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Thyroid Function Test (TSH and Free T4)

Test details

• TSH (thyroid stimulating hormone): made by the pituitary gland in the brain. It signals the thyroid how much hormone to make, so it is the usual first check of thyroid function.
• Free T4 (free thyroxine): the main hormone the thyroid makes, measured in the form that is free to act on the body. It helps control metabolism, body temperature and heart rate.
• Together, TSH and free T4 show both the signal to the thyroid and the hormone it is producing. This gives a fuller picture than TSH alone.
• Blood sample, collected in person at our Buffalo Grove or Lake Zurich location.
• For ages 18 and older. The person being tested must bring a matching photo ID.

How?

• Buy the test online, then visit either location for a short blood draw.
• A morning collection is generally preferred, since TSH is usually highest overnight and early morning.

How long?

• Results are typically ready in 1 to 2 days after the lab receives your sample. Some results take longer.

How to prepare?

• Fasting is generally not required. Follow any instruction given at your visit.
• Stop biotin and hair, skin and nail supplements at least 72 hours before your draw. Biotin can change thyroid test results. Biotin may also be listed as vitamin B7 or vitamin H.
• If you take thyroid medicine, ask your prescriber whether to take it before or after your draw. Do not stop or change a medicine without asking your prescriber.

Do I need to see a doctor?

• A doctor’s visit is not required to buy this test.
• This test does not diagnose a condition. Review your results with your own healthcare provider.

Why consider a thyroid test?

• You have symptoms that can go along with thyroid changes, such as tiredness, unexpected weight change, feeling too cold or too hot, dry skin, hair thinning, a fast or slow heartbeat, or changes in mood or periods. Many other conditions cause the same symptoms.
• You take thyroid medicine and want current levels to bring to your next visit.
• You are planning a pregnancy. Thyroid changes can affect periods and fertility, and thyroid hormone needs change during pregnancy. Talk with your provider.
• You have a family history of thyroid disease or an autoimmune condition.

Which thyroid test is right for me?

• Thyroid Function Test, TSH and Free T4 (this page): the signal and the main hormone, for a first look at thyroid function.
• Comprehensive Thyroid Panel: TSH, free T4, free T3, TPO antibodies and thyroglobulin antibodies. It adds the active thyroid hormone and two autoimmune markers.
• Female Hormone Panel: includes TSH along with FSH, LH, estradiol, progesterone, prolactin and testosterone.

Additional information about the test

Checking for hair thinning? The Hair Loss Panel includes TSH and free T4 along with iron, vitamin D and hormone markers.

Results are a snapshot of the time of your blood draw. They are shown with reference ranges from the performing laboratory, and normal ranges can differ by age and by lab. A healthcare provider looks at your results together with your symptoms and history. Other tests may be needed to find the cause of an abnormal result.

Related tests include the Vitamin D Test, Vitamin B12 Test and Cholesterol (Lipid) Panel, which people often check along with tiredness or weight changes.

What does a TSH and free T4 test measure?

It measures thyroid stimulating hormone and free thyroxine in your blood. TSH tells the thyroid how much hormone to make, and free T4 is the main hormone the thyroid releases.

Why test free T4 along with TSH?

TSH alone shows the signal to the thyroid. Adding free T4 shows the hormone level itself, which helps your provider read an unusual TSH result.

What are early signs of thyroid problems?

An underactive thyroid can go along with tiredness, feeling cold, dry skin, weight gain, constipation or low mood. An overactive thyroid can go along with a fast or irregular heartbeat, sweating, shaking, feeling anxious, feeling hot or weight loss. Other conditions cause these symptoms too.

What does a high or low TSH mean?

A higher TSH is often seen when the thyroid is underactive, and a lower TSH is often seen when it is overactive. Free T4 is read alongside it. Results do not diagnose a condition by themselves, so review them with your healthcare provider.

How often should I get a thyroid test?

It depends on your age, symptoms, and whether you take thyroid medicine. Ask your healthcare provider how often to check.

Do I need to fast for this test?

Fasting is generally not required. Follow any instruction given at your visit.

Can biotin affect thyroid results?

Yes. Biotin can change thyroid test results. Stop biotin and hair, skin and nail supplements at least 72 hours before your draw.

How much does a thyroid test cost without insurance?

At Vitality Express Labs in Buffalo Grove and Lake Zurich, the TSH and free T4 test is $60.

Is the testing accurate?

Samples are tested in a CLIA certified laboratory that follows quality assurance procedures. No test is perfect, so results are best read together with symptoms and other tests.

Do I need a doctor’s order?

A doctor’s visit is not required to buy this test. Review your results with your own healthcare provider.

Safety and when to get care

• A very fast or irregular heartbeat, severe tremor, fever with confusion, or fainting needs emergency care.
• If you take thyroid medicine, keep taking it as directed. Your provider should adjust the dose.
• This test is not an emergency service. For severe or sudden symptoms, call 911 or go to the nearest emergency room instead of waiting for results.

Questions about this test

What is the difference between the TSH and Free T4 test and the Comprehensive Thyroid Panel?

This test checks TSH and free T4, which is the standard screen for an underactive or overactive thyroid and for monitoring thyroid medication. The Comprehensive Thyroid Panel adds free T3, TPO antibodies and thyroglobulin antibodies to detect autoimmune thyroid disease such as Hashimoto’s or Graves’.

What is a normal TSH level?

Most labs use about 0.4 to 4.5 mIU/L. A high TSH suggests an underactive thyroid (hypothyroidism); a low TSH suggests an overactive thyroid. Free T4 confirms how much thyroid hormone is actually circulating.

Do I need to fast for a thyroid test?

No. Stop biotin supplements (vitamin B7, common in hair, skin and nail products) for 72 hours before the draw because biotin interferes with thyroid assays.

Should I take my thyroid medication before the blood test?

Draw before your morning dose for consistency, then take it right after. Taking levothyroxine just before the test can temporarily raise free T4.

Which thyroid test should I get for fatigue, hair loss or weight gain?

Start with TSH and free T4. If those are normal and symptoms persist, or there is a family history of thyroid disease, the Comprehensive Thyroid Panel adds free T3 and antibodies.

How often should I test my thyroid?

Every 6 to 12 months if you take thyroid medication and are stable, 6 to 8 weeks after any dose change, and every few years for screening if you have symptoms or a family history.

How long do thyroid test results take?

1 to 2 business days.

See all frequently asked questions

Comprehensive Health Panel — Women’s

Test details

• Complete Blood Count (CBC): counts red cells, white cells, hemoglobin and platelets. It screens for anemia and can flag infection, inflammation or a bleeding tendency. Abnormal values point to a cause but do not identify it on their own.
• Comprehensive Metabolic Panel (CMP): 14 tests covering blood sugar, electrolytes, calcium, kidney function (BUN, creatinine, eGFR) and liver enzymes. Fasting glucose on this panel is the diabetes screen.
• Cholesterol (Lipid) Panel: total cholesterol, LDL, HDL and triglycerides, used with age and blood pressure to estimate heart disease risk.
• Vitamin D, 25 hydroxy: your vitamin D level. Low levels are common in Illinois winters and affect bone and muscle health.
• Hemoglobin A1c: your average blood sugar over the past 2 to 3 months. 5.7 to 6.4 percent is prediabetes and 6.5 and above is in the diabetes range.
• High Sensitivity C Reactive Protein (hs-CRP): a marker of low grade inflammation used alongside cholesterol to estimate cardiovascular risk. A recent cold, injury or hard workout raises it temporarily.
• Urinalysis: screens urine for protein, glucose, blood, white cells and nitrite. It can suggest kidney disease, diabetes or a urinary infection. A suspected infection is confirmed with a urine culture and provider evaluation.
• Thyroid Stimulating Hormone (TSH): the pituitary signal that controls the thyroid and the standard first screen for an underactive or overactive thyroid.

How?

A blood sample and a urine sample are required for the test.

How long?

1 to 3 business days after the lab receives your sample. Some results take longer.

Do I need to see a doctor?

No, unless you want to discuss your results with one of our providers.

Additional information about the panel

This panel covers blood counts, kidney and liver function, blood sugar, cholesterol, inflammation, thyroid and vitamin D in one draw. Fast 8 to 12 hours beforehand for accurate glucose and triglycerides. Results are a snapshot of the day you were drawn and are reported with the lab’s reference ranges. The provider on shift calls you the same day about any critical value.

Safety and when to get care

• Chest pain, trouble breathing, fainting or sudden weakness need emergency care, not a lab test.
• Heavy bleeding that soaks a pad every hour, or severe pelvic pain, needs urgent care. If you could be pregnant, tell your provider before any treatment.
• Do not stop or change any medicine because of a result without talking with your provider.
• This test is not an emergency service. For severe or sudden symptoms, call 911 or go to the nearest emergency room instead of waiting for results.

Questions about this test

What is included in the Comprehensive Health Panel for women?

Complete Blood Count (CBC), Comprehensive Metabolic Panel (CMP), cholesterol (lipid) panel, vitamin D, hemoglobin A1c, high-sensitivity C-reactive protein (hs-CRP), TSH thyroid screen and urinalysis. It covers blood counts, kidney and liver function, blood sugar, cholesterol, inflammation, thyroid and vitamin D in one draw.

Do I need to fast for the women’s health panel?

Yes. Fast 8 to 12 hours before your appointment for accurate cholesterol and glucose. Water is fine. Stop biotin supplements 72 hours before, since biotin interferes with the thyroid assay.

Does the women’s health panel include hormones?

It includes TSH for thyroid. It does not include estradiol, FSH, LH, progesterone or testosterone. For those, add the Female Hormone Panel, and for menopause screening add the Menopause Panel.

What blood tests should I get for unexplained weight gain?

TSH for thyroid, A1c and glucose for blood sugar, a lipid panel and a CMP are the standard first step and are all in this panel. If periods are irregular, add the Female Hormone Panel to check for PCOS-related hormone patterns.

What time of my cycle should I do the women’s health panel?

Any day. None of the tests in this panel are affected by your cycle. Cycle timing matters only for the Female Hormone Panel and the Menopause Panel, which are best drawn on day 2 to 4.

How long do results take for the women’s health panel?

1 to 3 business days for the full report. You are notified when it is ready.

See all frequently asked questions

Anemia Panel

Test details

• Ferritin: This is a protein in your body that stores iron. A ferritin test measures how much ferritin is in your blood, which tells us how much iron your body has stored.
• Iron: The Iron test measures the level of iron in your blood. Iron is an essential mineral that plays a crucial role in transporting oxygen throughout your body. This test helps evaluate your body’s iron stores and can identify if you have an iron deficiency or excess iron levels, which can indicate certain health conditions.
• TIBC (Total Iron-Binding Capacity) Test: The TIBC test measures the total amount of iron that can be bound to proteins in your blood. It provides information about the capacity of proteins to transport and bind iron. By assessing TIBC levels, healthcare providers can gain insights into iron metabolism and determine if there are any abnormalities or imbalances.
• Vitamin B12: This is a nutrient that helps keep your nerves and blood cells healthy. A Vitamin B12 test measures the level of this nutrient in your blood.
• Folate (Folic Acid): Folate, also known as folic acid, is a type of B vitamin that’s important for forming red blood cells. A folate test measures the amount of it in your blood.
• Red Blood Count (RBC): This is a count of the number of red blood cells in a volume of blood. It’s part of the complete blood count test.
• White Blood Count (WBC): This is a count of the number of white blood cells in a volume of blood. White blood cells help fight infections.
• Hemoglobin: This is a protein in red blood cells that carries oxygen throughout your body. A hemoglobin test measures how much hemoglobin your blood has.
• Hematocrit: This measures the proportion of your total blood volume that is made up of red blood cells. It’s part of the complete blood count test.
• Platelet Count: This measures how many platelets you have. Platelets are small blood cells that help your body form clots to stop bleeding.

How?

• A blood sample from vein

How long\?

• 1 to 3 business days after the lab receives your sample. Some results take longer.

Safety and when to get care

• Heavy bleeding, black or bloody stools, fainting, chest pain or shortness of breath need urgent care, not a lab test.
• Do not start high dose iron without guidance. Too much iron can be harmful.
• This test is not an emergency service. For severe or sudden symptoms, call 911 or go to the nearest emergency room instead of waiting for results.

Questions about this test

What is included in the Anemia Panel?

A Complete Blood Count (red cells, hemoglobin, hematocrit, white cells, platelets) plus ferritin, serum iron, TIBC, vitamin B12 and folate. It identifies whether anemia is present and whether iron, B12 or folate is the cause.

What is the difference between ferritin and iron?

Serum iron is the iron circulating in your blood right now and swings with meals and time of day. Ferritin reflects your stored iron and is the best single marker of iron deficiency. TIBC shows how much capacity your blood has to carry more iron.

What is a normal ferritin level?

Lab ranges run about 20 to 250 ng/mL for women and 30 to 400 for men, but many providers consider ferritin under 30 to be iron deficient and aim for above 50 when treating fatigue or hair loss.

What is the best blood test for hair loss?

Ferritin is the first test most dermatologists order, along with TSH and vitamin D. The Anemia Panel covers ferritin and a CBC; add the Thyroid Function Test and Vitamin D Test to complete the workup.

Do I need to fast or stop iron pills before the Anemia Panel?

Book a morning appointment and stop iron supplements for 24 hours before the draw. Fasting is not required, but a morning draw before breakfast gives the most consistent serum iron.

Can I have low ferritin with a normal hemoglobin?

Yes. Iron stores drop before hemoglobin does. Low ferritin with normal hemoglobin is iron deficiency without anemia and can still cause fatigue, hair shedding and restless legs.

Can ferritin be high from inflammation?

Yes. Ferritin rises with infection, inflammation, liver disease and heavy alcohol use, which can hide iron deficiency. The panel includes TIBC and serum iron, which help separate true iron overload from inflammation.

How long do Anemia Panel results take?

1 to 3 business days.

See all frequently asked questions

Vitamin B12 Test

Vitamin B12 is a nutrient that helps keep your body’s nerve and blood cells healthy. It also helps make DNA, the genetic material in all cells. Checking your B12 level is important because if it’s too low, it can lead to tiredness, weakness, and other health problems.

Test details

• Vitamin B12 Level

How?

• A blood sample

How long\?

• 1 to 2 business days after the lab receives your sample. Some results take longer.

How to prepare?

• No special preparation is needed.

Safety and when to get care

• Numbness or tingling with trouble walking, confusion or memory loss needs prompt medical care. Low B12 can cause lasting nerve damage if it is not treated.
• If you take metformin or an acid reducer, ask your provider before changing it.
• Do not stop or change any medicine because of a result without talking with your provider.
• This test is not an emergency service. For severe or sudden symptoms, call 911 or go to the nearest emergency room instead of waiting for results.

Questions about this test

What is a normal B12 level?

Most labs report about 200 to 900 pg/mL. Under 200 is deficient. Symptoms can appear in the 200 to 300 range, so a low-normal result with symptoms is worth discussing with a provider.

Do I need to fast for a B12 test?

No, though a morning draw before breakfast gives the most consistent result.

Should I stop taking B12 supplements before the test?

Stop oral B12 for 24 to 48 hours before the draw if you want to know your baseline. If you are testing to confirm a supplement is working, keep taking it.

Which symptoms mean I should test B12?

Fatigue, numbness or tingling in the hands and feet, memory or concentration problems, mouth soreness, and unexplained anemia. Vegans, people on metformin or acid reducers, and anyone after gastric surgery should test regularly.

Can my B12 be normal and I still be deficient?

Yes. Serum B12 can be in range while tissue levels are low. If symptoms persist with a normal result, a provider may order methylmalonic acid or homocysteine, which can be added to your order.

How long do B12 results take?

1 to 2 business days.

See all frequently asked questions