Test results can be a bit of a tricky beast. Maybe you’ve been told you have Hashimoto’s, or you think you might have it, but now you have these results and you’re not really sure what to make of them. Don’t worry, because in this article I’ll help you make sense of everything!

So, let’s talk about it and talk through it. I’ll help you by covering some of the main markers, and what they mean, along with the optimal values and other important considerations. Whether you have a test in hand or not, here is what you need to know.

If you want to dive a little bit deeper, you can also learn more by signing up for my Optimal Thyroid Values Series. It’s a completely free video series, and I think it offers a lot of great insight into reaching your ideal values naturally! (Click Here: Discover your ideal values today

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Hashimoto’s Tests: The Main Markers

Let’s kick things off by diving into each of the markers and what they meant for your health…

Thyroid Stimulating Hormone (TSH) Score

Essentially, your TSH is the result of your pituitary gland telling your thyroid to release hormones. And, when it comes to understanding the score, things are a little bit backwards!

That means that the higher your score, the more your thyroid is sluggish or struggling. The lower your score, the more there is too much hormone in play.

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Keep in mind, though, that your TSH can get pretty high! You could see it reach over a couple hundred or higher. But, it can only go so low, somewhere around 0.01. No negatives.

There is a point at which, if you get more and more thyroid hormone, the TSH shuts down. But, it can’t get any lower or dip into the negative, no matter how much more you add into the mix.

When your TSH is higher than somewhere between 7-10, there is not always a direct relationship from one number to the next (Read More: Should you ignore your TSH score?).

This means that a 50 score is not clearly better than a 70 score. Or, that a 12 score is not clearly worse than a 7 score.

Key Insight: When TSH scores really start to get up there, the results are not always linear — they need to be understood in their context.
In general, we think about healthy people having TSH scores between 0.4 and 1.9. But, that differs if you:
  • Are pregnant
  • Are over 65
  • Have heart disease
  • Are very young

This means adults that are not pregnant and have no cardiac disease. If you are somewhere above that, though, even within a ‘normal’ range, it can be a sign that your thyroid is potentially slowing down.

Thyroid Antibodies

Next up we have thyroid antibodies, of which we have a couple (Read More: Four key things to know about thyroid antibodies). These include:

  • Antithyroglobulin
  • Antithyroperoxidase

These are antibodies that are attacking elements of the thyroid.

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Basically, thyroglobulin is the template on which thyroid hormones are built. On the other hand, thyroperoxidase is an enzyme that activates iodine and prepares it to be used.

When these are there, they confirm that there is an autoimmune attack present. If these are not there, if your antibody results are negative (or below a normal range), that does not rule out Hashimoto’s disease.

Key Insight: You can have Hashimoto’s and negative thyroid antibodies.
When your antibodies are very high, they may be factors leading to symptoms in your body, and they also are affecting the risk of heart disease. Additionally, they can also change the risk of disease progression.

So, please be aware of them. And, if they are extremely high, know that it is important to track them so you can keep a close watch over them.

Free Hormones (T3 and T4)

Here’s an important distinction: Sometimes, you may come across something that says only “T4” and not “free T4.”

That is the same as what we call “total T4.” While it is not bad, it is a little bit less accurate than we might otherwise want. That’s because some T4 is active, and some is inactive, and the total just shows both of them.

In most cases, we prefer the specific free T4 reading (Read More: My complete guide to testing your thyroid and optimal ranges).

There is a similar story when it comes to free T3. We do have some cases more relevant to Graves’ disease or hyperthyroidism, in which we like the market of “total T3.” But, as is the case with free T4, we want that specific marker.

Both of these are markers indicating how much hormone is currently in circulation in the body. But, it is helpful to know that this is what we call a “lagging indicator.”

This means that this marker moves after the TSH moves. This means that, while they are helpful to have, there are very rare circumstances where they change the big picture.

In most cases, you are already seeing what is happening based on your TSH.

Thyroglobulin (tg)

First and foremost, this is not the same as the previously-mentioned antithyroglobulin. Instead, it is a protein that can be found in the thyroid’s cells.

As thyroid cells die, their contents spill into your bloodstream. This causes those proteins to circulate, which leads us to measuring thyroglobulin.

Therefore, it is proportionate to the number of cells dying. Now, this might sound a little bit frightening, but some cell death is completely normal.

After all, there will always be some cells that are on the older side, and some “baby cells” ready to take their place. It’s basically the circle of life, and that’s okay!

But, when your thyroglobulin is really high, we can know that there are simply too many cells dying. That can be from:

  • An enlarged thyroid (potentially a goiter)
  • Thyroid cancer

Essentially, it is a marker of thyroid inflammation and the cell turnover rate.


In my opinion, ultrasounds are underused, but I am a big fan of them. These help know whether or not the structure of your thyroid is a problem.

While you might get some sense of this through a doctor’s exam, it really doesn’t paint the full picture or result in something concrete and measurable.

Key Insight: If you have not had a thyroid ultrasound, you should consider it. And, if you have had one, any abnormalities should be both tracked and followed up on.

Thyroid Testing For Accurate Data

A big thing to note is that your test results will only be meaningful if they are done in a way to get accurate data. But, it is very easy to do things that cause your data to fluctuate.

Many things have an impact on how your thyroid works, which can have an impact on any given moment (even the moment of testing).

So, if you test consistently, your results will be useful because your sample will be filled with solid comparisons. Here is how that applies to your thyroid.

Time of Day

Here’s the important thing: your thyroid fluctuates throughout the day. Especially your TSH scores.

So, this means that your TSH first thing in the morning is not the same even a couple of hours later. And, again in the afternoon and into the evening, it can all be different.

This means you need to test at the same time, every time, to get a consistent result that really reveals what is going on in your thyroid.


Medications are also a big factor. They can have an especially large impact on your free hormones. If you check your free hormones in the hours after taking your medicine, you could be pretty much anywhere (except not at your baseline).


Supplements that contain biotin, probiotics, and a few other things can throw off your thyroid scores. But, I am not saying that they hurt your thyroid or they cause harm, they simply make the test results less reliable.

That can even be the case days later. So, three days before you test, stop taking all supplements. This will result in cleaner findings that you can take action on.

Menstrual Cycles

When it comes to women with regular menstrual cycles, there is a compound called thyroid-binding globulin. And, how much you make is a function of how much estrogen is in your circulation.

If you are a woman with a regular menstrual cycle, the amount of estrogen in circulation is very different during your period than right after ovulation. So, you want to be consistent.

The worst time to check is in the middle of your cycle. The best time is the first week, roughly, or the very end of the cycle. Those are good times to check.


Whether you just had a meal, and how your blood sugar is playing out, will also change your thyroid scores.

Hashimoto’s Test Results: Here’s The Truth!

If you want consistent results, to really compare and understand your tests, you will want to know and to be confident in knowing that what you’re doing is helping.

So, for example, if you go on the Thyroid Reset Diet (Read More: Discover the Thyroid Reset Diet today), you likely want to know that it’s working and that you’re doing all the right things.

For that, you need a fair comparison. You need to be mindful of all the considerations above, and how they may put your results in a margin of error.

This all amounts to doing the following:

  • Check in the morning before you eat or take pills.
  • Skip any supplements three days beforehand.
  • Make sure you are in the right period of your cycle.

Each of these is critical. So, now that you know the markers, and how to ensure you are always getting consistent and reliable results, you can really understand and rely on Hashimoto’s test results.

Need A Second Opinion?

Still not one hundred percent sure what to make of your Hashimoto’s test results? In the article above, I hope I was able to bring some clarity to the subject. But, if you still have questions, how about a second opinion?

Click here to learn more about getting a second opinion with me, Dr. C, about your thyroid (Click Here: Schedule a second opinion today). I want to help dispel any confusion you have, while answering questions specific to you, so please consider learning more today.

P.S. Whenever you are ready, here is how I can help you now:

1. Schedule a complimentary consultation with one of my team of naturopathic doctors. This is a great starting point for assessing your unique health needs and treatment options.
2. Need A Thyroid Supplement Recommendation? Take My Thyroid Specific Formulations Quiz Now
3. Need a Personalized Supplement? Check out My Thyroid Specific Formulations
4. Download and use my Favorite Recipes Cookbook Here
5. Check out my podcast Medical Myths, Legends, and Fairytales Here

Dr. Alan Glen Christianson (Dr. C) is a Naturopathic Endocrinologist and the author of The NY Times bestselling Adrenal Reset Diet, The Metabolism Reset Diet and The Thyroid Reset Diet.

Dr. C’s gift for figuring out what really works has helped hundreds of thousands of people reverse thyroid disease, lose weight, diabetes, and regain energy. Learn more about the surprising story that started his quest.