Reference Ranges

[spookyscaryskeletons]

Good morning! I am sure I'm overlooking this resource, but I can't seem to find an easy-to-read reference range for thyroid testing. I've checked NICE and the American College of Endocrinology (I'm in the US), but I can't seem to find it. My doctor's appointment is tomorrow so I made a list of everything I hope to get tested. This is what I have:

TPO, Free T4 and T3, TSH, Thyroid antibodies, ferritin, folate, b12, vitamin D, estrogen, progesterone, testosterone, cortisol, DHEA levels

Do I need to add or remove anything from this list? Thank you so much!

[SeasideSusie Remembering]

spookyscaryskeletons

I can't seem to find an easy-to-read reference range for thyroid testing.

If you mean the reference interval which comes with your results then there is no universal one. Ranges vary from lab to lab so you can only use the range that comes with your result, you can't use a range from another lab.

TPO, Free T4 and T3, TSH, Thyroid antibodies, ferritin, folate, b12, vitamin D, estrogen, progesterone, testosterone, cortisol, DHEA levels

TPO is one of the thyroid antibodies. Antibodies are:

Thyroid Peroxidase antibodies (TPO)

Thyroglobulin antibodies (Tg)

These are the two that are generally tested for Hashimoto's - autoimmune thyroid disease which is the most common cause of hypothyroidism.

Ferritin, folate, B12 and Vit D are the key nutrients we advise are tested.

[PurpleNails Administrator]

There isn’t 1 standard range for results, if that’s what you are looking for?

Ranges vary between labs & you have to apply the lab reference to the result taken.

If you need to compare results from differing ranges, you will need to look a the % in range and contrast that way. There’s a calculator to help with that.

There are TPO & TG antibodies but there are more “thyroid antibodies” eg TSI & Trab TBII. If under-active it’s TPO & TG you need to request.

[helvella Administrator in reply to PurpleNails]

There are links to a number of calculators, for things like % through range, in my Vade Mecum document:

helvella - Vade Mecum for Thyroid

The term vade mecum means:

1. A referential book such as a handbook or manual.

2. A useful object, constantly carried on one’s person.

Please don't get put off by the number of pages!

Not everything is in this one document - my major medicines document is still separate!

From Dropbox:

dropbox.com/s/vp5ct1cwc03bl...

From Google Drive:

drive.google.com/file/d/1ZW...

[spookyscaryskeletons in reply to PurpleNails]

Thank you! No wonder I couldn't find it. lol

[helvella Administrator]

You just might find the article below (and the full paper, which you can access) interesting and/or useful.

The normal range: it is not normal and it is not a range

1. Martin Brunel Whyte

2. Philip Kelly

Abstract

The NHS ‘Choose Wisely’ campaign places greater emphasis on the clinician-patient dialogue. Patients are often in receipt of their laboratory data and want to know whether they are normal. But what is meant by normal? Comparator data, to a measured value, are colloquially known as the ‘normal range’. It is often assumed that a result outside this limit signals disease and a result within health. However, this range is correctly termed the ‘reference interval’. The clinical risk from a measured value is continuous, not binary. The reference interval provides a point of reference against which to interpret an individual’s results—rather than defining normality itself. This article discusses the theory of normality—and describes that it is relative and situational. The concept of normality being not an absolute state influenced the development of the reference interval. We conclude with suggestions to optimise the use and interpretation of the reference interval, thereby facilitating greater patient understanding.

dx.doi.org/10.1136/postgrad...

pmj.bmj.com/content/94/1117...