Thyroid UK
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Test Results Back - guidance please

Hello everyone - here are 3 test results from Genova: Thyroid Plus blood test, 24 hr Urine collection for Thyroid hormones and Comprehensive Adrenal Stress profile. I have Hashimoto's - am taking 50 mcg Levothyroxine - can't deal with upping it but have all the symptoms of hypo - and many of hyper. Have tried and done all sorts of things over the years to get well.

Thyroid Plus blood test:

Total T4 112 (58 - 161)

TSH 2.39 (0.40 - 4.00)

FT4 14.7 (11.5 - 22.7)

Free T3 4.6 ( 2.8 - 6.5)

Free T4: Free T3 ratio 3.2 (2.00 - 4.5)

Reverse T3 0.25 (0.14 - 0.54)

Thyroglobulin <20 (<40)

Peroxidase 83 (<35)

24 hr Urine test:

T3 415 (800 - 2500)

T4 1030 (550 - 3160)

T3:T4 ratio 0.40 (0.50 - 2.00)

Adrenal stress profile:

Cortisol levels

Sample 1 Post awakening 68.42 (7.45 - 32.56)

Sample 2 + 4 - 5 hours 5.52 (2.76 - 11.31)

Sample 3 + " " 8.28 (1.38 - 7.5)

Sample 4 Prior to sleep 3.59 (0.83 - 3.86)

DHEA sample 1 0.30 (0.25 - 2.22)

DHEA sample 3 0.15 (0.25 - 2.22)

DHEA mean 0.23

DHEA:Cortisol ratio 0.004 (0.015 - 0.150)

Secretory IgA 114 (102 - 471)

Dr AW ordered a urine test for me 10 years ago and he was the first one to identify that I was definitely hypothyroid when blood tests at GP did not. The Urine test shows what is happening at a cellular level, not what is circulating in the blood - so my urine T3 level is very low in that test - but the blood test shows 'normal' level, does that mean that I am converting ok but not ABSORBING. If so, where is the T3 going? I have only just found out about the faulty gene test and am awaiting the result. My father I realise struggled with all this too.

Thank you for any help.

7 Replies

Forgot to post the blood tests from GP done at same time:

B12 583 (180 - 2000)

Ferritin 211 normal 41 - 400

D3 77.3 adequate 50 - 75



Moorlandmists, I think low ferritin may be why you're having difficulty tolerating Levothyroxine dose increases. Ferritin is optimal half way through range. Supplement iron, Ferrous Fumarate, and take each tablet with 500mg-1,000mg vitamin C to aid absorption and minimise constipation. Take iron 4 hours away from Levothyroxine.

VitD is in the replete range 75-200. Supplement 2,500iu D3 Oct-April to maintain levels when ultraviolet light is too low to stimulate vitD.

B12>500 means there is unlikely to be deficiency. PA Society say B12 1,000 is optimal. You can't OD on B12 so you may want to supplement 500mcg-1,000mcg methylcobalamin sublingual lozenges, spray or patches. Take a B Complex vitamin to keep the other B vits balanced.


Moorlandmists, TSH 2.39 and FT4 low in range mean you are undermedicated. A dose increase will raise FT4 and FT3 and lower TSH. It's low TSH, high FT4 and low FT3 which indicate lack of T4 to T3 conversion., FT4.

If you feel hyper and hypo when you try to increase dose it may be due to low ferritin/iron. Do you know your ferritin level?


Thank you Clutter for looking at my results and making your comments and recommendations - much appreciated. Yes my Ferritin result was 211 (ref 41 - 400 normal).


Moorlandmists, sorry, I misread, thought ferritin was 21 not 211. So, ferritin's not the problem.

Have you tried increasing Levothyroxine dose in 12.5mcg increments? It can be easier for some people to tolerate dose increases this way.


Yes, I have tried increasing in very small doses like 12.5 mcg but still get terrible internal shakes. I have just started reading Paul Robinson's books regarding Adrenal Health - my Cortisol levels are high and DHEA low......connection with the thyroid....

Also, the Urine test is used in Europe and by some good docs - so I still want to find someone who can explain why my T3 is so low in that test.


Moorlandmists, you may have to address cortisol/DHEA to tolerate a dose increase.

I've not seen interpretation of thyroid urine results on the forum and it's not something I understand.


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