Thyroid
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September 14, 2023

Top Labs To Run Bi-Annually On Your Hyperthyroid Patients

Medically Reviewed by
Updated On
September 17, 2024

Around 20 million Americans have some sort of thyroid condition. Out of that 20 million, 60% of them are unaware they have a thyroid condition, making it essential to understand the signs, symptoms, and underlying causes of thyroid issues to identify and manage them effectively. Hyperthyroidism is a thyroid disease affecting 1 out of 100 Americans above the age of 12. Regular testing will be crucial for these patients first to help identify this condition in those who may be unaware and then to help them manage it appropriately. Functional medicine labs are excellent tools for practitioners investigating thyroid issues and enabling customized treatment options.

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What is Hyperthyroidism?

In a healthy individual, the thyroid gland produces hormones that regulate metabolism, growth, development, and many other body functions, as there is a thyroid receptor in every cell of the body. When there is an overactive thyroid gland, and it produces too much thyroxine (T4) and triiodothyronine (T3) thyroid hormone, this is characterized as hyperthyroidism. Since the thyroid helps to regulate many of our body functions, these functions speed up in patients with hyperthyroidism.

What Causes Hyperthyroidism?

Various factors, from autoimmune problems to genetics and environment, can contribute to hyperthyroidism. These factors include other conditions such as Graves' Disease, Goiters, and thyroiditis, along with genetic and environmental factors. Graves' disease is the primary reason for hyperthyroidism in places like the US. It's an autoimmune issue where the immune system attacks the thyroid, causing it to enlarge and produce too much thyroid hormone. 

In Toxic Multinodular Goiter, overactive thyroid nodules form, creating too much thyroid hormone. These nodules can make the thyroid larger than usual. 

With thyroiditis, this condition involves an inflamed thyroid leaking extra hormones into the bloodstream, causing hyperthyroidism. 

Genetics and environmental factors also play a role. Specific genes can increase the risk. Environmental factors like gut health, nutrition, infections, and substance exposure can trigger or worsen hyperthyroidism. Additionally, too much iodine from diet or medications can make the thyroid produce more hormones, leading to hyperthyroidism.

Hyperthyroidism Symptoms

When there is too much thyroid hormone, it can cause an increased metabolic state. Symptoms can be different for each person. Hyperthyroid symptoms include:

  • Anxiety
  • Depression
  • Nervous or irritable feelings
  • Appetite changes
  • Weight loss
  • Exhaustion and fatigue
  • Musculoskeletal weakness
  • Sleep disturbances
  • Hair loss
  • Frequent stools
  • Shaky hands
  • Goiters in the neck

Complications may arise without proper treatment. Some signs to look out for include:

  • Heart issues
  • High Blood Pressure
  • Bone and joint pain
  • Bulging eyes with Graves'
  • Damage to the brain
  • Swollen and red skin
  • Thyroid storm (fever, dehydration and delirium)

What Are The Benefits of Regular Lab Testing For Patients With Hyperthyroidism?

Regular testing is essential for individuals with hyperthyroidism. If this condition is left untreated or unmanaged, it can lead to complications with other body systems, such as the cardiovascular or neurological systems. Also, many people might not even realize they have this condition, which can lead to more severe problems. Testing helps uncover hidden causes behind their symptoms.

For those unaware of their condition, testing is a way to tackle the root issues effectively. Retesting thyroid hormones about 6-8 weeks after adjusting the treatment plan is also recommended. Once thyroid levels become stable, testing once or twice a year is suggested. This approach ensures optimal levels of thyroid hormones to keep the patient's health steady and well-managed.

Top Labs To Run Bi-Annually On Patients With Hyperthyroidism

The following are functional medicine labs often used by clinicians to help optimize the health of their hyperthyroid patients:

Complete Thyroid Panel with Antibodies

To understand thyroid function fully, a Complete Thyroid Panel is vital. It includes tests for thyroid-stimulating hormone (TSH), T3 (free and total), T4 (free and total), and reverse T3. Functional medicine practitioners will analyze these levels using functional medicine ranges to ensure optimal health. Low TSH and high T4 and T3 levels identify hyperthyroidism. This test can also help assess autoimmunity, indicating Graves'. Some Graves' patients might also have Thyroid Peroxidase (TPO) antibodies or antithyroglobulin antibodies, though these antibodies are more linked to Hashimoto's hypothyroidism in general. This test should be performed regularly on patients with hyperthyroidism to enable precise treatment strategies to maintain healthy and optimal thyroid hormone levels. Retesting will also provide insights into the effectiveness of those treatments, guiding appropriate adjustments.

Micronutrient Panel

Nutrients such as iodine and selenium are needed for thyroid production and function. A micronutrient panel can analyze nutrient levels that support thyroid health, including iodine, selenium, and other nutrients necessary for optimal health. Patients with hyperthyroidism have an increased demand for nutrients due to their hypermetabolic states. Evaluating nutrient levels can help personalize nutritional and supplement requirements to maximize thyroid function for patients with hyperthyroidism.

Comprehensive Stool Panel

Checking for gut health is crucial for hyperthyroid patients. Imbalances in gut bacteria (dysbiosis) and a leaky gut contribute to inflammation that affects the thyroid and triggers autoimmune problems like Graves' disease and certain thyroiditis forms. A Comprehensive Stool Test evaluates good and problematic gut bacteria levels, inflammation markers, leaky gut issues, parasites, and yeast. This test helps gauge the gut's condition and direct treatments to restore gut health for better thyroid function.

Environmental Tox Screen

Various environmental toxins, such as pesticides, bisphenol-A, PCBs, and heavy metals, are linked to thyroid issues and autoimmunity. Screening for these pollutants can assist practitioners in identifying exposure levels. Regular testing can guide recommendations for reducing contact, supporting detoxification, and other treatment protocols to decrease toxic load for hyperthyroid patients.

The Pathogen-Associated Immune Reactivity Screen

Certain infections, such as EBV and Helicobacter pylori, have been implicated in triggering thyroid autoimmunity reactions and should be evaluated for patients with hyperthyroidism if antibody levels are elevated. The Array 12 screens for pathogens that may lead to autoimmunity. Results of this test can provide practitioners with information on 'unexplained' causes of reactivity, and retesting can help monitor the effectiveness of treatment protocols.

Additional Labs to Check

Other tests to consider for hyperthyroid include a Radioactive Iodine Uptake (RAIU) and a thyroid ultrasound to evaluate an overactive thyroid through imaging. The RAIU will indicate hyperthyroidism with high iodine uptake results, and an ultrasound will assess for enlarged nodules in the thyroid.

[signup]

Summary

Hyperthyroidism is a condition with elevated thyroid hormone levels increasing body functions such as metabolism. The body system speeding up can cause weight loss, anxiety, and heart palpitations in individuals with this condition. Many people with a thyroid condition are unaware that they have thyroid issues, making it imperative to test patients who may have thyroid-related conditions. Testing can help practitioners identify thyroid conditions such as hyperthyroidism in their patients so appropriate treatments can be put in place to mitigate the risk of complications and improve overall health in these patients. Regular lab testing can help monitor treatments so that proper adjustments can be tailored to the patient's health needs.

Around 20 million Americans have some sort of thyroid condition. Out of that 20 million, 60% of them are unaware they have a thyroid condition, making it essential to understand the signs, symptoms, and underlying factors of thyroid issues to identify and manage them effectively. Hyperthyroidism is a thyroid condition affecting 1 out of 100 Americans above the age of 12. Regular testing can be crucial for these individuals to help identify this condition in those who may be unaware and then to help them manage it appropriately. Functional medicine labs can be useful tools for practitioners investigating thyroid issues and enabling personalized health strategies.

[signup]

What is Hyperthyroidism?

In a healthy individual, the thyroid gland produces hormones that regulate metabolism, growth, development, and many other body functions, as there is a thyroid receptor in every cell of the body. When there is an overactive thyroid gland, and it produces too much thyroxine (T4) and triiodothyronine (T3) thyroid hormone, this is characterized as hyperthyroidism. Since the thyroid helps to regulate many of our body functions, these functions may speed up in individuals with hyperthyroidism.

What Causes Hyperthyroidism?

Various factors, from autoimmune problems to genetics and environment, can contribute to hyperthyroidism. These factors include other conditions such as Graves' Disease, Goiters, and thyroiditis, along with genetic and environmental factors. Graves' disease is a common reason for hyperthyroidism in places like the US. It's an autoimmune issue where the immune system affects the thyroid, causing it to enlarge and produce more thyroid hormone than usual. 

In Toxic Multinodular Goiter, overactive thyroid nodules form, creating more thyroid hormone. These nodules can make the thyroid larger than usual. 

With thyroiditis, this condition involves an inflamed thyroid releasing extra hormones into the bloodstream, contributing to hyperthyroidism. 

Genetics and environmental factors also play a role. Specific genes can increase the risk. Environmental factors like gut health, nutrition, infections, and substance exposure can influence or exacerbate hyperthyroidism. Additionally, too much iodine from diet or medications can lead the thyroid to produce more hormones, contributing to hyperthyroidism.

Hyperthyroidism Symptoms

When there is too much thyroid hormone, it can cause an increased metabolic state. Symptoms can vary for each person. Hyperthyroid symptoms may include:

  • Anxiety
  • Depression
  • Nervous or irritable feelings
  • Appetite changes
  • Weight loss
  • Exhaustion and fatigue
  • Musculoskeletal weakness
  • Sleep disturbances
  • Hair loss
  • Frequent stools
  • Shaky hands
  • Goiters in the neck

Complications may arise without proper management. Some signs to look out for include:

  • Heart issues
  • High Blood Pressure
  • Bone and joint pain
  • Bulging eyes with Graves'
  • Changes in brain function
  • Swollen and red skin
  • Thyroid storm (fever, dehydration and delirium)

What Are The Benefits of Regular Lab Testing For Individuals With Hyperthyroidism?

Regular testing can be important for individuals with hyperthyroidism. If this condition is left unmanaged, it can lead to complications with other body systems, such as the cardiovascular or neurological systems. Also, many people might not even realize they have this condition, which can lead to more significant challenges. Testing helps uncover potential underlying factors behind their symptoms.

For those unaware of their condition, testing is a way to address the root issues effectively. Retesting thyroid hormones about 6-8 weeks after adjusting the health plan is also suggested. Once thyroid levels become stable, testing once or twice a year can be beneficial. This approach helps maintain balanced levels of thyroid hormones to support the individual's health.

Top Labs To Run Bi-Annually On Individuals With Hyperthyroidism

The following are functional medicine labs often used by clinicians to help optimize the health of their hyperthyroid patients:

Complete Thyroid Panel with Antibodies

To understand thyroid function fully, a Complete Thyroid Panel can be helpful. It includes tests for thyroid-stimulating hormone (TSH), T3 (free and total), T4 (free and total), and reverse T3. Functional medicine practitioners will analyze these levels using functional medicine ranges to support optimal health. Low TSH and high T4 and T3 levels may indicate hyperthyroidism. This test can also help assess autoimmunity, indicating Graves'. Some Graves' patients might also have Thyroid Peroxidase (TPO) antibodies or antithyroglobulin antibodies, though these antibodies are more linked to Hashimoto's hypothyroidism in general. This test should be performed regularly on individuals with hyperthyroidism to enable precise health strategies to maintain balanced thyroid hormone levels. Retesting will also provide insights into the effectiveness of those strategies, guiding appropriate adjustments.

Micronutrient Panel

Nutrients such as iodine and selenium are needed for thyroid production and function. A micronutrient panel can analyze nutrient levels that support thyroid health, including iodine, selenium, and other nutrients necessary for optimal health. Individuals with hyperthyroidism may have an increased demand for nutrients due to their hypermetabolic states. Evaluating nutrient levels can help personalize nutritional and supplement considerations to support thyroid function for individuals with hyperthyroidism.

Comprehensive Stool Panel

Checking for gut health is important for hyperthyroid individuals. Imbalances in gut bacteria (dysbiosis) and a leaky gut may contribute to inflammation that affects the thyroid and influences autoimmune problems like Graves' disease and certain thyroiditis forms. A Comprehensive Stool Test evaluates good and problematic gut bacteria levels, inflammation markers, leaky gut issues, parasites, and yeast. This test helps gauge the gut's condition and direct strategies to support gut health for better thyroid function.

Environmental Tox Screen

Various environmental toxins, such as pesticides, bisphenol-A, PCBs, and heavy metals, are linked to thyroid issues and autoimmunity. Screening for these pollutants can assist practitioners in identifying exposure levels. Regular testing can guide recommendations for reducing contact, supporting detoxification, and other strategies to decrease toxic load for hyperthyroid individuals.

The Pathogen-Associated Immune Reactivity Screen

Certain infections, such as EBV and Helicobacter pylori, have been implicated in influencing thyroid autoimmunity reactions and should be evaluated for individuals with hyperthyroidism if antibody levels are elevated. The Array 12 screens for pathogens that may lead to autoimmunity. Results of this test can provide practitioners with information on 'unexplained' causes of reactivity, and retesting can help monitor the effectiveness of health strategies.

Additional Labs to Check

Other tests to consider for hyperthyroid include a Radioactive Iodine Uptake (RAIU) and a thyroid ultrasound to evaluate an overactive thyroid through imaging. The RAIU may indicate hyperthyroidism with high iodine uptake results, and an ultrasound can assess for enlarged nodules in the thyroid.

[signup]

Summary

Hyperthyroidism is a condition with elevated thyroid hormone levels that may increase body functions such as metabolism. The body system speeding up can cause weight loss, anxiety, and heart palpitations in individuals with this condition. Many people with a thyroid condition are unaware that they have thyroid issues, making it important to test individuals who may have thyroid-related conditions. Testing can help practitioners identify thyroid conditions such as hyperthyroidism in their patients so appropriate health strategies can be put in place to support overall well-being and improve health in these individuals. Regular lab testing can help monitor health strategies so that proper adjustments can be tailored to the individual's health needs.

The information in this article is designed for educational purposes only and is not intended to be a substitute for informed medical advice or care. This information should not be used to diagnose or treat any health problems or illnesses without consulting a doctor. Consult with a health care practitioner before relying on any information in this article or on this website.

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Lab Tests in This Article

General Information/Press Room | American Thyroid Association. (2016). Retrieved August 24, 2023, from American Thyroid Association website: https://www.thyroid.org/media-main/press-room/

(2023, August 24). Hyperthyroidism (Overactive Thyroid). Retrieved August 24, 2023, from National Institute of Diabetes and Digestive and Kidney Diseases website: https://www.niddk.nih.gov/health-information/endocrine-diseases/hyperthyroidism

Clinic, C. (2021). Hyperthyroidism: Symptoms, Causes, Treatment & Medication - Cleveland Clinic. Retrieved August 24, 2023, from Cleveland Clinic website: https://my.clevelandclinic.org/health/diseases/14129-hyperthyroidism

Cloyd, J. (2023, June 12). A Functional Medicine Hyperthyroidism Protocol: Comprehensive Testing, Supplements, and Integrative Nutrition. Retrieved August 24, 2023, from Rupa Health website: https://www.rupahealth.com/post/a-functional-medicine-hyperthyroidism-protocol-comprehensive-testing-supplements-and-integrative-nutrition

Weinberg, J. L. (2023, April 28). A Functional Medicine Protocol for Hyperthyroidism. Retrieved August 24, 2023, from Rupa Health website: https://www.rupahealth.com/post/5-functional-medicine-labs-that-can-assist-a-root-cause-treatment-for-hyperthyroidism

Weinberg, J. L. (2023, March 2). Functional Medicine Treatment for Graves' Disease. Retrieved August 24, 2023, from Rupa Health website: https://www.rupahealth.com/post/functional-medicine-treatment-for-graves-disease 

‌Panicker V. (2011). Genetics of thyroid function and disease. The Clinical biochemist. Reviews, 32(4), 165–175.

‌LoBisco, S. (2023, March 2). The Thyroid Gut Connection: How to Nourish Your Microbiome for Better Thyroid Health? Retrieved August 24, 2023, from Rupa Health website: https://www.rupahealth.com/post/thyroid-gut-connection

‌Hyperthyroidism - Symptoms and causes. (2022). Retrieved August 25, 2023, from Mayo Clinic website: https://www.mayoclinic.org/diseases-conditions/hyperthyroidism/symptoms-causes/syc-20373659

‌Triggiani, V., Tafaro, E., Giagulli, V. A., Sabbà, C., Resta, F., Licchelli, B., & Guastamacchia, E. (2009). Role of iodine, selenium and other micronutrients in thyroid function and disorders. Endocrine, metabolic & immune disorders drug targets, 9(3), 277–294. https://doi.org/10.2174/187153009789044392

‌Calsolaro, V., Pasqualetti, G., Niccolai, F., Caraccio, N., & Monzani, F. (2017). Thyroid Disrupting Chemicals. International journal of molecular sciences, 18(12), 2583. https://doi.org/10.3390/ijms18122583

‌Pender M. P. (2012). CD8+ T-Cell Deficiency, Epstein-Barr Virus Infection, Vitamin D Deficiency, and Steps to Autoimmunity: A Unifying Hypothesis. Autoimmune diseases, 2012, 189096. https://doi.org/10.1155/2012/189096

‌Bassi, V., Marino, G., Iengo, A., Fattoruso, O., & Santinelli, C. (2012). Autoimmune thyroid diseases and Helicobacter pylori: the correlation is present only in Graves's disease. World journal of gastroenterology, 18(10), 1093–1097. https://doi.org/10.3748/wjg.v18.i10.1093

Iqbal A, Rehman A. Thyroid Uptake and Scan. [Updated 2022 Oct 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK555978/

Zamora EA, Khare S, Cassaro S. Thyroid Nodule. [Updated 2022 Sep 5]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK535422

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