$4.00
Priced per marker, with baseline labs included. You’ll see your total before you pay.
Thyroid
Thyroid cascade (reflex testing) test
Sequential thyroid testing — TSH first, then Free T4, then T3 or antibodies as needed.
At a glance
In about 5 days
Most results are ready in about 5 days. Some specialty markers can take up to 21 days.
May have a step to take first. Contact us to ask
Contact us before your draw if you’re not sure.
Walk in at Quest
Your lab order arrives by email. Most Quest locations take walk-ins, so bring it with a photo ID.
What it measures
It starts with TSH, the main thyroid screening test. If your TSH is outside the normal range, the lab automatically adds follow-up thyroid tests, so extra tests are run only when they’re needed.
Why it matters for women
Thyroid conditions are much more common in women and can affect energy, weight, mood, periods and fertility. This step-by-step approach gives a fuller picture when something looks off, without extra tests when your TSH is in range.
You might check it if…
- you want a thyroid check without choosing each test
- you feel tired, cold or foggy more than usual
- your periods have changed or you’re trying to conceive
- thyroid disease runs in your family
What your result may mean
High Thyroid cascade (reflex testing): what it may mean
High TSH on this test may point to an underactive thyroid (hypothyroidism), and the lab can then add free T4, free T3 or thyroid antibody tests in steps. What it may mean depends on the full pattern: a low free T4 can fit an underactive thyroid, while a normal free T4 can fit a mild or early change (subclinical hypothyroidism). Positive antibodies may point to Hashimoto's thyroiditis. Thyroid conditions can affect energy, weight, mood, periods and fertility, and some people may have no symptoms. Recent illness, a change in thyroid medicine or thyroid changes after a baby can also push TSH up.
Low Thyroid cascade (reflex testing): what it may mean
Low TSH on this test may point to an overactive thyroid (hyperthyroidism), and the same step-by-step add-on tests can follow. A low TSH can only be read with the full pattern: high free T4 or free T3 can fit an overactive thyroid, while normal levels can fit a mild change (subclinical hyperthyroidism). It can happen with Graves' disease, thyroid nodules, thyroiditis after having a baby, or too much thyroid medicine. Some people may notice a fast heartbeat, anxiety, weight loss or lighter periods. High-dose biotin can falsely lower TSH on some lab tests, and TSH can dip in early pregnancy.
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These notes provide context and do not diagnose a condition. Not yet available in NY, NJ, RI, HI, ND, SD or WV.