Ulta Lab Tests

Thyroid Pharmacist Recommended Tests

Thyroid-focused, pharmacist-recommended testing looks at more than TSH. It pairs core thyroid labs (TSH, Free T4, Free T3, antibodies) with medication-aware and nutrient checks that can influence symptoms, absorption, or results. Pharmacists help spot drug–nutrient interactions (for example, iron or calcium products taken near levothyroxine), assay interferences (biotin), and timing issues that can skew labs.

A proactive plan usually starts with TSH + Free T4 and adds Free T3 when hyperthyroidism is suspected or symptoms persist. Thyroid antibodies (TPOAb, TgAb) clarify autoimmunity; TRAb/TSI supports Graves disease. To round out the picture, many people check ferritin/iron indices, vitamin B12 ± MMA, vitamin D, lipids, and CBC/CMP. Select situations call for AM cortisol ± ACTH or late-night salivary cortisol to screen true endocrine conditions that mimic thyroid complaints. These labs support screening, diagnostic triage, and monitoring—but do not replace clinician evaluation, imaging, or urgent care when needed.

Signs, Symptoms & Related Situations

  • Underactive pattern (hypothyroid): fatigue, cold intolerance, weight gain, dry skin, hair loss, constipation, heavy or irregular periods

  • Overactive pattern (hyperthyroid): anxiety/irritability, heat intolerance, weight loss, tremor, palpitations, frequent stools, lighter periods

  • Neck & eyes: goiter/neck fullness, hoarseness, trouble swallowing; gritty eyes or bulging eyes (Graves)

  • Medication & supplement flags: high-dose biotin, iron or calcium taken near thyroid meds, proton-pump inhibitors, amiodarone, lithium, iodine exposure (contrast or supplements)

  • Life stages & risks: pregnancy/trying to conceive, postpartum thyroiditis history, family history of autoimmune disease, prior neck radiation

  • Urgent care now: chest pain, severe shortness of breath, fainting, high fever with confusion, or sudden vision changes

All symptoms and risks should be reviewed by a qualified clinician.

Why These Tests Matter

What testing can do

  • Confirm thyroid status (underactive, overactive, or euthyroid) and identify autoimmunity

  • Surface contributors that mimic or worsen thyroid symptoms (iron deficiency, B12 deficiency, dyslipidemia, vitamin D deficiency)

  • Support medication-aware monitoring, including consistent draw timing and recognition of assay interferences (e.g., biotin)

What testing cannot do

  • Diagnose nodules or cancer—those require ultrasound (and sometimes biopsy)

  • Replace clinical judgment when TSH is unreliable (pituitary disease, late pregnancy)

  • Use any single test to set medication dosing without a clinician’s oversight

What These Tests Measure (at a glance)

  • TSH (Thyroid-Stimulating Hormone): first-line screen and treatment monitor; typically high in hypothyroidism, low in hyperthyroidism.

  • Free T4 (± Free T3): unbound hormones; clarify severity/type. Free T3 adds value when hyperthyroid symptoms persist or T3-predominant patterns are suspected.

  • Thyroid antibodies: TPOAb (Hashimoto context), TgAb (autoimmunity and interference with thyroglobulin assays), TRAb/TSI (Graves confirmation).

  • Medication-aware context: Lipids (often rise when hypothyroid), CBC (anemia patterns), CMP(liver/kidney/electrolytes).

  • Nutrients that influence symptoms/absorption: Ferritin/iron/TIBC (iron deficiency), Vitamin B12 ± MMA, Vitamin D; magnesium or zinc in selected cases.

  • Endocrine look-alikes (selected): 8–9 a.m. cortisol ± ACTH; late-night salivary cortisol or 24-hr urinary free cortisol when hypercortisolism is suspected.

  • Important prep: high-dose biotin may cause falsely low TSH and falsely high T4/T3. Be consistent with the timing of your daily thyroid medication relative to the blood draw (many clinicians prefer drawing before the day’s dose).

Quick Build Guide

Clinical goal Start with Add if needed
Baseline thyroid status TSH • Free T4 Free T3 if hyper symptoms or T3-predominant suspicion
Suspected autoimmune thyroiditis TSH • Free T4 • TPOAb TgAb; clinician-directed ultrasound for goiter/nodules
Possible Graves disease TSH • Free T4 • Free T3 TRAb/TSI; eye evaluation if ocular symptoms
Symptoms persist despite “normal” basics TSH • Free T4 • Free T3 Ferritin/iron • Vitamin B12 ± MMA • Vitamin D • Lipids • CBC/CMP
Medication monitoring / absorption concerns TSH • Free T4(consistent timing) Iron/ferritin if heavy menses or supplements; review biotin use
Pregnancy or trying to conceive TSH (trimester-aware) • Free T4 TPOAb (selected) and closer follow-up per clinician
Endocrine mimic (wired/tired, late insomnia) AM cortisol ± ACTH LNSC (×2) or 24-hr UFC if hypercortisolism suspected

How the Testing Process Works

  1. Pick your starting set: most begin with TSH + Free T4, adding Free T3 and antibodies as indicated.

  2. Prepare for accuracy: list all medicines/supplements; pause high-dose biotin 24–48 hours if advised. Keep blood-draw timing consistent relative to your daily thyroid dose.

  3. Provide samples: standard blood draw (saliva or 24-hour urine only for select cortisol tests).

  4. Get secure results: most post within a few days.

  5. Plan next steps: review results with your clinician or pharmacist to align labs with symptoms, imaging (if needed), and a monitoring cadence.

Interpreting Results (General Guidance)

  • High TSH + low Free T4 → overt hypothyroidism; antibodies indicate if it’s autoimmune.

  • Low TSH + high Free T4/T3 → overt hyperthyroidism; TRAb/TSI supports Graves disease.

  • High TSH + normal Free T4 → subclinical hypothyroidism; risk of progression is higher with positive TPOAb.

  • Normal TSH with ongoing symptoms → consider absorption issues, assay interference (biotin), binding-protein changes (pregnancy/estrogen), nutrient deficiencies, or non-thyroid causes.

  • Abnormal lipids, low ferritin/B12, or low vitamin D → common companions that can worsen fatigue, hair loss, or mood—discuss with your clinician.
    Always interpret results with a qualified healthcare professional; trends and consistent test methods matter.

Choosing Panels vs. Individual Tests

  • Core pharmacist-recommended panel: TSH • Free T4 • Free T3 • TPOAb • TgAb

  • Graves confirmation add-on: TRAb/TSI

  • Nutrient & context add-ons: Ferritin/iron/TIBC • Vitamin B12 ± MMA • Vitamin D • Lipids • CBC • CMP

  • Endocrine mimic add-ons (selected): AM Cortisol ± ACTH • Late-Night Salivary Cortisol (×2) • 24-hr UFC
    Use bundled panels for efficiency; layer individual markers to answer targeted questions and monitor progress.

FAQs

Do I need to fast for thyroid labs?
Usually no. Fast only if your order includes fasting glucose or lipids.

Should I take my thyroid pill before the blood draw?
Be consistent. Many clinicians prefer drawing before the daily dose to avoid short-term Free T4/T3 peaks. Follow your clinician’s instructions.

Can supplements affect results?
Yes. Biotin can distort TSH/T4/T3. Iron and calcium products taken close to thyroid medication can affect absorptionand downstream labs.

When is Free T3 useful?
When hyperthyroidism is suspected or symptoms persist despite normal T4, Free T3 can add clarity.

Do positive antibodies mean I need treatment now?
Not always. Antibodies confirm autoimmunity; treatment depends on TSH/Free T4, symptoms, and plans (e.g., pregnancy).

Can labs detect thyroid cancer?
Labs monitor after treatment (thyroglobulin, calcitonin) but do not diagnose nodules—that requires ultrasound and possibly biopsy.

How often should I recheck?
Commonly 6–8 weeks after any medication change, then every 6–12 months when stable—your clinician will set the schedule.

Related Test Categories & Key Tests

  • Thyroid Tests Hub

  • All Thyroid Tests • Hashimoto Thyroiditis Tests • Graves Disease & Hyperthyroidism Tests • Hypothyroidism Tests • Thyroid Health Tests • Thyroid in Pregnancy • Thyroid Cancer Tests

  • Key Tests: TSH • Free T4 • Free T3 • TPO Antibodies • Thyroglobulin Antibodies • TRAb/TSI • Ferritin • Iron/TIBC • Transferrin Saturation • Vitamin B12 • MMA • Vitamin D • Lipid Panel • CBC • CMP • AM Cortisol • ACTH • Late-Night Salivary Cortisol • 24-hr Urinary Free Cortisol

References

  • American Thyroid Association — Guidelines for hypothyroidism, hyperthyroidism, thyroid nodules/cancer.
  • AACE/ACE — Clinical practice guidelines for thyroid disease.
  • Endocrine Society — Thyroid testing in pregnancy and special situations.
  • AACC/NACB — Laboratory best practices; biotin interference advisory.
  • NCCN — Thyroid carcinoma follow-up principles.
  • Clinical reviews on drug–nutrient interactions and timing effects on thyroid function testing.

Available Tests & Panels

Your Thyroid Pharmacist Recommended Tests menu is pre-populated in the Ulta Lab Tests system. Start with the core pharmacist-recommended panel (TSH, Free T4, Free T3, TPOAb, TgAb). Use filters to add TRAb/TSI for suspected Graves, nutrient panels (iron/ferritin, B12, vitamin D), lipids/CBC/CMP for context, and cortisol options only when clinically appropriate. Follow any prep guidance—especially biotin holds and consistent medication timing—and review results with your clinician to align labs with imaging and a monitoring plan.

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Blood Draw, Phlebotomist
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The Mold Allergy Panel measures IgE antibodies to common mold allergens, including Alternaria alternata, Aspergillus fumigatus, Candida albicans, Cladosporium herbarum, and Mucor racemosus. Elevated levels may indicate mold allergies, which can cause nasal congestion, sneezing, itchy eyes, coughing, wheezing, or asthma. This panel helps identify mold sensitivities and supports management through avoidance strategies or allergy treatments.

Blood
Blood Draw
Also Known As: Allergy Panel 11, Mold Allergy Test
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The Alternaria Alternata m6 IgE Test measures IgE antibodies in the blood to detect allergic reactions to Alternaria alternata, a common mold. Elevated results may indicate mold allergy, which can cause symptoms such as asthma, nasal congestion, coughing, or wheezing. This test helps support diagnosis and management of mold-related allergies.

Blood
Blood Draw
Also Known As: Alternaria Alternata IgE Test, Alternaria Alternata m6 Test
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The Aureobasidium Pullulans m12 IgE Test detects IgE antibodies to Aureobasidium pullulans, a mold often found in damp indoor areas. Elevated IgE levels may indicate an allergic response, which can contribute to respiratory problems such as coughing, wheezing, or asthma. This test helps in identifying mold-related allergies and guiding management strategies.

Blood
Blood Draw
Also Known As: Aureobasidium Pullulans IgE Test, Aureobasidium Pullulans m12 Test
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The Babesia microti IgG IgM Antibodies Test detects antibodies to the parasite that causes babesiosis, a tick-borne infection affecting red blood cells. IgM indicates recent or active infection, while IgG suggests past or ongoing exposure. Doctors use this test to diagnose babesiosis in patients with fever, chills, anemia, or fatigue, and to differentiate it from Lyme disease or other tick-borne illnesses for accurate treatment.

Varied
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The Bartonella Species IgG IgM Antibodies with Reflex to Titer Test detects antibodies to Bartonella, the bacteria that cause cat scratch disease and other infections. IgM suggests recent infection, while IgG indicates past or ongoing exposure. If positive, titers confirm antibody levels. Doctors use this test to evaluate patients with fever, swollen lymph nodes, or suspected vector-borne illness, helping confirm diagnosis and guide treatment.

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The Candida Albicans (M5) IgE Test measures IgE antibody response to Candida albicans, a common yeast that can trigger allergic reactions. Elevated IgE may indicate sensitivity linked to respiratory, skin, or digestive symptoms. Physicians use this test to identify potential allergic responses, distinguish yeast-related immune activity, and guide evaluation of conditions affecting allergy, inflammation, or overall immune health.

Blood
Blood Draw
Also Known As: Candida Albicans M5 IgE Test
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The Cladosporium herbarum m2 IgE Test measures IgE antibodies to Cladosporium herbarum, a common mold found indoors and outdoors. Elevated antibody levels may suggest an allergic reaction, which can cause respiratory issues, nasal congestion, or skin irritation. This test helps in evaluating mold-related allergies and guiding avoidance or treatment strategies.

Blood
Blood Draw
Also Known As: Cladosporium Herbarum IgE Test, Cladosporium Herbarum m2 Test
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The Complete Blood Count with Differential and Platelets Test is a comprehensive blood test that checks red blood cells, white blood cells, hemoglobin, hematocrit, and platelets. The differential analyzes types of white blood cells to detect infections, anemia, clotting abnormalities, immune conditions, and certain cancers. This essential test is often ordered for routine health exams, diagnosis, and monitoring treatment progress.

Blood
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Also Known As: CBC Test, CBC with Differential and Platelets Test, CBC w/Diff and Platelets Test, Full Blood Count Test, Complete Blood Count Test
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The Comprehensive Metabolic Panel (CMP) Test measures 21 markers to assess metabolic health, liver and kidney function, and electrolyte balance. It includes glucose, calcium, sodium, potassium, chloride, CO2, albumin, globulin, A/G ratio, total protein, bilirubin, ALP, AST, ALT, BUN, creatinine, BUN/creatinine ratio, and eGFR. The CMP helps detect diabetes, liver or kidney disease, and supports routine screening and chronic condition monitoring.

Blood
Blood Draw
Also Known As: CMP Test, Chemistry Panel Test, Chem Test, Chem 21 Test, Chem 14 Test 
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The Copeptin Test detects copeptin levels in blood as a biomarker of vasopressin release, fluid regulation, and systemic stress. Abnormal results may indicate heart failure, myocardial infarction, kidney dysfunction, or endocrine imbalance. This test provides insight into cardiovascular health, water balance, and systemic conditions influenced by stress response and vasopressin activity.

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The Cytomegalovirus (CMV) IgG IgM Antibodies Test detects both recent and past infection with CMV, a common herpesvirus. IgM indicates recent or active infection, while IgG shows past exposure and possible immunity. Doctors order this test for pregnant women, immunocompromised patients, or those with unexplained fever or fatigue. Results help diagnose CMV, guide treatment, and assess risk of complications such as congenital infection or organ damage.

Also Known As: CMV Antibodies Test, CMV IgG IgM Antibodies Test, Cytomegalovirus IgG IgM Test
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The Epicoccum Purpurascens m14 IgE Test measures IgE antibodies to proteins from the mold Epicoccum purpurascens. Elevated levels may suggest an allergic reaction, which can cause symptoms such as nasal congestion, sneezing, asthma, coughing, or skin irritation. The test helps identify mold-related allergies and supports diagnosis and management, including treatment options and environmental exposure reduction.

Blood
Blood Draw
Also Known As: Epicoccum Purpurascens IgE Test, Epicoccum Purpurascens m14 Test
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The Epstein-Barr Virus Antibody (EBV) Panel detects antibodies to EBV, including VCA IgM, VCA IgG, and EBNA IgG, to determine current, recent, or past infection. EBV causes infectious mononucleosis and has links to chronic fatigue and certain cancers. Doctors order this test for patients with fever, sore throat, swollen lymph nodes, or fatigue. Results help identify stage of infection, confirm diagnosis, and guide clinical management of EBV-related illness.

Blood
Blood Draw
Also Known As: EBV Antibody Test, EBV Ab Test, EBV Test, EBV Antibody Panel
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The Epstein-Barr Virus (EBV) Early Antigen D IgG Antibody Test detects IgG antibodies to EBV’s early antigen, helping identify recent or reactivated infection. Elevated levels may indicate acute mononucleosis, viral reactivation, or chronic EBV. Doctors order this test when patients present with fatigue, fever, sore throat, or swollen lymph nodes. Results provide key insight into EBV activity, supporting diagnosis, monitoring, and treatment decisions.

Also Known As: EBV Ab to Early Antigen D Test, EA-D IgG Ab Test, EBV EA-D Test
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The Ferritin Test measures ferritin, a protein that stores iron in the body, to evaluate iron levels and detect deficiency or overload. It helps diagnose anemia, iron deficiency, hemochromatosis, and chronic disease-related inflammation. Doctors often order the ferritin test to investigate fatigue, weakness, or unexplained symptoms. It is also used to monitor iron supplementation, treatment effectiveness, and overall iron metabolism health.

Blood
Blood Draw
Also Known As: Iron Storage Test
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The Fusarium Moniliforme m9 IgE Test measures IgE antibodies to Fusarium moniliforme, a common mold found in soil, plants, and decaying matter. Elevated IgE levels may indicate an allergic reaction, which can cause respiratory issues, asthma, or other allergy-related symptoms. This test helps identify mold exposure as a potential trigger, supporting diagnosis and personalized management of allergies.

Blood
Blood Draw
Also Known As: Fusarium Moniliforme IgE Test, Fusarium Moniliforme m9 Test
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The Helminthosporium Halodes m8 IgE Test measures IgE antibodies to the mold Helminthosporium halodes. Elevated IgE levels may indicate an allergic reaction, which can cause respiratory issues such as sneezing, nasal congestion, wheezing, or asthma-like symptoms. The test helps identify mold exposure as a potential trigger, supporting diagnosis and management of environmental allergies.

Blood
Blood Draw
Also Known As: Helminthosporium Halodes IgE Test, Helminthosporium Halodes m8 Test
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The Herpes Simplex Virus 1 and 2 IgG Type-Specific Antibody HerpeSelect® Test detects IgG antibodies to HSV-1 and HSV-2, distinguishing between the two types. A positive result indicates past exposure, as IgG develops weeks after infection and remains long-term. Doctors use this test to confirm herpes diagnosis, guide treatment, or support sexual health decisions. Results provide vital insight into HSV status, infection history, and long-term immune response.

Blood
Blood Draw
Also Known As: Herpes 1 and 2 Test, Herpes IgG Test
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Tests that a Thyroid Pharmacist Recommends That You Should Be Aware Of

According to the American Thyroid Association, more than 12 percent of Americans experience a disease or condition of the thyroid in their lifetime, yet 60 percent of those with thyroid disease are unaware they have a condition. Women are much more likely to develop thyroid problems.

Untreated thyroid conditions can lead to serious health issues like infertility, heart problems, and even death. It is very important that you stay proactive about your health, monitor changes in your body closely, and get tested for common conditions like thyroid disorders.

Conditions of the thyroid tend to be life-long, but common treatments are available to improve quality of life and health. Don't hesitate to order lab tests if you're concerned about your thyroid function.

When Should You Test Your Thyroid Function?

Your thyroid is an essential organ in your endocrine system that helps regulate:

  • Hormone levels
  • Metabolism
  • Body temperature
  • Brain function
  • Heart rate

People with thyroid disorders generally suffer from either an underactive or overactive thyroid. Sometimes, this is an issue of the thyroid itself. Other times, other health conditions are affecting how the thyroid functions.

An underactive thyroid is not processing thyroid hormones as quickly as it should, so the body slows down, and the metabolism decreases in function. People who suffer from an underactive thyroid typically experience symptoms such as:

  • Fatigue
  • Weight gain
  • Dry skin
  • Cold limbs

An overactive thyroid is processing thyroid hormones too quickly, which speeds up the function in the body. People who suffer from an overactive thyroid can experience anxiety, heart palpitations, and weight loss.

Thyroid pharmacist-recommended lab tests and panels can help analyze the blood for thyroid hormones and other indicators that could assist in diagnosing your condition.

Benefits of Thyroid Lab Tests and Panels

To assess thyroid function, thyroid blood tests can test the levels of thyroid hormones in your bloodstream. These blood tests are the best way to assess exactly what is affecting your endocrine system. Most commonly, thyroid tests will check for TSH, T3, and T4 levels.

The pituitary gland produces TSH (thyroid-stimulating hormone) to tell the thyroid to work. If blood tests show that your TSH levels are abnormal, it could mean that your pituitary gland is reacting to abnormal thyroid function.

T3 and T4 are the hormones that the thyroid itself produces and sends out to tell the body how to use energy. If a test finds abnormal T3 and T4 levels in the blood, it means that the thyroid is functioning at an abnormal speed.

Sometimes, blood tests will show normal levels for one type of hormone and abnormal levels for another. For example, if your TSH is too high, but your T3 and T4 are normal or too low, it could mean that the pituitary gland is working overtime to try to get the thyroid to function at a normal level. Therefore, you have an underactive thyroid.

If your initial blood test shows that you have an underactive thyroid, you can take further tests to determine why. Some people are born with an underactive thyroid, while others might have suffered physical damage to their thyroid or have an autoimmune disease that attacks it.

Overall, ordering a thyroid blood test or panel will help you find the reason behind your symptoms and further investigate why your thyroid might not be functioning properly.

What Are Thyroid Pharmacist Recommended Lab Tests?

Ulta Lab Tests offers thyroid pharmacist recommended lab tests and lab panels that will help you assess thyroid function and investigate root causes of your condition. To get a better understanding of what tests are available to you, below is a list of panels you can order and what they determine.

TP - Basic Thyroid Panel

The basic thyroid panel checks for the typical three biomarkers that most medical professionals will consider when diagnosing a thyroid condition. This blood test will check for Free T3, Free T4, and TSH.

TP - Root Cause Thyroid Panel #1

In the Root Cause Thyroid Panel #1, you'll assess Free T3, Free T4, T3 Reverse, and TSH. These biomarkers will show how your pituitary gland and thyroid are communicating and the levels of hormones your thyroid is producing.

Thyroid Peroxidase and Thyroglobulin Antibodies are also tested, which will help determine if your immune system is attacking your thyroid, whether due to conditions like Hashimoto's Thyroiditis or Grave's Disease.

TP - Root Cause Thyroid Panel #2

The Root Cause Thyroid Panel #2 tests the same biomarkers as #1. The difference is that it excludes T3 reverse. Typical blood tests generally do not check T3 Reverse unless symptoms persist beyond usual treatment.

T3 Reverse continues to be controversial, as testing can show abnormal results because treatments have not yet been found for this issue. Knowing that you have an issue with T3 Reverse, however, could be useful in understanding your condition.

TP - Root Cause Infections Panel

Medicinal science has found that a large number of infections can either trigger or cause thyroid conditions. This Root Cause Infections Panel checks your bloodstream for indications that you've been infected by:

  • Babesia Microti
  • Bartonella Species Antibodies
  • Coxsackie B
  • Cytomegalovirus
  • Epstein-Barr
  • Herpes Simplex
  • Lyme Disease

Finding these infections early and treating them can lead to improved health and thyroid function.

TP - Root Cause Epstein-Barr (EBV) Panel Plus

If you know that you've had mononucleosis in the past, you might have Epstein-Barr living in your system. Epstein-Barr is known to lead to similar symptoms as thyroid conditions, and it also has been studied in correlation with thyroid conditions, so it's a good idea to get tested with the Root Cause Epstein-Barr Panel for the virus.

TP - Mold Illness Panel #1 and #2

Mold is a thyroid disruptor, and it can attack your thyroid when exposed. Testing for mold exposure can help find the cause of your condition. Mold Illness Panels check for alpha-melanocyte-stimulating hormone, copeptin, and HLA DRB3, 4, and 5. Panel #2 checks for Hla Class Li Dr Dq Dna Typing, too.

TP - Mold Allergy Panel Expanded (IgE)

Mold Allergy Panel Expanded (IgE) is a blood test that checks for 11 different antibodies in your bloodstream that react to common outdoor and indoor molds. People with mold allergies that breathe in mold spore can suffer from allergic reactions and thyroid dysfunction.

The Thyroid Secret Root Cause Panel and Plus Panel

The Thyroid Secret Root Cause Panel checks for your typical thyroid hormones (Free T3, Free T4, TSH, antibodies). In addition, it runs a complete blood count (CBC) and a comprehensive metabolic panel. These extra panels will check for irregularities in your blood platelets, nutrients, and other necessary molecules in your system.

The Plus Panel checks for all of that in addition to your Reverse T3. 

Order Your Thyroid Pharmacist Recommended Lab Tests and Panels from Ulta Lab Tests

Ulta Lab Tests offers highly accurate and reliable tests so that you can make informed decisions about your health. Here are a few great things to love about Ulta Lab Tests:

  • You'll get secure and confidential results
  • You don't need health insurance
  • You don't need a physician's referral
  • We offer a 100 percent satisfaction guarantee

Order your Thyroid Pharmacist Recommended Lab Tests and Panels today, and you will receive results in 24 to 48 hours for most tests.

Take control with Ulta Lab Tests today!