All three books of Drs. Richard and Karilee Shames recommend saliva and blood spot testing as superior methods to evaluate thyroid and other hormones . Hormone testing is useful, whether you are mildly affected by hormone imbalance, severely impacted and unable to function, or are simply wondering if the hormone issue is a factor in your everyday health.
Once you have submitted your samples to the lab, and have had the results sent back to you, it is now time for interpretation. What you want to find out is whether your results are in the normal range, or whether one or more is showing some abnormality. (The normal range for each test is at the far right hand side of the page, on the same line as your test result)
Thyroid Lab Test Report
Start with your thyroid lab test report (for example, the lower third part of the page for the Advanced Plus Panel).
There are 4 separate thyroid determinations each measuring a different facet of your thyroid function (and a Vitamin D level, if you ordered the Advanced Plus Panel).
FT4 (free thyroxine - transport form of thyroid hormone)
This is the actual level of transport thyroid hormone that the thyroid gland makes and releases into the body. It is considered the "inactive" form, from which active thyroid hormone is eventually made. The ideal level is the middle or upper part of the normal range.
FT3 (free liothyronine - active form of thyroid hormone)
T3 measures the amount of active thyroid hormone that has already been converted from T4 and is ready to go to work in your tissues. The ideal level is the middle or upper part of the normal range.
TSH (thyroid stimulating hormone)
Measures how much your brain and pituitary are asking for more thyroid. A higher than normal number indicates that the brain’s is sensing a need for more energy, and is asking your thyroid gland to make more thyroid hormone. Conversely, if hardly any TSH can be measured, this usually means the amount of thyroid energy now in your tissues is plenty. (In other words, a higher than normal TSH often means low thyroid; while a lower than normal TSH often means too much thyroid) The ideal place to be on this measurement is in the bottom quarter of the normal range.
TPO (Thyroid peroxidase antibody)
This measures whether or not your immune system is making antibodies against thyroid hormone production. A normal result here means, "No, it isn't." A high result means, “Yes, it is.” Making antibodies against the thyroid is a common underlying cause of thyroid hormone imbalance. If your antibody level is high, you could have a thyroid problem, even though your TSH, FT4, and FT3 are all in the normal range.
Vitamin D (D2, D3, and total)
Having your total vitamin D results be in the upper half of the normal range is your goal here. This is known as being “replete” or “ample” as regards such an important vitamin. In fact, regarding thyroid function, vitamin D is much more of a necessary co-hormone, than a mere vitamin. Being in the lower end of the normal range, and especially if you are below the normal range, could hamper your metabolic function.
Next, consider your reproductive hormone scores: (Both genders have estrogen, progesterone, P/E ratio, and testosterone levels. The ranges of normal reported on the results page differs for males & females)
Ideally this estrogen score falls in the middle third of the normal range. The normals are listed depending on your gender, age, and special situation.
This is a hormone that is considered a balancer of estrogen levels, and a supporter of thyroid and adrenal function. It is interpreted depending on your gender, age, and special situation.
The progesterone/estrogen ratio, if abnormally low, is an indicator of “estrogen dominance”, a situation that is often uncomfortable, and detracts from optimal thyroid function.
Measures an important androgen level in both genders; you want to be ideally in middle of normal range. Being in the upper end is not necessarily better than being in the mid-normal range. On the other hand, in some people, being in the lower end of the normal range feels for them like being too low.
Adrenal Hormone Levels
Now consider adrenal levels:
This is an abundant adrenal hormone that is sometimes at too high or too low a level in the body, for optimal adrenal and thyroid function. Your levels are best at mid-normal range.
4-sample cortisol levels (8 am, noon, 4 pm, 11 pm)
Ideal would be to be in middle of the listed normal range for each of the 4 times tested. Your score also shows as a dark blue line on the graph at the bottom right of the results page. A smooth gentle continuous downward curve is ideal. Other kinds of curves are abnormal, and might be associated with physical or mental symptoms.
Comparison of the Three Hormone Systems
Ideal levels are generally the middle of normal range (except for TSH and Vitamin D described above).
If adrenal and reproductive testing was mostly normal, and only thyroid showed significant abnormality, then you should immediately begin recommendations for thyroid re-balancing.
If you were mostly quite normal in thyroid and reproductive hormones, but showed glaring abnormals in adrenal testing, then you should start with adrenal rebalancing.
If you were mostly quite normal in thyroid and adrenal levels, but reproductive hormones clearly showed glaring abnormalities, then you might need to initiate your re-balancing efforts in the reproductive system first.
The most abnormal system is the one you begin to re-balance first. Then, if still needed, you can re-balance the second and third most abnormal system later.
If you are working with a practitioner, simply share these results with that person and strive to get their best input. Remember that everyone's approach is slightly different. Some practitioners would use this information to start you on over-the-counter products, then suggest you move to prescription items if more help was needed. Others may want to start with prescription treatment first, then move to milder items for maintenance.
If you or your practitioner would like help in interpreting these hormone test results or in deciding on the best course of action based on these results, you may elect to have a coaching session with Dr. Shames. Simply go to www.ThyroidPower.com/content/appointments and preview the information related to telephone coaching sessions.
You can arrange for your health provider to have a "brief practitioner consultation" with Dr. Shames; or you can speak with Dr. Shames yourself for a full 50 minute appointment by telephone. Some people choose to have their practitioner conferenced in for part of their 50 minute appointment, if needed. We hope this information is helpful as you seek to reclaim your health!
Blessings on your journey,
Karilee & Rich Shames
authors Feeling Fat, Fuzzy or Frazzled?, Thyroid Power, and Thyroid Mind Power.