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.
Chiropractic, rehab, and labs from Tustin
McKenzie Method work is a strong fit when back or neck pain has a direction that makes it better or worse. Corrective exercise is the homework. Adjustments are used when a specific joint is restricted, after the screen that says a thrust is appropriate.
Functional medicine visits cover thyroid, sleep, and gut health when those are the actual complaint. The Tustin chiropractor page collects the local routes into the three pillars.
Fees, referrals, and the doctors
Out of network. Superbill. HSA and FSA. No referral required. We will not change a prescription from your physician. Emergency symptoms, including sudden neurologic loss, go to the ER rather than to La Alameda.
Drs. Sani and Tara Kohen practice at FRI. Their backgrounds are on the about page. The suite and gym are on the office page.
Old Town, the Legacy, and the North Tustin hills
Tustin has three different weeks. Old Town is walkable, with short blocks and a lot of sitting in cafes and small offices. Tustin Legacy, on the old base, is wide, new, and built around a car. North Tustin and the hills toward Foothill are grades, older homes, and a drive down to the 55. A low back from Legacy commuting is not a knee from a North Tustin hill. We ask which one you live in before we guess at a load.
The District and the shopping around the Legacy add standing errands on top of desk jobs. Neck pain and headaches often belong to the screen. Knee pain and hip pain show up when hill residents add steps without a plan. Plantar fasciitis shows up in people whose walking is almost all concrete between the car and a door.
South on the 55
The 55 south to the 73 is the usual path to La Alameda. About 16 miles. Twenty-five minutes is a good day. Forty is a 55 that is not cooperating. Address: 26400 La Alameda, Suite 100, Mission Viejo, CA 92691. Parking at the building. Monday through Thursday, 9 to 6.
Do not book the visit as a gap between school pickup in Old Town and a meeting. The exam needs you present, not halfway back on the freeway in your head. Call (949) 312-1754. A complimentary 20-minute consultation is available if you want to meet the doctors before an evaluation.
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 Tustin
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 Tustin to ask about it.
- Thyroid Panel overview
The clinic-wide technique page, without a city attached.
- Tustin chiropractor
Drive, neighborhoods, and the rest of the care offered to Tustin 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.
