scientist doing tests in a lab

The thyroid stimulating hormone test (or TSH test) is one of the most common tests used to determine whether or not someone has an underactive or overactive thyroid. This test can be indicative of hypothyroidism or hyperthyroidism, respectively. How does it work? And what does normal even mean when it comes to this blood test? You can find out all about TSH in this complete guide to what it is and why you need one.

Why do you need to get a TSH test?

A stimulating thyroid hormone (TSH) test is a blood test that measures how much thyroxine your thyroid gland produces. It can diagnose or monitor certain conditions, such as an underactive or overactive thyroid gland.

scientist working with a vial in a lab

A normal TSH level indicates the thyroid gland produces enough hormones that the body’s cells and tissue need to function normally. High levels indicate that too much thyroxine is being released by the thyroid gland, while low levels suggest it’s not producing enough. If you have any concerns about your thyroid gland or if someone in your family has had hypothyroidism or hyperthyroidism, talk with a healthcare professional about getting tested for TSH.

How do you know when you should get tested?

Some people may notice underactive or overactive thyroid symptoms long before they get tested. If you’re experiencing any of the following symptoms, it’s time to get tested:

  • Weight loss, despite increased appetite
  • Increased heart rate, heart palpitations, higher blood pressure, nervousness, and excessive perspiration
  • More frequent bowel movements, sometimes with diarrhea
  • Muscle weakness, trembling hands
  • Development of a goiter (an enlargement in your neck)
  • Lighter or shorter menstrual periods
  • Lethargy, slower mental processes, or depression
  • Reduced heart rate
  • Increased sensitivity to cold
  • Tingling or numbness in the hands
  • Development of a goiter (an enlargement in your neck)
  • Constipation, heavy menstrual periods, or dry skin and hair

If you’re experiencing any of these symptoms, you may have hyperthyroidism or hypothyroidism. Either way, getting tested will help you identify what needs to be treated to feel better.

How can you get tested?

Testing can take place in three different ways. Each has its pros and cons.

table with different types of home tests and medication

In-home with a DIY kit – A popular option for those who are well-versed in the process and want to save some money on lab costs. You’ll have to go through the steps of drawing your blood, sending it to the lab for processing, then mailing it back to you once it’s ready.

In-home with a professional nurse – An option for those who don’t know how to draw their blood or are nervous about doing so themselves. The nurse will come to you and draw the blood needed for testing.

hand in glove and syringe
hand with glove holding syringe with blood

In-person at a clinic – A more traditional way of getting tested involves scheduling an appointment and showing up to get your blood drawn.

It’s important to get tested periodically to ensure your thyroid levels stay within the normal range. If they’re not, there are a few treatment options, including medication (Synthroid), radioactive iodine therapy, antithyroid medications, or removing part of the thyroid gland.

How much does a TSH test cost?

TSH testing costs will vary depending on the testing method used. At home, tests are available at various sites, but it’s best to get tested by a medical professional. In-home testing with a professional nurse is ideal as it comes with medical guidance and interpretation of results.

Typically these in-home lab tests are around $400. You’ll likely have to work through insurance and clinic pricing with clinic testing. You can expect to spend more if your insurance doesn’t cover the cost. Suppose you know your thyroid levels are out of whack but don’t know why a TSH test is a good way to figure it out without wasting time trying other treatments that won’t fix what’s wrong with you. The sooner you start treatment for hypothyroidism or hyperthyroidism, the better off your life will be.

Treatment options for high TSH levels

Doctors will prescribe levothyroxine (a synthetic form of thyroid hormone) to patients with hyperthyroidism. This medication replaces the natural thyroid hormone that the body is not producing enough of. High TSH levels are very common. The most common treatment for this condition is taking thyroid hormone pills orally. These hormones replace the ones not being produced by the person’s thyroid gland.

Treatment options for low TSH levels

In hypothyroidism or low thyroid levels1, doctors may recommend a treatment option such as

  • Thionamides – Antithyroid drugs inhibit the synthesis of thyroxine (T4) and triiodothyronine (T3). These are typically taken in pill form. They can be used to help restore your body’s natural hormone production.
pills and injections in black and white light except the injection liquid which is blue
  • Beta-blockers – Medicine that blocks the effects of adrenaline on certain areas of the heart and blood vessels. These are often prescribed for people with an overactive heart. They work by blocking adrenaline receptors, reducing the number of heartbeats per minute.
  • Radioactive iodine treatment is a medicine that changes the way the thyroid gland works. Iodine attaches to proteins in cells.

Recap

A thyroid-stimulating hormone (TSH) test measures the level of this hormone in the blood. The thyroid gland produces TSH to control how quickly our bodies use energy. If your body has too much or too little TSH, it can lead to health problems. A TSH test can help determine if your thyroid gland is underactive or overactive. It can also help find out if you have hyperthyroidism or hypothyroidism.

It’s common for TSH levels to be too high or too low. There are treatment options available for each situation. For hypothyroidism, taking thyroid hormone replacement medicine will help make up for the lack of hormones produced by the gland. For hyperthyroidism, taking an antithyroid drug like methimazole will slow down the production of these hormones. Your doctor will work with you to devise a plan that works best for your specific needs!

Testing can be performed in a clinic or at home, whether you believe your TSH is too high or too low. In-home testing with a professional nurse gives you the best of both worlds. The in-home testing provides comfort and convenience, while the nurse provides a medical professional to answer any questions and help interpret your results.

References

[1] Jonklaas J, Bianco AC, Bauer AJ. et al. American Thyroid Association Task Force on Thyroid Hormone Replacement. Guidelines for the treatment of hypothyroidism: prepared by the american thyroid association task force on thyroid hormone replacement. Thyroid. 2014 Dec.;