Home Health: Monitoring Thyroid Hormone Levels

There are two forms of independent thyroid testing that may allow certain individuals to either diagnose or monitor a thyroid condition on their own. However, due to the complexity of thyroid disease, these testing methods are not recommended for all patients.

For the millions of Americans with thyroid disease, frequent hormone monitoring is a fact of life.Staying on top of a thyroid condition usually means regular laboratory visits, coupled with a follow-up visit to the doctor each month.Does the rise in popularity of home testing kits and internet labs offer a viable alternative to this sometimes inconvenient chore?In certain cases, these self-directed testing methods may provide an easier way to stay on top of a thyroid condition.

There are essentially two forms of independent thyroid testing.One is a fairly straightforward at-home thyroid test kit readily available for $35 on the internet.The other alternative is one of the many full online medical laboratories that offer a variety of specialized testing.These tests ranging in price from $60 to $250, depending on the nature of the test performed.Both options allow an individual to monitor their own thyroid hormone levels, but the end result of the tests are very different.

The at-home test kit is specifically designed to measure only TSH, or thyroid stimulating hormone.TSH is a chemical found in blood that indicates the presence of a thyroid condition.The amount of TSH detected is directly related to whether an individual has an overactive or under active thyroid gland - hyperthyroidism produces a low TSH, while hypothyroidism results in a high TSH reading.

The at-home test kit is easy to use and approved by the US Food and Drug Administration.Each kit contains directions on how to properly collect a blood sample, a lancet, a special collection devise, lab authorization forms, and bar codes to label the sample for confidentiality.The test produces a numerical result, and these results are reviewed by a doctor before return to the individual.Within 2-5 days of receipt of the completed test, an analysis is returned.

While this test can provide an at-home alternative to in-office TSH monitoring, TSH alone is rarely used to monitor a thyroid condition.An under- or overactive thyroid is usually a symptom of another condition, such as an autoimmune disease or post-menopausal problems.Proper thyroid disease diagnosis and treatment is dependent upon what is actually causing the thyroid to over or under produce.TSH measurement can confirm the presence of a problematic thyroid, but is usually just one part of thyroid disease management.Therefore, this at-home kit may be best suited to individuals who suspect a thyroid problem due to other symptoms, and have yet to be diagnosed by their doctor.

Another form of self-directed thyroid testing is offered by a variety of full service laboratories on the internet, also known as direct access testing. These online labs offer the same variety of specialized testing as traditional labs, yet without the need for doctor consent or insurance coverage or referral. The overall mission of these labs is to allow individual to control their own testing, or to provide testing services for those without insurance.

The tests themselves are sometimes performed in a very traditional matter.After purchasing a specific test by telephone or over the internet, a set of lab authorization forms are sent to an individual, along with a list of participating local laboratories.Purchasers go to a participating lab and have their blood drawn by a certified phlebotomist, and the results are then provided directly to the patient from the online lab.Tests range from $60-$300, depending on complexity.Other online labs use the same "blood spot" home testing methodology used by the at-home kit outlined above.

These direct access labs offer a full range of specialized thyroid testing, including monitoring free T3 and T4 hormone levels, TPO or thyroid antibodies, and full thyroid panels.This type of specialized testing offers much information to monitor the actual causes of thyroid disease.

Even though they can offer some conveniences, direct access labs do have significant drawbacks.The results of such specialized testing cannot truly be interpreted by a lay person, and important thyroid changes could be overlooked simply by an inability to read the results properly.Some states, such as New York and California, do not allow specialized tests to be performed on blood not collected in a proper lab atmosphere by a professional, and therefore could not be used for medical records or claims purposes.

While at-home testing may allow individuals to self-diagnose a thyroid condition, the unique and sensitive nature of thyroid disease makes home management very difficult. For specific cases and/or patients, however, self-directed testing may save time and money.

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