Guest post from Mary Shomon.
One of the questions I frequently hear from people who are trying to figure out if they are hypothyroid is that they don’t think they have a thyroid problem, because, “I recently had a physical/checkup, and blood tests and all, and the doctor never told me that there is anything wrong with my thyroid. Wouldn’t they tell me if they found something?”
The issue here is that many of us don’t know that a typical annual physical or checkup does not include thyroid function tests. The typical bloodwork done during an annual physical looks is the basic metabolic panel (BMP) — sometimes called a CHEM-7 — which looks at sodium, potassium, chloride, bicarbonate, blood urea nitrogen (BUN), creatinine, glucose, and calcium. Doctors often include a cholesterol panel as well, measuring HDL, LDL, triglycerides, and total cholesterol. But thyroid function tests — even the most basic Thyroid Stimulating Hormone (TSH) test that so many traditional physicians rely on — is not part of any standard workups. It’s only measured if the doctor suspects a thyroid problem, or if a patient requests it and the physician complies.
So in this case, no news is not good news. If you have had a checkup, and you haven’t heard anything about a thyroid problem, you probably never had any thyroid tests included. Time to go back to the physician, and request, at minimum, a TSH, a Free Thyroxine (Free T4), Free Triiodothyronine (Free T3), and Thyroid Peroxidase Antibodies (TPOAb) to start – get a free sample lab slip here.
A tip: While some doctors, HMOs and insurance companies will push back at a request for this more detailed panel (compared to the less expensive TSH test alone, or no tests at all!), a good time to ask your doctor to run this more detailed panel is at your annual physical. Physicians, HMOs and insurance companies typically budget for an annual physical to have a bit more face time between patient and doctor, and allow for more latitude in testing. So if you’re unable to get what you need during other appointments, or you can’t go outside your HMO or insurance network to see a thyroid-friendly practitioner, this may be a way to at least get a start on the tests you need.