How to get a full thyroid panel tested in Australia
I recently watched an ‘A Current Affair’ report on thyroid conditions and, as a naturopath who has specialised in thyroid health for over 20 years, it was a breath of fresh air to finally see the Australian media spreading awareness about thyroid health.
One of the biggest takeaways for me was the Professor of Medicine urging patients to insist their GP order the full panel of thyroid function testing.
I thought it would be helpful to discuss what is preventing these tests from being routinely ordered by GPs and how you can ensure that they are carried out.
Firstly, I will discuss how people with a suspected thyroid condition can order all the tests needed for correct diagnosis.
Secondly, I will discuss how people with an existing thyroid condition can order all the tests needed to monitor their thyroid function and thyroid hormone replacement type and dosage requirements effectively.
How is thyroid function tested in Australia?
Australian GPs are taught in medical school to initially test for thyroid stimulating hormone (TSH) alone to assess thyroid function in undiagnosed patients. However, medical research has shown that TSH alone is not a reliable indicator of thyroid conditions as TSH often falls within ‘normal range,’ especially in the early stages of thyroid disease.
The ‘normal’ TSH range is also considered too broad, and recommendations have been made to narrow the range to between 0.5 – 2, rather than the current 0.5 – 5.5. Research recommends that the thyroid hormones, Free T4 and Free T3, also be tested to correctly diagnose thyroid disease.
Many GPs keep up to date with this research, however, when they want to order Free T4 and Free T3 for undiagnosed patients, they are often prevented from doing so by the Medicare Benefits Schedule (MBS). The MBS states that a GP can usually only order Free T4 and Free T3 for undiagnosed patients if their TSH level is outside of the ‘normal range’. As I previously stated, this does not always occur in patients with thyroid conditions, particularly in the early stages of thyroid disease.
As GPs are often only allowed to test for TSH in undiagnosed patients under the MBS, you can see why over one million Australians are living with an undiagnosed thyroid disorder.
Most thyroid conditions in Australia are caused by autoimmunity, usually Hashimoto’s thyroiditis in low thyroid function. If you have Hashimoto’s thyroiditis, your immune system attacks your thyroid gland by producing abnormally high levels of the thyroid antibodies, TPO and TgAb.
As thyroid antibodies are often elevated well before TSH become abnormal, a thyroid antibodies blood test gives you a better chance of receiving a diagnosis of a thyroid condition if your TSH falls within ‘normal’ range.
Autoimmunity is often genetic, so advise your health practitioner of any family history of thyroid conditions, including Graves’ disease, as well as other autoimmune conditions such as coeliac disease, rheumatoid arthritis, or type 1 diabetes, as it will encourage them to order a thyroid antibodies test.
How to get a full thyroid panel tested for a suspected thyroid condition:
You have a couple of options available:
See a GP:
list all your signs and symptoms (Thyroid Western Australia has a checklist you can download from their Facebook Page)
advise of any family history of thyroid or other autoimmune conditions
ask for the full thyroid panel to be tested: TSH, Free T4, Free T3, and thyroid antibodies (TPO and TgAb)
if your GP cannot order some of these tests due to MBS guidelines, ask to pay for them yourself. Non-Medicare fees can vary widely between pathology labs, so ask the cost before proceeding.
Consult with a naturopath:
find one who specialises in thyroid conditions and can order pathology testing
I can arrange for full thyroid panel testing during a naturopathic consultation for a laboratory fee of $46.20, which is usually much less than the non-Medicare fee
if your test results indicate you have a thyroid condition, I can refer you to one of the thyroid savvy GPs recommended by the Thyroid Western Australia support group to receive thyroid hormone replacement, if required
I can also treat autoimmunity, if it is the cause of your thyroid condition, with naturopathy to help reduce your symptoms and slow down the progression of your thyroid disease. (Most GPs have not been trained in how to treat autoimmunity).
How to get a full thyroid panel tested for an existing thyroid condition:
See a GP:
ask for TSH, Free T4 and Free T3 to be tested every time your GP reviews your thyroid function. T4 must be converted into T3 to be used in the body, so testing T4 alone is not sufficient to correctly assess thyroid function
even though the MBS allows for Free T3 to be tested ‘for the purpose of monitoring thyroid disease in the patient’, you need to specifically ask for Free T3 as many GPs are trained to routinely test for Free T4 only
the MBS test item number you need to request to make sure you get TSH, Free T4 and Free T3 tested is 66719
if you do not know if autoimmunity is causing your thyroid condition, it is important to find out by requesting a thyroid antibodies (TPO and TgAb) test
if your GP will not test for thyroid antibodies, you can offer to pay the non-Medicare fee but ask the cost first, as fees can vary widely between pathology laboratories.
Consult with a naturopath:
if your GP will not order Free T3, a naturopath who specialises in thyroid health with a pathology account can order it for you
my laboratory charges $18.70 to test TSH, Free T4 and Free T3, which is usually much less than the non-Medicare fee
if your T3 is in the lower end of the range, you have difficulty converting T4 into T3 and may require a different type of thyroid hormone replacement than thyroxine
I can refer you to a thyroid savvy GP recommended by the Thyroid Western Australia support group to discuss other types of thyroid hormone replacement besides thyroxine, such as NDT and T3
you could also benefit from naturopathic treatment that supports gastrointestinal, liver, adrenal and reproductive function, as these body systems all influence T4 to T3 conversion
if your GP will not test thyroid antibodies, my laboratory charges $27.50, which is usually much less than the non-Medicare fee.
Treat the cause not just the symptoms of your thyroid condition to feel well:
Medication for the autoimmune disease, Hashimoto’s thyroiditis which causes low thyroid function, is the hormone/s that your thyroid can no longer produce.
Whilst it is essential for your health, it does nothing to treat the most common cause of thyroid conditions, autoimmunity.
As I mentioned above, most GPs are not trained in how to treat thyroid autoimmunity, however naturopaths have studied this extensively.
Treating autoimmunity, if it is the cause of your thyroid condition, alongside taking thyroid hormone replacement is an effective way to help reduce your symptoms and slow down your thyroid disease progression so you can finally feel well.
Want to find out how I treat thyroid conditions and autoimmunity?
As a naturopath, I can develop a personalised treatment plan for you to treat autoimmunity, a common cause of thyroid conditions, to help you feel energised, shift weight, and think clearly. Take a look at my Thyroid service page for more info…
