-find-a-doctor-to-treat-your-thyroid/
Perhaps you can help me understand…my test results were TSH W/Reflex to FT4 9.4 and my Free T4 was 0.7 so they increased my ND to 45 mg. Up 15 mg.
Then in 8 weeks it went To TSH 1.88 and FT4 1.9
They would not retest the TSH W/Reflex to FT4……why wouldn’t they retest the one that was really high? Is this the same as TSH?
Also what is low RT3?
Thanks
Patricia
Hi Patricia,
The TSH with reflex to T4 only tests the T4 if the TSH is abnormal. Low rT3 just means you have low reverse T3.
Doesn’t that seem unusually fast change to change from 9.4 to
1.9 in 8 weeks?
Patricia K.
Does it seem strange that my FT4 went from 9.4 then 8 weeks later it was 4.19
The Doctor increased my ND up 15 mg.
Does this seem within normal change?
It seems a lot to me, but ??
Thank you Patricia K.
Hi Patricia,
That’s not all that uncommon, to be honest. It would depend on how accurate both sets of lab tests were and how they were drawn. Factors like the time of day that the labs were drawn and when you took your thyroid medication in relation to when you had the blood drawn can all play a role. I would say those factors probably played a bigger role in your lab test results as opposed to changes in your medication but both likely had an impact.
Thank you!!
Patricia K.
Hi Dr.Childs,
Thanks so much for all the good info. I am 39 yr. old female. I have always kept my weight between 130-135 lbs in the last 5 months my weight has increased to 144lbs with no changes. I am fatigued, cold, tight calf muscles, weakness, etc. I feel trapped in a body that is not my own. I recently saw my gynecologist thinking it was hormone relates. Testosterone was low and started compounded cream, also tsh was elevated at 3.41(0.3-3). Followed up with PCP 3 weeks later and TSH 2.648(0.34-4.2), freeT3 2.83(2.4-4.4), freeT4 0.88(0.58-1.7), tpo Ab <0.25(<9). I feel like a sloth and that is not me. I recently ordered some of your supplements, and am hopeful they will help. Also super concerned about my LDL which was 142, triglycerides 60, HDL 67, and I eat healthier, I believe than 75% of Americans and I eat lots of greens, organic meats, and very rare fast food or sweets. I feel like my doctor thinks I'm just depressed and lazy, but I am determined to get better. Any recommendations would be much appreciated, also do you see patient's virtually? Also, my son said you used to be a mine craft youtuber is that right?
Thanks so much! Melissa
Hi Melissa,
I’m thinking he must be confusing me with someone else since I’ve never played Minecraft before! I’m not seeing patients right now but if that ever changes I will send out an email to my mailing list.
In regards to weight loss, I would recommend checking out these case studies from thyroid patients to give you a better idea of what type of treatments and therapies work best:
https://www.restartmed.com/weight-loss-naturethroid/
https://www.restartmed.com/weight-loss-hypothyroidism-success/
https://www.restartmed.com/diabetes-reversed/
https://www.restartmed.com/thyroid-weight-loss/
https://www.restartmed.com/victoza-weight-loss/
https://www.restartmed.com/adding-t3-ndt/
Can Herpes A virus cause thyroid antibody reaction or inflame the autoimmune response, and can this connection be diagnosed? How to diagnose?
Hi Tom,
Theoretically, any viral infection could stimulate an antibody reaction and autoimmune response.
I go into my doctor’s office with a list of labs that I would like for him to order and he orders them. I have to travel to Chicago from Pennsylvania to see him because I can’t find a competent thyroid doctor in Pennsylvania. I see him for in-person appointments once a year and telemedicine between visits.
I’ve done a lot of self-education on interpreting labs because most doctors don’t have a clue what they are looking at. Unfortunate but true.
Hi! I just did my first blood test with Paloma a couple weeks ago and will have my first virtual doctor’s visit in a couple weeks. The app has some good tracking programs. So far- everything was super easy.
I had RAI in 2011 in my early 30s because I was hyperthyroid and having crazy heart palpitations. Fast forward to 2019 – I noticed changes after feeling for the most part pretty good and my endocrinologist wasn’t listening- said my levels were a little high for me but normal. Offered to test again in 4 months, still said I was normal. Fast forward another year and 10 pounds- I switched to an internal medicine doctor who really listened- she did a lot of other blood work besides thyroid & increased my levothyroxine and added b12 and d3. However every time she sent my orders for blood work, she coded it as diagnostic and I ended up with $700 bills after insurance. This happened a couple years in a row. I am trying Paloma mainly to have them take over my thyroid prescription.
I started a few supplements about 3 months ago – maca root, a pre & pro biotic and just a few weeks ago switched my vitamins to your Thyroid Essentials because it can replace my D3 and B12 I was already taking too. Felt extra exhausted the first 8-10 days but am definitely feeling better.
Your articles about conversion have me wondering if that’s my issue or maybe time to switch medications.
So far with Paloma- the year membership isn’t covered by my type of insurance or the blood work but I can use my HSA on both ordering the labs and my doctors visits! But it’s going to be way cheaper than my last doctor’s labs.
As someone that knows my body changes pretty well and has been dealing with thyroid issues for 13 years- I appreciate all your resources!
Hi Melissa,
My concern is that Paloma is really just a mask for standard practitioners who practice in the same was as PCPs and endos with some clever marketing targeting thyroid patients. I just don’t see how they can practice any different at scale given the standard of care and the consequences that would follow if they broke the mold. I’m hoping I’m wrong, though.
so this is from life extension, who send a client to lab corp to get tested and they are on sale all tests are on sale but just listing this one here……………
Thyroid Panel (TSH, T4, Free T4, Free T3) Blood Test
$75.00 Sale $56.25 Save 25%
I could hardly handle let’s get checked, my blood clotted and I had to poke my fingers endlessly.
Hi Joann,
Does that include lab draw fees as well?
And I do agree with the lets get checked finger pricking issue, we had the same issue when experimenting with it.
Life Extension does cover the blood draw. I have used them for years. They also will “review” your test results, but do not give medical advice. Excellent site!
I just recently ordered through Ulta Lab which uses Quest. My functional doctor, who normally uses Lab Corp, told me what she wanted and was ok with me doing this. The thyroid tests came back as requested (TSH, FT3, FT4 and RT3) but other labs didn’t include all of what she wanted-probably because I didn’t pick the right one. I thought I would save money but by the time she charged for interpreting them (which took longer being a totally different lab) plus the 45 minute visit with me to explain, I’d been better off going with her panel that was $400 and included the visit to explain. My functional doctor can’t prescribe my NP Thyroid dose so I have to see my PCP yearly for that. The PCP will only order the TSH & Free T4 & isn’t as knowledgeable about thyroid. It’s very frustrating to have Medicare plus a supplement and not be able to get all that’s needed in one place. I SO appreciate your website and supplements. The T3 booster is a must have for me now! Will continue to investigate options for an integrative Dr that can also prescribe.
My dr has kept me on levothyroxine 50 mcg for years telling me Im in the stable range. I tell him I feel terrible & my thyroid swells monthly. Im losing hair & feel cold all the time, temp is 97.6. I need another opinion so Im going to order a test & have someone else read the results to me. I may need to find a new dr too. Thank you for the info.
I have elevated thyroid antibodies – below 100. I have no insurance nor is there any doctor that I can find to work with in my local area that doesn’t want to give you a prescription. I am ordering my own labs through Life Extension. They have Docs on staff that you can consult with. I am working through telemedicine with a homeopathic Doctor from CA. This is not the only issue I have. He looks at the whole body. I am a trauma survivor and did not realize that I had been sleeping on guard for the last 11 years. Your body can’t heal from anything if you do not get adequate sleep. So, I am under a Doctor’ care but still order my own labs and send to him. I think it is very important for each individual to teach themselves about their health and not rely totally on the medical community.
You left out testing for reverse T3. Is there a reason for this. When I paid to get my late father’s full thyroid lab tests it included reverse T3. His RT3/T3 ratio was 5 times higher than normal which helped explain his near comatose state. Once he started taking T3, he got a couple years of life back.
Hi Marcos,
Most of the lab testing companies don’t provide reverse T3 testing and its utility is somewhat debatable. I still think it’s worthwhile to get, but only if you really understand what it means and its limitations.
Go(od points. I get my own bloodwork done at least once every 6 months. I get a comprehensive panel thyroid, overall wellness, inflammation, sometimes some nutrients. I had severe Hashimotos (postpartum) and saw an endo for about 1.5 yrs. He was such a horrible person and not a great doc, so thank God my Hashi went into remission (no meds needed after 1.5 yrs postpartum) Doc said I should still come in regularly for bloodwork. No way! I’ve been ordering it myself for 17+ years now. All good. You’re right though, if it wasn’t good I’d need to find a good doc. I talk to my GYN about it sometimes. She would be there for me if I needed help.