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Thyroid UK
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Help with understanding results please

Hi All – I am new to this board and hoping you may be able to help me, I am going through some fertility issues and have long suspected my thyroid is the culprit, despite TSH tests always coming back clear.

Last month I did the Genova Diagnositics test and it came back saying my T3 was 524 pmol/24 which they say indicates functional hypothyroidism (measured via urine test), and when I compare it to a blood test that I had done a year ago it says: TSH is 1.25 Mu/L, Free T4 is 16.3 and Free T3 is 5.1 pmol/l. From reading these I don’t seem to be comparing like with like and am thoroughly confused…

My naturopath has put my on nutri adrenals (as she feels my adrenals need fixing first), which has really helped with the jittery feelings, but still no weight loss despite vigilant eating/exercise.

My questions are – should I take T3? (I have a supply I brought back from a holiday in Greece last week) Should I take anything else like selenium or magnesium supplements?

My 11am and prior to sleep cortisol levels were also low, and DHEA (which I am now taking) is also low.

If you have low thyroid does this mean the same thing as Hashimotos?

I feel so relieved to have an explanation for the way I am feeling, but not sure where to go now and want to fix myself…..apologies for all the questions, any help/advice would be very much appreciated, thank you :-)

16 Replies

Hi Putneygirl, welcome to the forum! But sorry you're here. :)

No, you're definately not comparing like with like when you try to compare a urine test with a blood test. What you have to do is go by the ranges with each individual test. So, it would always be helpful if you post the ranges when you post your test results. :) Without them, it's difficult to help.

There are a lot of things that can stop you losing weight. But if it's hypo-weight-gain, you are not going to lose it with diet and exercise, because it's nothing to do with calories. In fact, if your calories are too low, and you over-exercise, you may even put more on! Because it will make you more hypo.

Should you take T3? Well, I would say, at this stage, no. First, we would need to see the results of your test - with ranges - to know. Secondly, your naturopath seems to have things well in-hand at the moment, by treating your adrenals before putting you on any thyroid hormone replacement - which is the way it's supposed to be done. If I were you, I would wait and see how things progress with him/her.

Hashimoto's disease is an autoimmune disease, where the antibodies attack the thyroid until it can no-longer produce enough hormone to keep you functioning - you become hypo. It isn't primarily a problem with the thyroid gland itself. But you can be also become hypo for various reasons which mean that the gland itself is failing. It can often be difficult to know why it's failing, but the end results are the same - hypothyroidism. And, as things stand, the treatment is the same whatever the reason for your hypothyroidism.

I would suggest that your next step ought to be getting tested for nutritional deficiencies :

vit D

vit B12




Hypos are very often deficient in these - and other things - but they all need to be optimal for your body to be able to use the thyroid hormone you will eventually be giving it. B12 should be about 1000 - ignore the silly ranges. And the others should be at least mid-range. You should then supplement any deficiencies - we can help you with all that when you have the results.

As to whether you should be taking other things, if I were you, l would wait until you get the tests done. Starting anything before that might skew the results.


Thank you so much for your response, I am very new to all this and it is quite the minefield!

In terms of the ranges, on the paper work from Genova it says:

T3 524 pmol/24, Normal Range 800-2500

And on my blood tests from a year ago it says:

TSH 1.25, Reference 0.27-4.20 Mu/L

Free T4 16.3, Reference 12.0-22.0 pmol/L

Free T3 5.1, Reference 3.1 - 6.8 pmol/L

I thought the ranges printed were just standard references/ranges, but are they different for everyone?

Thanks very much for your advice on food/exercise, I am only doing moderate exercise (daily walks and yoga) and eating a balanced diet with no crazy cutting out of calories but getting quite upset with lack of results.

When you say "Hypos are very often deficient in these - but they all need to be optimal for your body to be able to use the thyroid hormone you will eventually be giving it." do you mean that my it is inevitable that I will be taking thyroid hormones?, or that once my body is working properly my body will be able to use the thyroid hormone that it is producing naturally?

And one last question, where do people typically get these blood tests for VitD, B12 etc done?

Thanks so very much for your help, I am very grateful to have come across this community :-)


OK, so on the blood test you had a year ago, you weren't at all hypo - everything looked good. But on that urine test, the T3 would appear to be way below range, and a T3 that much below range would indicate that you are hypo. But, as you said, comparing apples with pears.

It would be much better if you could get another blood test done so that we can compare like with like. And, as mentioned below, get antibodies done at the same time. TPOab and Tgab. Either or both could be high. A lot can happen in a year, you know - especially if you have antibodies.

No, I didn't mean that, but I did think that you had had a diagnosis from what you said - your naturopath treating your adrenal first, etc. If you have got a diagnosis of hypo, then yes, you will have to start taking thyroid hormone replacement. But you need your nutrients to be optimal for your body to be able to use that.

On the other hand, if you Don't have antibodies, there is always the possibility that treating any nutritional deficiencies might just get things working again if your problem is just conversion - but without seeing an FT4 and FT3 together, it's impossible to say if that's the problem. But, anyway, it's rather a slim hope.

You Don't say where you live, but if you're in the UK, it's perfectly possible to get these done by your doctor - I'm surprised a naturopath hasn't already done these tests. But ask, anyway. :)


Hi – thanks so much for your help with this, you need to be a complete detective don’t you to figure all this stuff out?! As luck would have it, when I was at my fertility clinic (which is in Greece) last week I asked them to test me (blood test), and my results just came through as the same time as your post suggesting that I test again :-)

So, from last week they read as follows:

T3 = 1.0 ng/ml, reference values for adults over 20 years old 0.6-1.6

T4 = 53.3 ng/ml, reference values 48.7 – 117.2

TSH = 1.392 ng/ml, reference values 0.3-5

I wonder if they could have been skewed by the fertility drugs I was taking to boost my egg numbers/quality?

My bloods a year ago were:

Free T3 5.1, Reference 3.1 - 6.8 pmol/L

Free T4 16.3, Reference 12.0-22.0 pmol/L

TSH 1.25, Reference 0.27-4.20 Mu/L

And my urine thyroid test in May was: T3 524 pmol/24, Normal Range 800-2500

So, I am still thoroughly confused….. From reading my greek results it would seem that my T4 is at the low end, but T3 normal. But my urine tests taken 2 months ago showed very low T3 and hypothyroidism….

Also, would you mind explaining why the reference values/ ranges different for each test - or is that just that each lab test differently?

So, in terms of next steps am I right in thinking I should get my antibodies tested (these seem like the missing piece of the puzzle) so I have the whole picture, alongside my vitamins and minerals?

I live in London, so this shouldn’t be a problem, thank you for suggesting this. It was my naturopath that suggested the cortisol, DHEA, Thyroid test which I have had already and which she used to diagnose me, so I’ll go back to her to talk about further testing of antibodies and Vits/Minerals now.

Huge thanks for your help, and sorry for all the additional questions...


Are those Greek tests Frees or Totals? The T4 is definately a total, but difficult to say with the T3. I'm afraid the Total test is not much use to anyone.

But even so, that T4 is right at the bottom of the range, and the T3 is just a tad Under mid-range, which might be too low for you. The TSH is very good but doesn't mean much on its own.

Tests are different in different labs because they use different machines, so you need to know the range for their particular machine.

So, yes, get your antibodies, vitamins and minerals checked. And if you could possibly get the FT4 and FT3 done, that would be a help. No reason why your naturopath wouldn't order them at the same time as the others.


Greygoose, thank you so much for your help, I really appreciate it. Yes, from reading the results it looks like those are totals (they don't mention the word free) so I shall get those tests you suggested done. Is it best/most accurate to get it done via blood/urine? And I'll get the vits and minerals.

Thanks again!


I Don't think the NHS does urine tests. And if they did, a UK doctor probably wouldn't be able to interpret them - they have enough trouble with blood tests!

If you just get the standard blood test, then we'll be able to compare it with the one you have done last year.

In an ideal world, I think all tests would be urine, but this world is far from ideal, and we have to do the best we can with what is available to us. And if would be far easier for all concerned if they just take the blood in one go and do all those tests from it. :)


I'm not sure I'm going to be able to convince my GP to run the tests anyway - I shall give it a good go though. Just so I'm clear, I am asking for them to test TSH, Free T3 and Free T4 and my Thyroid peroxidase antibody (TPOab) and thyroglobulin antibody (TgAb) blood tests - just checking I have that right?

And then I will ask my naturopath to test for the vits/minerals.

Thanks again for your help - my brain is aching slightly :-)


OK, well, whatever way is easiest for you. :)


Hopefully my GP will be able to be convinced, but she is not always very helpful. Just checking I have my list correct of tests to ask for?

Thanks so much.


Sorry, I think I am being a bit dense, do you think the GP may also do the vits/mineral test - I thought/assumed I had to go to the naturopath for that, but if you think it's worth asking my GP, I certainly will :-)


It's Worth asking your GP for all of them. But, of course, there's no guarantee she'll agree - especially if she's not very helpful - which a lot of them aren't! And even if she agrees, there's no guarantee the lab will agree to do them all, I'm afraid. We can but ask. Those that Don't get done that way, you could ask your naturopath if she can do them - I Don't know what naturopaths can and can't do. But if all else fails, you could get them done privately.

So :






vit D

vit B12




It's a long list, and might give your doctor a heart attack! But, nothing ventured, nothing gained. Ask.


Fabulous, thank you, I shall ask, thank you so very much for your help and guidance - I'll let you know how I get on :-)


You're welcome. Good luck! :)


Welcome to the forum, Putneygirl1975.

NICE recommend the TSH of women planning conception should be in the low-normal range 0.4-2.0 with FT4 in the top 75% of range. Your thyroid blood results last year look euthyroid (normal) and didn't indicate thyroid problems or the need for T3. I'm not familiar with thyroid urine testing so I'm unable to comment on your recent result.

Hashimoto's is an autoimmune thyroid disease which causes 90% of hypothyroidism. Thyroid peroxidase antibody (TPOab) and thyroglobulin antibody (TgAb) blood tests confirm or rule out Hashimoto's.


Being low or deficient in the vitamins and minerals GreyGoose mentioned can cause musculoskeletal pain, fatigue and low mood similar to hypothyroid symptoms.


Thank you so much Clutter, so you think along with testing the vitamins and mineral GreyGoose mentioned it would also be worth testing Thyroid peroxidase antibody (TPOab) and thyroglobulin antibody (TgAb), just to confirm what's really going on with me?


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