TSH is the pituitary's signal
TSH is the hormone the pituitary sends to tell the thyroid to work. A high TSH often means the gland is being asked to do more because output is low. A low TSH can mean the opposite, or it can reflect medication. It is a signal, not the hormone the tissues use. Ordering TSH alone is sometimes enough for a screening question and too thin for a person who still feels wrong on paper that was called normal.
Thyroid panel adds the downstream hormones when the question needs them. Dr. Tara Kohen says which ones are being drawn and why, before the needle. The draw is an additional cost. Review visits often run 30 to 60 minutes depending on the plan. A free 20-minute consultation can decide whether a fuller panel is useful or whether your prescriber's existing labs are already the right set.
Free T4, free T3, and reverse T3
Free T4 is the main hormone the gland releases, unbound and available. Free T3 is the more active form many tissues use, made largely by converting T4. If T4 is present and T3 is low, the conversion step is part of the conversation. Illness, calorie intake, and some medications can affect that step. The panel shows the numbers. It does not invent a disease from one low T3.
Reverse T3 is an inactive form that can rise when the body is conserving energy, during illness, or under certain stresses. It is ordered when that question is real, not as decoration. Thyroid dysfunction symptoms, cold, weight change, fatigue, hair, and bowel changes, are matched to these numbers. Chronic fatigue is not assumed to be a thyroid problem until the panel and the story agree.
Antibodies and an immune pattern
Thyroid antibodies, such as those associated with Hashimoto's, suggest the immune system is targeting the gland. They can be present before hormone levels move much. Hashimoto's thyroiditis is a medical diagnosis. A positive antibody on this panel is a reason to involve the prescriber, not a reason for FRI to title you with a disease and start a protocol. Dr. Sani Kohen reports the antibody and the next right clinician.
Antibodies also do not explain every symptom you have ever had. Joint pain, mood, and gut issues may be related or may be separate. Hormonal imbalance questions sometimes need DUTCH hormone testing as well, because sex hormones and thyroid are different pages. One panel is not asked to do both jobs.
The prescriber owns any medication change
If you take thyroid medication, the dose is the prescriber's. FRI does not raise it, lower it, or switch forms. The panel can be shared so that conversation is better informed. Bringing your current dose and the time of day you take it makes the numbers interpretable. A blood draw at a random hour relative to the pill can mislead.
The office is out of network, accepts HSA and FSA cards, and provides a superbill for the visit. Ask what the lab fee will be before you draw. If your physician has already ordered the same tests recently, repeating them for a second opinion on the same week is usually waste. Bring those results. A new draw is for a new question or a stale one.
What a Thyroid Panel visit is like
Expect a history of energy, temperature, weight, bowel pattern, menstrual change, medication, and prior labs before any box is checked on the requisition. The draw is ordinary bloodwork. You should know which of TSH, free T4, free T3, reverse T3, and antibodies are included, and which were left off on purpose.
The review explains each number in the same plain language the order used. You will not be handed a new dose. If the pattern needs a prescriber's decision, that is the recommendation, including when to be seen sooner. A normal panel with severe symptoms is also a result: the search moves elsewhere.
Straightforward office policies
No referral required. Out of network. Superbill. HSA and FSA. We do not invent a copay. Labs, if ordered, cost extra and are explained first. Medication stays with your prescriber.
You will see Drs. Sani and Tara Kohen's practice, described on the about page. Photos of the gym and rooms are on the office page. If a problem is outside chiropractic and functional medicine, we will say so rather than stretch the visit to cover it.
Town Center days and Aliso Canyon edges
Aliso Viejo is compact, master planned, and hillier than it looks from the 73. The Town Center is errands, sitting, and short walks. The neighborhoods toward Aliso and Wood Canyons add dirt descents and stairs. A lot of residents commute north to Irvine business parks and then come home to a hill. Necks take the office. Knees take the canyon. We want both halves of that day, because treating only the part that hurts ignores the part that loaded it.
The canyon trails are a gift and a test. People start plantar fascia or knee complaints after they add mileage on dirt while their week is otherwise a chair. Gait analysis and a loading plan are more useful than a month of rest followed by the same trail.
Alicia, Pacific Park, and the 73
From the Town Center, Alicia Parkway toward Mission Viejo is direct. From the south and west edges, Pacific Park or the 73 north to a Mission Viejo exit also works. About 7 miles and 12 to 20 minutes when the parkways move. The suite is 26400 La Alameda, Suite 100, Mission Viejo, CA 92691. On-site parking. Monday through Thursday, 9 to 6.
If your day already includes the 73 toll road to Irvine, stacking a clinic visit on the south end of that drive can be efficient. Do not book so tight that you walk in from a stressful drive and expect a meaningful neck exam. Call (949) 312-1754. The complimentary consultation is 20 minutes if you want to start smaller.
Care that fits a canyon-and-commute city
Neck pain, lower back pain, and headaches track with the Irvine commute. Hip and SI pain tracks with hills and carrying kids up them. Joint mobilization and corrective exercise are everyday tools. McKenzie care is the spine option when symptoms have a direction that centralizes them.
Hormone and gut visits are part of the same practice. Perimenopause and SIBO have their own pages so those questions are not buried under sports advice. The Aliso Viejo chiropractor page is the hub.
Questions patients ask
Why order more than TSH?
TSH is the pituitary signal. Free T4 and free T3 show what the gland and the conversion step are providing. Antibodies ask whether the immune system is involved. Reverse T3 is added only when that question matters.
Will you adjust my thyroid medication?
No. Dose changes belong to the prescriber. The panel can be shared to inform that visit. It is not a new prescription.
Does a positive antibody mean I have Hashimoto's?
It suggests an immune pattern that a physician should interpret. FRI reports the result and refers. The diagnosis is not assigned from this visit alone.
Should I take my pill before the draw?
Ask before the morning of the test. Timing relative to the dose changes how the numbers look. A random timing can waste the panel.
Related methods and problems for Aliso Viejo
Thyroid Panel is one tool inside Functional Medicine. It is not booked as a standalone trick disconnected from the exam. These links are the neighboring methods and the problems that most often lead someone from Aliso Viejo to ask about it.
- Thyroid Panel overview
The clinic-wide technique page, without a city attached.
- Aliso Viejo chiropractor
Drive, neighborhoods, and the rest of the care offered to Aliso Viejo patients.
- Functional Medicine
The pillar this method belongs to.
- Advanced Bloodwork
Advanced bloodwork goes past a bare metabolic panel when the question needs more context. Lipids in more detail, glucose with insulin, iron.
- DUTCH Hormone Testing
The DUTCH test uses dried urine collected across a day to look at sex hormones, their metabolites, and the shape of cortisol.
- Nutrition & Supplementation
Nutrition at Functional Restoration Institute starts with food. A supplement is added only when a lab or a clear clinical question calls.
- Functional Lab Testing
Functional lab testing is the visit where the history chooses a lab, instead of a cart of kits. DUTCH, a GI-MAP stool.
- Thyroid Dysfunction in this city
Thyroid trouble is not one feeling. A slow pace can leave you cold, heavy, and constipated. A fast pace can leave you.
