Thyroid Test Came Back Negative – How to Get an Accurate Diagnosis of Thyroid Disease

Is She Giving You the Most Accurate Test?

by: Dr. Craig A. Maxwell

It is estimated that approximately 20 million Americans suffer from some form of thyroid disease. Although people of all ages and ethnicities are susceptible, women are up to eight times more likely to have thyroid problems than men. If you suspect you have thyroid disease but your thyroid test came back negative, you’re not alone. This happens more often than you might think.


Three Reasons Your Thyroid Test Came Back Negative

1. Normal is a Relative Term

Many screening thyroid tests will come back negative for thyroid disease if the patient falls in the “normal” TSH range, between 0.5 to 4.5. I consider anything above 2.5 to be diagnostic for hypothyroidism. You will also need a Free and total T4, Free and total T3 and Reverse T3 to make an accurate diagnosis. Do not rely on TSH alone! Be sure to also rule out any auto-immune component by checking for thyroid antibodies. About 60% of patients who have hypothyroidism have an auto-immune component.

2. Thyroid Levels Fluctuate Daily

Inaccurate thyroid testing is also caused by the fact that your thyroid hormones fluctuate on a daily basis. What you eat and what you’re exposed to has an immediate impact on how much of the hormone your thyroid releases. Even the weather and seasonal changes can affect thyroid levels.

3. Conventional Tests Don’t Measure Hormone Absorption

Your thyroid test may also have come back negative because although your hormone levels fall within the “normal” range, conventional thyroid tests do not measure how much of the hormone you’re actually absorbing. If you have become resistant to the hormone due to an autoimmune reaction, you may not be able to utilize it no matter how much your thyroid gland is producing.


Tell-Tale Symptoms of Hidden Thyroid Disease

If your thyroid tests came back normal, but you’re still suffering, hidden thyroid disease could be to blame.

Do these symptoms sound familiar?

Hyperthyroidism (Over-Active Thyroid)

  • Anxiety
  • Shaking Hands
  • Hyperactivity
  • Irritability
  • Excessive Sweating
  • Depression
  • Heart Palpitations
  • Gastrointestinal Discomfort
  • Loss of Libido
  • Muscle Aches

Hypothyroidism (Under-Active Thyroid)

  • Fatigue
  • Sensitivity to Cold
  • Pale, Dry Skin
  • Facial Puffiness
  • Unexplained Weight Gain
  • Constipation
  • Muscle Pain and Stiffness
  • Brittle Hair and Nails
  • Decreased Concentration
  • Leg Swelling



Get Accurate Testing for Thyroid Disease

A complete thyroid blood test should include the following:



Fasting Required: No

Specimen: Blood

Results: 5-7 Business Days


Tests Included:

T3, total triiodothryonine: Increased T3 often occurs in hyperthyroidism, but in approximately 5% of cases only T3 is elevated, “T3 toxicosis.” Do not confuse T3 with T3 uptake; these are two different tests. The latter is done very commonly as part of the usual thyroid profile. Less than 1% of T3 is unbound.

Reverse-T3 does not stimulate metabolism. It is produced as a way to help clear some T4 from the body.

Free T3: This test is used to evaluate thyroid function. It is also used to diagnose hyperthyroidism. It is also used to assess abnormal binding protein disorders and to monitor thyroid replacement and suppressive therapy.

Free T4: This test is used to evaluate thyroid function in individuals who may have protein abnormalities that could affect total T4 levels. It is used to evaluate thyroid function and monitor replacement and suppressive therapy.

TPO: The TPO gene provides instructions for making an enzyme called thyroid peroxidase. This enzyme plays a central role in the function of the thyroid gland. Thyroid peroxidase assists the chemical reaction that adds iodine to a protein called thyroglobulin, a critical step in generating thyroid hormones. Thyroid hormones play an important role in regulating growth, brain development, and the rate of chemical reactions in the body (metabolism).

TAA: This test helps to detect possible thyroid problems. Thyroglobulin is a protein that is normally confined to the thyroid gland. It is the source of the thyroxine and triiodothyronine hormones in the body. The presence of autoantibodies to thyroglobulin can lead to the destruction of the thyroid gland. Such antibodies are more likely to appear after trauma to, or inflammation of, the thyroid gland. This is one of the acute phase proteins that increase during systemic inflammation.

As an example, it’s been suggested that testing CRP levels in the blood may be an additional way to assess cardiovascular disease risk. A more sensitive CRP test, called a highly sensitive C-reactive protein (hs-CRP) assay, is available to determine heart disease risk.


Thyroid Panel w/TSH includes:

T-3 Uptake: A T3 resin uptake (also called a T3 uptake or T3RU) is performed as part of an evaluation of thyroid function.The thyroid is a gland in the neck that produces the hormones that help regulate many body processes, including growth, energy balance, body temperature, and heart rate. Thyroid function involves the interaction of many hormones, including triiodothyronine (T3) and thyroxine (T4). Both of these hormones exist in two forms in the blood. The more abundant forms are bound to a carrier protein called thyroxin-binding globulin (TBG), which helps transport the hormones through the body. The less abundant forms circulate unattached or “free.” Only the free forms of the thyroid hormones (free T4 and free T3) are available to affect body processes. The T3 resin uptake is used by doctors to estimate the amount of TBG in the blood, and how much T4 and T3 in the blood is free form and available to affect the body. If there’s either too much or too little TBG in the blood, the measurements of total T3 and T4 levels will be affected, which can make it difficult for doctors to tell whether a person actually has a thyroid problem without also knowing the results of the T3 resin uptake.

T4, total: A T4 test measures the blood level of the hormone T4, also known as thyroxine, which is produced by the thyroid gland and helps control metabolism and growth. The T4 test is performed as part of an evaluation of thyroid function. T4 measures the entire amount of thyroxine in the blood, including the amount attached to blood proteins that help transport the hormone through the bloodstream.

Free Thyroxine Index (T7): FTI stands for the Free Thyroxine Index and is also sometimes referred to as T7. It is a calculated value determined from the T3 uptake test and total T4 test and provides an estimate of the level of free T4 in the blood.

TSH (Thyroid Stimulating Hormone): A high TSH level indicates that the thyroid gland is failing because of a problem that is directly affecting the thyroid (primary hypothyroidism). The opposite situation, in which the TSH level is low, usually indicates that the person has an overactive thyroid that is producing too much thyroid hormone (hyperthyroidism). Occasionally, a low TSH may result from an abnormality in the pituitary gland, which prevents it from making enough TSH to stimulate the thyroid (secondary hypothyroidism). In most healthy individuals, a normal TSH value means that the thyroid is functioning normally.

The standard thyroid stimulating test (TSH) will often miss hypothyroidism, as it does not directly measure the output of free T3 and free T4 from your thyroid gland.

This panel of tests will not only tell you whether you have hyperthyroidism or hypothyroidism, but Hashimoto’s thyroiditis as well.

The lab slip may be ordered through Just take the test order slip to any Quest Laboratory to get your blood drawn and Quest will send it away for you. You’ll get your results in as little as 5 business days!


Still Need Help?

If you’re still struggling with the symptoms of thyroid disease despite normal blood test results, something is amiss. If your doctor continues to dismiss your understandable concerns, it might be time to get a second opinion.

I’ve treated patients with thyroid disease and chronic illness for over 30 years and understand how frustrating living with it can be.

Please feel free to contact me to schedule a telemedicine consultation or consultation at our Integrative Medical Center in historic Metamora, Indiana.

In my practice, I use only natural thyroid replacement products, such as compounded thyroid, Nature-Throid, WP Thyroid, ERFA, and Armour Thyroid.

I am able to help you get to the source of your symptoms and offer you a personalized dietary, supplement, and lifestyle regimen to help you treat your condition naturally!


Please enter your comment!
Please enter your name here