COMPENDIUM ON FUNCTIONAL MEDICINE - Flipbook - Page 169
● Reverse T3
This expanded panel is recommended for patients with abnormal
initial results, strong clinical suspicion despite normal tier 1 results, or
risk factors for autoimmune thyroid disease.
Tier 3: Specialized Assessment
● Tier 2 tests plus:
● TSH Receptor Antibodies
● TBG
● Thyroglobulin (primarily for thyroid cancer monitoring)
● T3 Uptake or Free T4 Index (in pregnancy or suspected
binding protein abnormalities)
This detailed panel is reserved for complex cases, suspected rare
disorders, or monitoring specific conditions like thyroid cancer.
Special Considerations in Test Interpretation
The Rockwell practitioner should be mindful of several key
considerations when interpreting thyroid function tests:
Reference Range Limitations
Standard laboratory reference ranges represent statistical
distributions (typically 95% of a presumed healthy population)
rather than optimal functional ranges. The Rockwell approach
considers narrower optimal ranges that better correlate with
symptom resolution and physiological function [16].
For example, while conventional TSH reference ranges often
extend from 0.4-4.5 mIU/L, research suggests many individuals
achieve optimal function with TSH between 1.0-2.5 mIU/L.
Individual Variation and Set Points
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