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Test and talk – know your thyroid by TSH testing

Knowing your thyroid can help make the most of the time with your healthcare professional, but how do you do that? The key is to test and talk.

To mark International Thyroid Awareness Week, we’re raising awareness about the importance of thyroid function testing and honest communication between patients and physicians to maintain good thyroid health.

What is a TSH test?

The TSH test is the best way to find out if your thyroid gland is working properly.1

Testing your thyroid function helps you understand if your thyroid gland is producing the right amount, but not too much or too little, of the T4 hormone (thyroxine) into your blood to support your body’s digestion, heart and muscle function, brain development, bone upkeep and keep other organs working as they should.1

To assess this, the TSH test measures the level of another hormone that is key in the control of your thyroid, called TSH (thyroid stimulating hormone).1 TSH is vital as it allows communication between your pituitary gland and your thyroid.1 If the pituitary gland detects low levels of T4 in your blood, it produces TSH, which works by stimulating the thyroid gland to produce more T4 in order to restore balance.1 In many ways the thyroid is like a heater and the pituitary like a controlling thermostat. But like any system, it can malfunction causing it to stop working as it should.

How does the TSH test work?

The best way to measure the TSH levels is by taking a blood sample.1 Changes in TSH can serve as an “early warning system” – often occurring before the actual level of T4 hormones in the body becomes too high or too low:1

  • A high TSH level indicates that the thyroid gland is not making enough thyroid hormone (hypothyroidism).
  • A low TSH level usually indicates that the thyroid produces too much thyroid hormone (hyperthyroidism).
  • In most healthy individuals, a normal TSH value means that the thyroid is functioning properly.

What to do next?

Talk to your physician and ask if you might need a TSH test, particularly if you have any concerns about your current care or are experiencing any new symptoms, such as:2

  • Sadness, mood swings and depression
  • Fatigue
  • Muscle and joint pain
  • Weight gain despite lifestyle control
  • Constipation
  • Abnormal menstrual periods and / or fertility problems
  • Thin and brittle hair or fingernails and / or dry flaky skin

Good communication between you and your physician is vital. When done right, patients and their physicians are able to respect each other, share feelings, hold open and honest discussions, and agree on the right goals for treatment and care.3 As a result, studies have shown that good communication leads to better treatment outcomes.3,4

Remember, a healthy patient-physician relationship involves honest discussions about more than just treatment,5 so do make sure to share with your doctor information about your general wellbeing, symptoms, and any other health issues you might have. A handy wellbeing diary is available here to help you track your symptoms and prepare for appointments.

  1. American Thyroid Association. Thyroid Function Tests. Available at: https://www.thyroid.org/wp-content/uploads/patients/brochures/FunctionTests_brochure.pdf. Accessed April 2022.
  2. Thyroid UK. Signs & Symptoms of Hypothyroidism. Available at: https://thyroiduk.org/if-you-are-undiagnosed/hypothyroid-signs-and-symptoms/. Accessed April 2022.
  3. Doctor-Patient Communication: A Review. Ochsner J. 2010 Spring; 10(1): 38–43.
  4. Patient satisfaction and quality of life in hypothyroidism: An online survey by the British Thyroid Foundation. 2021. Clinical Endocrinology. 94(3):513-520
  5. Patient-centered Management of Hypothyroidism. Indian J Endocrinol Metab. 2017 May-Jun; 21(3): 475–477.

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Prepared April 2022