Autoimmune and thyroid disorders are increasingly recognised in the UK, and early testing can provide valuable insight into symptoms such as fatigue, hair loss, weight changes, low mood, anxiety, cold intolerance or digestive issues.
This comprehensive panel combines thyroid function markers, iron status, and autoimmune antibodies, giving a broad overview of how the immune system and thyroid gland are functioning.
This panel includes the following nine tests:
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ANA1 – ANA by IIF (pattern + titre)
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Anti-TG (Thyroglobulin antibodies)
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Anti-TPO (Thyroid peroxidase antibodies)
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Ferritin
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FT3 (Free T3)
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FT4 (Free T4)
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ASMA – Smooth Muscle Antibodies, IIF
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AMA – Anti-Mitochondrial Antibodies, IIF
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TSH
Below you will find a complete explanation of why each test is important, what results may indicate, and the typical UK reference ranges.
(Ranges may differ slightly between NHS and private UK laboratories.)
1. ANA (Antinuclear Antibodies) – IIF Method (Pattern & Titre)
Why is this test important?
ANA testing is one of the first-line laboratory tools used to explore autoimmune activity.
It detects antibodies that target the nucleus of the body’s own cells. This test is not specific to one condition but can help guide further investigation when symptoms suggest an autoimmune process.
The IIF method reports:
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Pattern of fluorescence (e.g., homogeneous, speckled, centromere)
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Titre (strength of antibodies, e.g., 1:80, 1:160, etc.)
Typical UK reference:
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Negative: < 1:80
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Borderline/low titre: 1:80
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Positive: ≥ 1:160 (depending on lab)
What may results suggest?
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Low titres are common and may occur without illness.
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Higher titres may indicate autoimmune activity and require clinical correlation.
Patterns help guide which autoimmune pathways might be involved, but ANA alone does not diagnose any condition.
2. Anti-TG – Thyroglobulin Antibodies
Why is it tested?
Anti-TG antibodies are markers of autoimmune thyroid activity. They often appear in conditions where the immune system targets thyroid tissue.
Typical UK range:
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Negative: < 60 IU/mL (lab-dependent)
What may results indicate?
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Elevated anti-TG: autoimmune thyroid involvement (common in Hashimoto’s).
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Normal anti-TG: immune system not targeting thyroglobulin.
3. Anti-TPO – Thyroid Peroxidase Antibodies
Why it matters
Anti-TPO is one of the most clinically useful thyroid autoimmune markers. Elevated levels mean the immune system may be reacting to thyroid peroxidase, an enzyme essential for hormone production.
Typical UK range:
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Negative: < 34 IU/mL
What results may suggest:
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High anti-TPO: commonly seen in autoimmune thyroid conditions.
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Normal anti-TPO: no active autoimmune attack on TPO.
Anti-TPO is often elevated years before thyroid hormone changes appear.
4. Ferritin – Iron Storage Marker
Why test ferritin?
Ferritin shows how much iron is stored in the body. Low ferritin may cause symptoms similar to thyroid imbalance, including fatigue, hair loss, cold intolerance and low mood.
Typical UK reference ranges:
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Women: 15–200 µg/L
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Men: 30–400 µg/L
What results may mean:
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Low ferritin: common in menstruating women; may reflect low iron stores.
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High ferritin: may be related to inflammation, iron overload or liver stress.
5 & 6. FT3 and FT4 – Free Thyroid Hormones
These hormones reflect how well the thyroid gland is functioning and how active thyroid hormones are in the bloodstream.
FT3 (Free Triiodothyronine)
Typical UK range:
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3.1–6.8 pmol/L
What results may indicate:
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Lower FT3: decreased thyroid hormone activity or conversion.
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Higher FT3: increased thyroid hormone activity.
FT4 (Free Thyroxine)
Typical UK range:
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12–22 pmol/L
What results may indicate:
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Low FT4: reduced thyroid hormone output.
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High FT4: increased thyroid hormone production or supplementation effects.
FT3 and FT4 help interpret TSH (see below) and give a full picture of thyroid function.
7. ASMA – Smooth Muscle Antibodies (IIF)
Why is this test useful?
ASMA antibodies may appear in autoimmune processes that affect smooth muscles.
Typical UK reference:
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Negative: < 1:40 titre
What may results suggest?
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Low titres: can be nonspecific.
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Higher titres: may indicate autoimmune liver or muscle-related activity.
ASMA alone is not diagnostic and must be interpreted with full clinical context.
8. AMA – Anti-Mitochondrial Antibodies (IIF)
Why test AMA?
AMA targets mitochondria within cells. These antibodies are associated with autoimmune processes involving bile ducts and liver health.
Typical UK reference:
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Negative: < 1:40
What may results indicate?
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Positive AMA: suggests autoimmune mitochondrial activity; requires clinical correlation.
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Negative AMA: no detectable mitochondrial antibodies.
9. TSH – Thyroid Stimulating Hormone
Why it is essential
TSH is the most commonly used marker to assess thyroid function. It shows how the pituitary gland is signalling the thyroid.
Typical UK reference range:
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0.4–4.0 mIU/L
(Some UK labs use narrower “optimal” ranges of 0.5–2.5.)
What results may indicate:
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High TSH: the thyroid may be underactive (low FT4/FT3).
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Low TSH: the thyroid may be overactive or influenced by supplementation.
TSH should always be interpreted alongside FT4, FT3 and antibody results.
Why this Autoimmune & Thyroid Panel is Valuable
This combination of tests provides a broad and detailed picture of:
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thyroid gland function,
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hormone production and conversion,
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iron storage (which strongly affects thyroid performance),
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autoimmune activity affecting thyroid, liver and other tissues.
These tests do not confirm a diagnosis, but they offer essential insights for understanding symptoms and guiding discussion with a healthcare professional.