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As hypothyroid patients no matter the cause, it was discovered that lab results really are important! They help explain what’s going on, because symptoms don’t always do the same. Check out this information below. ~Janie, hypothyroid patient and site creator

Lab work is important—we have seen this all these years! And why is it important? Because we had to figure out the heard way over the years that it’s NOT just “how you feel”. For example, we can feel good before our free T3 especially is optimal, thus it backfires, sooner or later. So it’s about being OPTIMAL with these labs, not just “in range”, which the Lab Values page explains very well. Remember to do an internet search on what supplements or meds you should not be on before any particular labwork.

1) Free in front of T4 / T3 measure what’s available for use; totals do NOT  2) TSH along with low free T3 (not on meds) to discern hypopituitary  3) Reverse T3 (goes up due to low iron, high cortisol, inflammation)  4) Anti-TPO and TgAB, not just one  5) FOUR iron labs (Ferritin, % Saturation, serum iron & TIBC)  6) 24-hour Saliva cortisol (not blood)  7) B12 and Vit. D tend to fall with thyroid issues  8) CMP Minerals like Magnesium, Potassium, Sodium important–RBC versions give better info!!  9) Sex Hormones can go south in some with thyroid problems  10) MTHFR and other genes: Many use, then upload to

OTHER LABS YOU MAY WANT TO CONSIDER to ask your doctor about:

11. RBC zinc, copper and ceuroplasm: We have noticed a certain body of us with too high levels of copper, and the latter is toxic to your liver, brain, mito, etc. See this page and learn!)

12. Inflammation labs This is extremely important and probably should be listed above. For most, the ferritin will show inflammation. But to be sure, there’s also CRP and ESR inflammation labs. See this page.

12. Lyme testing (recommended if you just never seem to get well–IgeneX or DNA Connexions does a good job.)

13. Epstein Barr Virus (EBV) (stress can raise this! Ask for the activated test, not whether you had past exposure)

14. Candida overgrowth (from antibiotic use, impaired immune system, etc)

15. OAT (click here: Organic Acids Test(Reveals either cellular blockages or nutrient deficiencies)

16. Thyroglobulin (not the anti-thyroglobulin) is used by doctors if thyroid cancer is suspected.

Direct Labs below has testing for Neurotransmitters, as well as hair testing for metals.


We just take our thyroid meds as usual one day (and probably bring a night dose up to the afternoon), then do labs first thing the next morning before taking our meds for that day. i.e. we do not do labs after taking meds, as we’ll just be measuring the rise in our blood.


Summary: TSH (with a low free T3) is more about hypopituitary; “Free” in front of T3 and T4 is measuring what is available for use unlike the the “total”; both anti-TPO and anti-thyroglobulin are needed, not just one; all four iron labs are needed because ferritin can be low due to high heavy metals, not just low iron; blood cortisol might discern Addison’s or Cushings, not the cortisol problems we tend to get, thus saliva is needed; b12 can go low if undiagnosed or poorly treated hypo; Magnesium, other minerals, plus D3 and D2 can go low with hypo; Remember to have them remove tourniquet when doing a blood draw for potassium; sex hormones like estrogen & progesterone tested seven days after ovulation i.e. days 10 – 20 / FSH & LH tested days 2-4 of cycle with day 3 being ideal / Testosterone, DHEA any time; MTHFR mutation plus hair testing for high heavy metals. See Direct Labs link below for hair testing.

LADIES! CLICK HERE to read about sex hormones!


*Click HERE to see OPTIMAL LAB VALUES…i.e. what your lab results mean and where you want to be. Also see ADDENDUM C in the updated revision STTM book. Your doctor may use other lab facilities. 


  1. The ZRT saliva test has proven over and over to be top notch. And they still have ranges, instead of those silly “less than or equal to” goals. Using the latter link gives the ZRT saliva test at $5 cheaper than going to the ZRT website.
  2. Self testing is often not allowed in these US states NY, NJ, RI, MA or MD, though Ulta has worked it out with Massachusetts, and ZRT only mentions they can’t send to New York and Maryland, and California can only be sent with a doctor’s approval.
  3. INFO ON OTHER SALIVA TESTS FROM PATIENTS, BUT YOU CAN DECIDE as there have been issues with these over the years: 1) Cell Science-some patients have reported results that didn’t fit their symptoms, but other patients were ok with it . 2) Quest-you will have at least one “less than” goal instead of a range;  3) Dutch testing— we don’t know exactly why, but some report it gives results that don’t fit their symptoms or what saliva shows 4) Genova— again, some “less than” goals instead of ranges. 5)  LabCorp--two of their ranges have the less than symbol before them as the goal instead of a range.
  4. IMPORTANT: use of any of these facilities it between you and the facility. If there are any problems, please reach out to the facility and repeatedly if necessary. Stop the Thyroid Madness LLC cannot do that for you, nor be responsible for any facility, and you agree to that.


Need to test your cortisol levels? This is one of the best saliva cortisol tests out there, with four results and a range per result. None of the silly “less than” goals. You can choose from one with DHEA, one without.

Ulta Lab Tests

A great variety of STTM RECOMMENDED tests! CLICK HERE. P.S. Use the above saliva test, though….Ulta has one with the ridiculous “Less than” goals, which you do NOT want. All the other tests you’ll see on the linked page are great. You can even go beyond that page to order any tests you do not see!

Direct Labs

 DIRECT LABS designed specifically for readers of Stop the Thyroid Madness…and includes Neurotransmitter testing, hair testing for heavy metals and other good labs. Patients do not recommend their saliva testing, as they now use Quest which has the terrible “less than” ranges. Use this one instead.
IMPORTANT NOTE about using this page: you will need to use scroll down bar just to the right of the red “Add to Cart” to view all labs they offer.  

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TRUE HEALTH LABS offering direct lab testing since 2010, this facility has most of the STTM recommended labwork you need and want! Watch for discounts they give throughout the year, which will show up at the top of their page if there is one! You can even use code STTM to get an additional $5 off testing. You’ll see a friendly page just for labwork which patients know is key!!    

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PRIVATE MD LABS have no STTM-recommended page on their website like the above facilities have, and you’ll have to search, sadly, but you can order the lab work recommended above, plus any others you feel you need and/or those results you want to share with your doctor.  

**Have any suspicion of having thyroid cancer? The thyroglobulin test is a tumor marker (not the antibodies test–just the thyroglobulin.) But take heart…there can be other reasons, including continued hypo, which can raise thyroglobulin, too.

AUSTRALIA:–they will send you the tests and patients find this facility the most reliable!

CANADA: 1) ZRT will ship to Canada!! ZRT is tops for accuracy of the results in fitting symptoms. 2) We used to recommend getting the saliva kit at pharmacies from Rocky Mountain Labs. Update: Canada’s Rocky Mountain Labs (a division of Lifelabs, basically the only private lab company in BC, Canada) no longer offers the saliva cortisol test. I just called them. It was from a company called Genova, which they no longer work with. 3) can ship saliva cortisol test kits to Canadians

FINLAND: 1) Test kits from Genova diagnostics via MDD Terveyspalvelut, which are problematic  2) Europe Category

GERMANY: 1)  Saliva testing and helpful facility 2) Lots of tests 3)  4) Europe Category

NETHERLANDS: 1) (need to state if you want a midnight sample otherwise they do 3 morning samples plus noon and 6pm samples)  2) 3) Europe Category

SWEDEN:  1) Europe Category

SWITZERLAND: 1)  2)  3) Europe Category

UNITED KINGDOM: These three have either a Genova Saliva test (no range for bedtime, which is sad) or one that gives odd results–regeneuslabs, which is often not recommended.;; Europe Category

Important note: STTM is an information-only site based on what many patients worldwide have reported in their treatment and wisdom over the years. This is not to be taken as personal medical advice, nor to replace a relationship with your doctor. By reading this information-only website, you take full responsibility for what you choose to do with this website's information or outcomes. See the Disclaimer and Terms of Use.