Thyroid UK
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Help needed to decipher blood results

My weight keeps climbing despite no obvious changes to my diet or exercise routines - all the excess weight in on my bust & tummy / hips. I often suffer with bloating & often have acid in my stomach & sometimes a feeling as if i have swallowed a stone, the DR has prescribed a daily tablet of Altosec. Although I am on BP meds (adco zetomax 10mg) it is still often high, i have tiredness particularly mid afternoon with a surge of energy early evening, salt/sugar cravings, stiff joints when i first get up and when i first get out of bed in the morning my feet hurt to walk (the souls of my feet), i get sinus & bladder infections easily. I have started taking a daily dose of live probiotics and 1tbl of coconut oil. My doctor ran blood tests (9am), these were the results, but i don't really undertand them (she says Cortisol too low and i should supplement with liquorice & avoid stress & exercise)  : 

Cortisol  184 (142-651 nmol/l)

TSH 1.6 (0.3-4.2 mIU/l)

Free T4 16 (10-24 pmol/l)

Insulin fasting 5 (0-10 mIU/l)

Magnesium 0.79 (0.66 - 1.07 nmol/l)

Ferritin Roche 28 (13-150 ng/ml)


Sodium 140 (136-145 nmol/l)

Potassium 4.2 (3.5 - 5.1 nmol/l

Chloride 104 (98-107 nmol/l)

Bicarbonate 25 (22-29 nmol/l)

Urea 4.3 (1.7 -8.3 nmol/l)

Creatinine 66 (49-90 umol/l)

eGFR (CKD-EPI) 96 (>90 ml/min

Estimated glomerular filtration rate (ml/min/1.73m2) (CKD-EPI)

14 Replies

Altosec?  Is this for excess acid?  More likely to be low acid in which case apple cider vinegar is used by many on here.  There's no results for FT3, ferritin nor vitamins B12 and D?

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yes altosec, because i am complaining of burning in my gut and sometimes acid reflux and sometimes a sensation of having swalllowed a stone. 

the Ferritin Roche 28 (130150 ng/ml) but doesnt seem any test fors FT3 or vit B12 or vit D.

excuse my ignorance, not sure why these were not tested or why they should have been tested ? 


OK, would ditch that and buy some apple cider vinegar which is for low stomach acid, hypo folk are prone to this.  When you say you feel that you've swallowed a stone is there swelling or tenderness around the thyroid area?  I don't know anything about this but it may be that an Endo should palpate, hopefully someone can advise.

A full blood count would include ferritin and possibly vitamin D.  Low B12 may relate to your aches and could be worth asking for this to be done although GPs don't tend to be well up on B12 deficiency.

It's unfortunate but we do have to fight to get things done with GPs, they're not knowledgeable about vitamins and minerals let alone understand the role they play as building blocks to good health.

Are you taking any thyroid meds?

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No i am not taking any thyroid meds, do u think I need to.

When the doc called me to give me the blood results (copied above) she said that my cortisol levels are very low & diagnosed endocrine fatigue. She said my thyroid was a bit low but it was linked to my low cortisol and didnt require medicating - she felt if i get my cortisol levels up my thyroid will correct.

The swallowing stone sensation is lower down - toward my actual stomach - maybe i should describe it as indigestion ? 

I took myself for 2 x neurobian vit b 12 injections - perhaps I should have more ? 

Will low stomach acid also present as an acidic feeling in the tummy and acid reflux ? will this cause the intermittent bloating ? 

are any of my levels low enough to have an impact on my middle region weight gain ? 


TSH should be around 1 so realistically you've no chance of being prescribed thyroid meds.   Would still be interested in ferritin and whether you have any antibodies.  Am very surprised that a doctor has diagnosed endocrine fatigue and possibly cortisol would increase with thyroid meds, again am not up to speed on this.

Definitely worth trying apple cider vinegar and perhaps going gluten-free to see if that helps with the bloating.

Sorry, am not being any help here but would recommend doing a search for a user called Marz who is up to speed on B12, search box in top right hand corner.


she did test ferritin - results were the Ferritin Roche 28 (13-150 ng/ml)

yip she said thyroid levels not bad enough to warrant taking meds and should correct when i get my cortisol levels corrected by eating clean, resting, exercising & taking liquorice (supplement called burn out). do my cortisol levels look ok to you ? 


Yes, your cortisol is low. But doing an early morning blood test does not tell you the whole story - or even a chapter. You should really have a 24 hour saliva test, but you won't get that on the NHS, I'm afraid.

I'm not too sure about your doctor's recipe for restoring adrenals! Good food and relaxation, yes, but if your low cortisol is caused by low T3 (which you haven't had tested) it's not going to be enough. And if your T3 is low, exercise is going to make it worse.

Liquorice... hm, not sure about that. If I were you, I would do my own research on that one. It isn't for everyone. However, adrenals do need lots of salt, vit C and B vitamins.

You say you've been giving yourself B12 injections. You really should have waited until you'd had the B12 tested to do that, because now, any test result will be skewed. You need to know exactly what your level of B12 is so that you can estimate your dose. Just plunging in and taking just anything isn't going to cut it. If I were you, I would wait about a month - as you've only had two injections - and then get tested. :)

If your level is very low, you would then need to be tested for Pernicious Anemia. If it's below 500, you would need to supplement in some way, but you should always take a B complex with B12 suppléments, to keep the Bs balanced. 1000 is optimal for B12.

So, as well as the cortisol testing, and the FT3 and B12 - and vit D! - you should also get your antibodies tested : TPOab and TgAB. The most frequant cause of low thyroid is autoimmune thyroiditis - also known as Hashimoto's Disease. The antibody tests will tell you if you have it.

I know that's a lot to take in in one go! Thyroid is a complicated subject. But you can always come back and ask as many questions as you like. There will always be someone here to answer them. :)    

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Ferritin, vitD, B12 and folate are individual tests and are not part of a full blood count.


Low vitamin D also causes fatigue and aches and pains. Maybe go back to gp and request b12, ferritin and vit d tests?

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she did test ferritin.. the Ferritin Roche 28 (13-150 ng/ml) although i am not sure what this is or what my results mean

are my cortisol levels in fact low ? and low enough to explain my weight gain ? 


It is pretty low then, I would be supplementing with iron x


I don't know much about cortisol levels though sorry x

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Low B12 can often mimic Hypo symptoms and if the results are under 500 - then neurological symptoms can appear.

Scroll down in the above link to see the neurological symptoms.  The website will tell you everything you need to know about B12.  What your GP does not know about B12 can harm you ....  Check out the videos under the heading Films on the menu.

Ferritin is a form of stored iron in the liver.  Your result is low and a supplement is required - taken with VitC to aid absorption.  Seek out a gentle one as some can be too tough on the stomach - sorry not able to help here as I am not up to speed on iron.  Many here suggest a level of Ferritin that is around mid-range.

Low acid will make you feel bloated - as the stomach needs good levels of acid so that proteins can be broken down.  When the acid is low - foods remain in the stomach too long.  This can cause fermentation and it is the upward movement of this fermentation that can cause burning.  Dr Sarah Myhill talks about SIBO - in her latest book - Small Intestinal Bacteria Overgrowth - which she prefers to call gut fermentation.  She suggests taking 2000mg of VitC on going to sleep and increasing to bowel tolerance.  I have had Crohns for over 40 years and have found it helpful.

I have also read that the 24 hour saliva test for Cortisol is more revealing than the blood test.  Unfortunately this is a Private test.  You can also have private testing done through Blue Horizon should your GP prove difficult in giving you the tests you need.


I have all the same symptoms as you and on 100mg of Levothyroxine to which I believe is not converting to T3 causing me these symptoms I am in the process of considering purchasing nature pigs thyroxine have you thought about doing this also I'm surprised your doctor did these tests as my GP only does the TSH 


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