Type
Blood Testing
Biomarkers
8
Duration
15 min
A comprehensive thyroid panel measuring TSH, free T4, free T3, reverse T3, and thyroid antibodies (anti-TPO, anti-TG) to provide a complete picture of thyroid function, conversion efficiency, and autoimmune thyroid status. Substantially more thorough than the single TSH marker typically ordered by GPs.
Standard thyroid screening in the Netherlands typically begins and ends with TSH — a pituitary hormone that provides only an indirect signal about thyroid output. While TSH is a useful first-line marker, it can miss subclinical thyroid dysfunction, conversion problems between T4 and T3, and early autoimmune thyroid disease. The Schildklier Totaal panel addresses these gaps by measuring the full thyroid axis. Free T4 (the primary thyroid hormone) and free T3 (the biologically active form) reveal whether the thyroid is producing adequate hormone and whether T4 is being efficiently converted to T3 in peripheral tissues. Reverse T3 is a metabolically inactive form of T3 that can accumulate during illness, chronic stress, or caloric restriction — its measurement helps distinguish true hypothyroidism from non-thyroidal illness syndrome. Anti-TPO and anti-TG antibodies screen for Hashimoto's thyroiditis and other autoimmune thyroid conditions, which can be present for years before TSH moves outside the reference range. At EUR 259, this panel provides the kind of thorough thyroid assessment that would typically require a specialist endocrinology referral through the Dutch healthcare system. It is particularly relevant for individuals with persistent fatigue, unexplained weight changes, cold intolerance, hair thinning, or mood changes who have been told their TSH is normal, as well as those with a family history of thyroid disease or existing thyroid conditions who want to monitor their full thyroid function.
Key Details
- Biomarkers
- 7
- Focus
- Complete thyroid axis
- Includes
- Antibodies + reverse T3
- GP referral
- Not required
Who Is This For?
Thyroid symptom investigation, normal-TSH fatigue, family history of thyroid disease, autoimmune thyroid screening, monitoring existing thyroid conditions
What's Included
Panel Categories
Biomarkers Tested
8The active form of thyroid hormone responsible for regulating metabolism, energy, and body temperature. Free T3 is converted from T4 in tissues and is three to four times more potent than T4.
The unbound, active form of the main thyroid hormone T4. Free T4 directly reflects thyroid gland output and is used alongside TSH to diagnose and monitor thyroid disorders.
Free triiodothyronine; high levels indicate hyperthyroidism, low levels hypothyroidism.
Free thyroxine; high levels indicate hyperthyroidism, low levels hypothyroidism.
A group of proteins in blood including antibodies (immunoglobulins), transport proteins, and enzymes. Elevated globulin can indicate chronic infection, inflammation, or blood cancers. Calculated by subtracting albumin from total protein.
An inactive form of T3 produced when the body converts T4. Elevated reverse T3 can occur during illness, stress, or caloric restriction and may indicate impaired thyroid hormone activation despite normal TSH levels.
Antibodies against thyroid peroxidase, an enzyme essential for thyroid hormone production. Positive TPO antibodies indicate autoimmune thyroid disease, most commonly Hashimoto's thyroiditis, even before symptoms or TSH changes appear.
The primary screening test for thyroid function. TSH is produced by the pituitary gland to regulate thyroid hormone production. High TSH indicates an underactive thyroid (hypothyroidism), while low TSH suggests an overactive thyroid (hyperthyroidism).
- Category
- Diagnostic
- Duration
- 15 min