Latest blood test results for untreated hypothyroidism condition, any comments appreciated?

Main symptoms: very little energy, sudden energy slumps, excessive fatigue requiring over 15 hours of sleep daily, weakness, brain fog, dizziness, excessive sweating (cold sweat if anxious or during and long after physical activity), intolerance of excessive temperature, cold feet all the time, excessive fatigue getting worse in the last year, plus horizontal ridges, bumps on weak nails.


TSH and FT4 blood test results over 9 year period:

30/10/2013 - TSH: 8.1 H mu/L (0.3 - 4.2); FT4: 15.6 pmol/L (12 - 22)

09/07/2012 - TSH: 2.5 mu/L (0.3 - 4.2); FT4: not given

30/01/2008 - TSH: 7 mu/L (0.3 - 4.2); FT4: 13 pmol/L (12 - 22)

27/07/2007 - TSH: 7.5 mu/L (0.3 - 4.2); FT4: 13.1 pmol/L (12 - 22)

11/06/2004 - TSH: 4 mU/l (0.3 - 4.2); FT4: not given

But only diagnosed as subclinical hypothyroidism and no treatment offered. So requested tests for TSH; FT4; FT3; Thyroid antibodies; Ferritin; Folate; B12; Vit D3; Calcium; Homocysteine to help throw light on my condition and urge GP to treat and to refer to specialist.

TSH, (not provided this time, previous years above) FT4 (not provided this time, previous years above), FT3 (not provided this time or any other time), Thyroid antibodies (provided); Ferritin (provided); Folate (provided); B12 (provided); Vit D3 (not provided), Calcium (provided); and Homocysteine (not provided astest for homocysteine must be spun and separated within 1 hour, so only available if I attend hospital).

Blood test results for 6 Jan 2014:


TPO ANTIBODIES - (KT) – normal – no action

Thyroid peroxidise antibody level: 16 iu/mL (0.00 – 34.00 iu/mL)

B12/FOLATE LEVEL- (KT) - normal – no action

Serum vitamin B12: 260 ng/l (190.00 – 663.00ngl)

Serum folate: 8.1 ug/l (4.60 – 18.70ug/l)

BONE - (SDB) – normal – no action

Serum calcium level: 2.21 mmol/L (2.15-2.55mmol/L)

Corrected serum calcium level: 2.09 mmol/L (2.15-2.55mmol/L)

Serum inorganic phosphate: 0.94 mmol/L (0.87 – 1.45mmol/L)

Serum total protein: 77 g/L (66.00 – 87.00g/L)

Serum albumin: 46 g/L (35.00-50.00g/L)

Serum alkaline phoshatase: 46 iu/L (35-129.00iu/L)

IRON – (SDB) – normal – no action

Serum iron level: 15 umol/L (6.60-26.00umol/L

Serum TIBC: 70 umol/L (40.80-76.60umol/L)

FERRITIN – (SDB) – normal – no action

Serum ferritin: 36ug/l (13.00 – 150.00ug/l)

CHOLESTEROL – (SDB) – normal – no action

Serum cholesterol: 6.1 mmol/L (Targets are total cholesterol <5 mmol/l (LDL cholesterol <3 mmol/L in the general population and total cholesterol <4 mmol/L (LDL cholesterol <2 mmol/L) in high risk groups)

DIFFERENTIAL – (SDB) – normal – no action

Neutrophil count: 3.0 (1.70-7.50)

Lymphocyte count: 2.1 (1.00-4.00)

Monocyte count: 0.3 (0.20-1.00)

Eosinophil count: 0.2 (0.00- 0.40)

Basophil count: 0.0 (0.00-0.10)

COMPLETE BLOOD COUNT – (SDB) – normal – no action

Haemoglobin estimation: 134 g/L (115-165)

Total white cell count: 5.6 (3.50-12.00)

Platelet count: 376 (140-400)

Mean corpuscular volume (MCV): 83.4 fL (78-98)

Red blood cell (RBC): 4.76 (3.80-5.80)

Haematocrit: 0.40 L/L (0.37-0.50)

Mean corpusc haemoglobin (MCH): 28.2 pg (27-32)

MCHC: 338 g/L (310-360)

Red blood cell distribut width: 14.4% (11.50-16.00%)

As I don't seem to have elevated thyroid antibodies which would mean I would be offered thyroxine for TSH <5, I will write to GP referring to Dr Toft's answers to questions in Pulse Online article:

Q2 I often see patients who have an elevated TSH but normal T4. How should I be managing them?

A: In the absence of symptoms some would simply recommend annual thyroid function tests until serum TSH is over 10mU/l or symptoms such as tiredness and weight gain develop. But a more pragmatic approach is to recognise that the thyroid failure is likely to become worse and try to nip things in the bud rather than risk loss to follow-up.

Treatment should be started with levothyroxine in a dose sufficient to restore serum TSH to the lower part of its reference range. Levothyroxine in a dose of 75-100µg daily will usually be enough.

Any advice would be much appreciated?

20 Replies

  • Your symptoms definitely suggest hypothyroidism. Have you asked for a trial of Levothyroxine? In Sweden a TSH over 2.7 is treated. x Kat

  • Hi kiltis, symptoms suggest hypothyroid but GP not interested in UK unless TSH is over 10, if FT4 is normal. I will be writing to GP to ask for trial Levothyroxine and referal to specialist.

  • Wow that is crazy. Good on you for writing to your GP. Best of luck. x

  • Hi kiltis, yet to write the letter but know what I'm going to say, replied to you on other thread also.

  • I've only had a quick read through as a lot of those results I don't know much about but your B12 and definitely your ferritin ought to be higher. I've read that with a ferritin below 70 you're unable to use T4...

    I don't understand why you haven't been offered treatment with those symptoms and a TSH of 8.1 - if you're just seeing a GP you should request to see an endo or if it's financially an option go private.

  • Thank you abcba, after all blood tests throughout the years, was informed all normal. It was only when I got a copy of them all in order to show a private specialist (unfortunately one who couldn't prescribe levythyroxine / armour / or naturethroid) did I discover my levels.

  • Hi first of all , with those symptoms you are definitely hypo. it is really irrelevant if auto immune. As that is fairly new. The treatment is exactly the same and mostly is autoimmune. Means you have to watch out for other autoimmune diseases to appear, especially Diabetes, which is hormonal and autoimmune. Annual tests it is often a battle with .GP`s as they think common is easy, if fact very complicated. If you decide to see an Endo, ;pick your own carefu,lly and then ask for a referral

    As you know the bloods for thyroid are fairly useless without a FT3. It is usually vetoed by the lab managers, can use Blue Horizon, main site, quote TUK 10 for for a discount. Their finger prick test is fine,as i is still a phial of blood. you need TSH, T4 and Ft3 done together Your T 4 is a little low but should only be in the top third of range. FT3 if low makes the TSH high, also causes most of the symptoms. A lot of people need T4, levo and T3. If seeing an En do , check first with sec that they use T3.

    b12 is much too low, Endo would treat it, probably not GP. ferritin OK but would be best to take Spatone, liquid , very gently and safe, just a tube a day, No one would treat it..

    Cholesterol which should be checked annually, is a little high, that is usually linked to the thyroid. BP, if high, is sometimes, too.

    I think that if you have the 3 tests that i mention the FT3 will show it is too low.

    Anything else - then send me a pm.


  • Thank you Jackie. Louise sent me a list of good NHS endos, so will ask for referal to one of those. Unfortunately finances are limiting for private testing, but if all else fails will self-medicate. I am currently on my 3rd week of Nutri Adrenal Extra, and will probably go on to take Nutri thyroid in a week or so. If these don't make me feel well enough and I don't get Levythyroxine via GP, do you think I should I try Armour, Nature-Throid or any other?

  • Just found armour vs other brands article for others interest:

  • B12 low

    ferritin way below minimum of 70

    folate low

    Cholesterol high

    you have tpo antibodies

    vital that tsh ,free t4,free t3 are done

    you are suffering all the symptoms of hypothyroid and many of the blood test results confirm this disturbance of your system

    If your GP refuses to face this issue you may have to self treat

    have you gone totally gluten free

    have you ensured all cookware is only glass or stainless steel ......avoid aluminium and flouride and non stick coated like the plague

  • Hi reallyfedup123, thank you for taking the time to comment and your findings. What do you mean when you say 'you have tpo antibodies' as I thought that the reading of Thyroid peroxidise antibody level: 16 iu/mL (0.00 – 34.00 iu/mL) was acceptable, that is, negative? The T3 was supposed to have been done this time, don't know why it wasn't, and only have the TSH & T4 for Oct 2013 and the previous years.

    I am certainly going to self-medicate if letter to GP does not resolve in trial levythyroxine and referal to specialist (Louise supplied with list of good NHS endos). I am currently on my 3rd week of Nutri Adrenal Extra, and will probably go on to take Nutri thyroid in a week or so. I was wondering if these don't make me feel well enough, should I try Armour, Nature-Throid or any other?

  • Hold up, what do non stick pans or flouride have to do with hypothyroidism? And please forgive me, l live in the US so what is a GP? Doctor? My TSH is at 17.98 and my T4 is low, so hypothyroidism. Just started Levothyroxine 50mcg. I have symptoms of both hypo and hyper...I was diag with Bipolar Disorder 12yrs ago but given Lithium within the last 2 years. I read Lithium can cause thyroid issues... they have tested for years for my thyroid and never found anything, till the last month. I also have a polyp removeal and ablation in the next month. Always had insomnia. My hair has really started falling out since the new med, is that normal? It's been 5 days...

  • Hi alwitt74, another member kiltis, I think, stated flouride impairs your thyroid, which seems to be echoed in the following health article:

    Yes GP (General Practitioner) is a doctor, we refer to them either way in the UK.

    Your TSH is extremely high, I'm a newbie here, so not very knowledgeable, but from what I've read so far, very high. My TSH is 8 (range 0.3 to 4.2 ) and T4 lowish: 15.5 (range 12 - 22). I sometimes think I have symptoms of both hypo and hyper, but definitely mainly hypo. Perhaps the hyper symptoms are just caused by fluctuating cortisol. Need to ask and research more on this. Sorry to hear about the Bipolar diagnosis. I probably have this, but will wait till I self-medicate with NDT after my B12 range has increased, through the use of B12 injections which I began approx 2 weeks ago. I don't know anything about Lithium or Lithium and thyroid issues, have you googled the connection? Typical that they test for ages, probably overlooking indications of oncoming problems and only diagnose you when the problem is blatant and difficult to control. Was the polyp removal and ablation on your thyroid? What is the new med? Very sorry to hear about hair falling out, most distressing, mine has thinned out a lot over last few years and hope it improves with the NDT treatment. Please do post specific questions on this forum as the members are very knowledgeable and helpful. Whenever possible give last blood test readings with ranges.

  • Why are you not being treated for hypothyroidism your previous Thyroid blood tests and cholesterol levels alone scream it.

  • Thanks MCoates, I wasn't even made aware of the readings apart from being told 'normal', which were taken as I was complaining of excessive fatigue over the years, It was only when I got a copy of the blood test results in 2013 order to show a private specialist that I became aware of the results over the years. But in any case GP not interested in UK unless TSH is over 10, if FT4 is normal range.

  • I agree with what the others have said, Caroline. You are Hypo, your B12, folate and ferritin are low in range and could do with boosting. Interesting that your TPo Abs aren't elevated. I wonder why your TSH dropped in July 2012?

    You dont appear to have had your vitD3 tested. I would recommend this. Chances are it is deficient or low in range. If you supplement iron with Spatone, mix it with soluble vitC to aid absorption.

    I would push your GP for a 3 month trial of 75mcg Levothyroxine. Tell him or her you aren't prepared to wait until your TSH exceeds 10 by which time you will be very ill and you will self medicate if GP won't help you.

  • Thank you Clutter. Yes I also wondered why TSH dropped in July 2012, someone on here suggested might be Hashimotos but as we now know TPO isn't elevated to indicate Hashimotos, so remains a mystery. I was supposed to get Vit D3 and FT3 tested, no idea why it wasn't.

    I will be writing to GP, listing results and symptoms, to suggest the trial Levythyroxine and referal, and will add 'aren't prepared to wait until your TSH exceeds 10 by which time you will be very ill' thank you. Not sure if threat to self-medicate will have any effect ; ), but will also say that.

  • Maybe this will help too - TUK getting a diagnosis - perhaps your GP may take heed of the reference to heart strain and cholestrol furring up arteries etc. Best Wishes J

  • Very low ferritin

    low folate

    lowish b12

    high cholesterol

    tsh is way too high

    t4 is lowering

    this lot plus tpo antibodies and your symptoms are highly indicative of hypothyroid

    treat the ferritin and folate first though to get them back up to beyond halfway in the range before taking thyroxine as you wont be able to convert the t4 in thyroxine into the t3 your cells need

    the sooner your treated. Now the faster you will recover

  • When i had my first blood test my T4 was normal but my TSH was 10 in December 2013 and remained the same late January 2014. I was referred to endo who started me off on 50mg thyroxine in March 2014. 4 months later i've just had my first blood test done yesterday and that was a real hassle to get the GP to do a blood test to check how i'm going on the thyroxine!!! I have this feeling that my results will come back as 'normal' thus need to go private. My goitre still exists since December as well....

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