Local Service — Park Ridge, IL
THYROID TEST IN PARK RIDGE
The full panel — TSH, free T3, free T4, reverse T3, TPO antibodies, and thyroglobulin antibodies. Run together so you can finally see what TSH alone never showed you. Same-day draw at our Park Ridge clinic.
Written and medically reviewed by Missy Zammichieli, DNP, APRN, FNP-BC · Updated May 3, 2026
From the Provider
Missy Zammichieli, DNP, APRN, FNP-BC
Doctor of Nursing Practice
Board-Certified Family Nurse Practitioner
The most common reason patients walk into my office tired, foggy, and gaining weight in the midsection is not laziness or aging — it's a thyroid that's underperforming inside a "normal" TSH. I see this every week. Their primary care ordered TSH, it came back at 3.1, and they were told everything was fine. But when we run the full panel — free T3, free T4, reverse T3, and antibodies — the picture is almost never that simple.
About one in five women I scan for the first time in perimenopause has elevated TPO antibodies — meaning they're in early Hashimoto's and don't know it. Catching that before the thyroid is destroyed changes the entire treatment runway. The lab cost to find that pattern is trivial. The cost of missing it is years of misdirected treatment.
If your TSH is "normal" and you still feel hypothyroid, the right next step isn't repeating the same one-marker test. It's running the rest of the panel.
WHAT A REAL THYROID PANEL LOOKS LIKE
A 4-marker screen tells you whether your pituitary is shouting at your thyroid. A 6-marker panel tells you what your thyroid is actually doing.
TSH
The pituitary's request signal. High TSH usually means the thyroid is underproducing; low TSH usually means overproduction. But TSH lags by weeks and can sit "normal" while the rest of the system fails.
Free T4
The storage form your thyroid actually produces. T4 is biologically inert until it's converted into T3. Low free T4 with normal TSH points to early thyroid failure.
Free T3
The active hormone. This is what your tissues actually use. Low free T3 — even with normal TSH and T4 — explains a huge percentage of "normal labs but feel terrible" cases.
Reverse T3
The mirror-image of T3 that occupies the receptor without activating it. Elevated reverse T3 is your body's way of pumping the brakes during stress, illness, or chronic dieting — and it can leave you symptomatically hypothyroid even with "good" labs.
TPO Antibodies
Marker of Hashimoto's thyroiditis — autoimmune destruction of the thyroid. Often elevated for years before TSH moves. Affects roughly 10% of US adults; underdiagnosed because most providers never test for it.
Thyroglobulin Antibodies
Second autoimmune marker. Adds sensitivity for catching Hashimoto's that TPO alone misses. Together with TPO, antibody testing catches roughly 95% of autoimmune thyroid disease.
WHY AN IN-PERSON CLINIC, NOT A MAIL-IN KIT
Mail-in finger-prick kits are unreliable for thyroid
Capillary blood from a finger-stick has different reference ranges than venous blood, and the assays available for at-home kits don't include reverse T3 or both antibodies. If you want a real thyroid picture, you need a venous draw and a full panel.
A panel is only as useful as the person reading it
"Normal" on a lab printout doesn't mean optimal. We read every result against your symptoms, medications, and other markers. See our take on the optimal vs. normal range gap.
If labs reveal something, the next step happens here
If your panel shows Hashimoto's, low T3, or a conversion problem, you don't have to find a new clinic and start over. We treat hypothyroidism, optimize T4-to-T3 conversion, and monitor antibody trends in the same place you draw labs.
WHAT TO EXPECT
1. Book online
No referral. Pick a fasting morning slot if you're bundling with our 60+ marker panel. Otherwise any time works.
2. 15-minute draw
In and out. Skip biotin supplements for 72 hours before. We use Quest for thyroid assays — turnaround typically 3–5 business days.
3. Provider-reviewed results
We don't auto-release results to a portal and disappear. Missy walks you through what each marker means and what — if anything — needs to change.
Pricing
Full thyroid panel is included in our $285 comprehensive 60+ marker panel — the most cost-effective way to see thyroid in context with everything else (sex hormones, metabolic, inflammation, micronutrients). Stand-alone thyroid-only pricing available on request. HSA/FSA accepted.
COMMON QUESTIONS
Why isn't TSH enough on its own?
TSH is a feedback signal from the pituitary, not a measurement of how much active thyroid hormone is reaching your tissues. You can have a normal TSH and still be hypothyroid at the cellular level if your body isn't converting T4 into active T3, if reverse T3 is high, or if Hashimoto's is silently destroying thyroid tissue. The 4-marker screen most labs run will miss all three patterns.
What does a full thyroid panel include?
TSH, free T4, free T3, reverse T3, TPO antibodies, and thyroglobulin antibodies. Together these tell you whether the thyroid is producing, converting, and signaling correctly — and whether your immune system is attacking it.
How much does a thyroid test cost at Moonshot?
The full thyroid panel is included in our $285 comprehensive 60+ biomarker blood panel. Stand-alone thyroid-only pricing is available on request. HSA/FSA accepted. We don't bill insurance, which is exactly why we can run the markers your insurance won't approve.
Do I need to fast before a thyroid test?
Thyroid markers themselves don't require fasting, but if you're getting them as part of a comprehensive panel that also includes glucose, insulin, and a lipid profile, fast 10–12 hours and skip biotin supplements for 72 hours before the draw. Biotin can interfere with the assay and falsely lower TSH.
How long until results?
Typically 3–5 business days for thyroid markers. We notify you when results are in and book a follow-up to walk through the panel together.
RUN THE FULL PANEL
Book a comprehensive blood panel in Park Ridge. Thyroid included, in context, reviewed by your provider.
Book a Blood PanelEducational information only. Not medical advice. Lab interpretation requires clinical context — symptoms, medications, history. Reference ranges vary by lab and assay. Pregnant or trying to conceive: thyroid management has additional considerations not covered on this page; speak directly with your provider. Moonshot Medical and Performance is a licensed medical clinic in Park Ridge, IL. All evaluations are performed by Missy Zammichieli, DNP, APRN, FNP-BC, who holds full practice authority in Illinois.