Help with reading blood test results please?

Hi everyone, thanks for being such a fantastic support, I have learnt so much from you all over the last 3 years.

At last I have my blood results back from Blue Horizon and I was wondering what others now think my next move should be?  Prior to having this test done I cut out all vitamins and minerals for 3 months or more to see exactly what is going on. 

I have so many hypo symptoms, I'll list them under the results to see what you think.

My doctor is desperate to help but limited by the regulations at my surgery of the 'normal' range!

This has been reduced in the last few months, so normal range is under 4.2 rather than 5.2 so this may be helpful to me!

Blood results:-

TSH - 4.39  (0.27-4.20).........  High 

T4 Total - 100 (64.5-142 nmol/L)

Free T4 - 14.86 (12-22) pmol/L

Free T3 - 4.51 (3.16.8 pmol/L)

Reverse T3 - 23 (10-24 ug/L)

Reverse T3 Ratio - 19.61 (>20) .........  Low  

Anti-Throid Peroxidase abs - 10.5 (<34 kIU/L)

Anti Thyroglobulin Abs - 86.2 (<115 kU/L)

Vitamin D 86

Bitamin B12 573

Serum Folate - 28.07 (10.4-42.4)

Ferritin - 33.2 (20-150) ........... Low in range?

As you can see the TSH is now above the 'normal' range, the Reverse T3 Ratio is only just under but the Ferritin is low in the 'normal' range.

Symptoms are:-


dry cracked skin

ridged and poor nails

1/3rd of outer eyebrows disappearing over the 3 years

tongue very crimped edges all the time

glands 'feel' enlarged but ultrasound shows normal

legs ache and ache

Feet hurt even just when sitting -  heels very painful as though I have jumped and landed from a height onto my heels.

Hair very early greying, large clumps now very white leading up to 2" circle of baldness in two areas now at back of head,

Puffy face especially along jawline, and fast growing a saggy chin/chubby face over just 1 year, 

Fast hear rate even though doctors 24hr heart monitor shows it as 'normal'

High pulse and blood pressure even first thing in morning after waking.

Now diagnosed with OsteoArthritis of knees so puffy knees and painful/creaking joints.

If anyone can shed some light on their verdict I would be so grateful.

After all my reading and investigations on this forum and elsewhere I am convinced that I have hypothyroidism, but would like others to see what they think.

Endo met me and signed me off immediately, Ultrasoundologist said on the day that thyroid was slightly enlarged, but on report sent to doctor said it was 'normal!'.

I am soooo frustrated with this whole saga now.

Look forward to hearing what some of you think.

Many thanks in advance for taking the time to look through it all for me.

jbthyro x

7 Replies

  • Jbthyro,

    If your GP surgery's range for TSH goes up to 4.20 your TSH is now above that and your GP should be able to commence treatment.  FT4 is low in range but FT3 takes longer to drop and is likely to be sustained by your high TSH.  Reverse T3 ratio is low because your FT4:FT3 ratio is low.

    Thyroid may become enlarged and inflamed with TSH flogging it to produce hormone.  The 'swollen' feeling will probably resolve when your thyroid levels improve. 

    Antibodies are negative for autoimmune thyroid disease (Hashimoto's).

    VitD 86 is in the replete range.

    There's unlikely to be deficiency when B12 is >500 but PA Society say 1,000 is optimal so you could supplement 1,000mcg methylcobalamin and take a B Complex vitamin.  Folate is good.

    Ferritin is optimal halfway through range to 100.  Supplement iron with 500-1,000mg vitamin C to aid absorption and minimise constipation.  When you are prescribed Levothyroxine be sure to take it 4 hours away from iron.


    I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

  • Clutter, thank you so much! 

    After a long battle I'm really hoping that my GP will now be able to help me. Thank you for looking through the results and confirming my own thoughts. 

    What would a likely dose be if I am lucky enough to have Levo administered?

    My GP is very supportive so I'd like to make sure I am on the correct dose from the start, she will listen to me and understands the frustration! 

    So grateful for the help. 


  • Jbthyro,

    25-50mcg as a starting dose probably.  Thyroid levels should be retested 6-8 weeks later and dose adjusted if necessary.  Most people will be well with TSH 1.0 or lower and FT4 in the upper range but symptoms may lag for 2-3 months.

  • Thank you so much. I've booked an appointment for this week so crossing fingers that I can finally start getting somewhere! 


  • T3 is the active hormone which controls the metabolism so the Free T3 result is the most important and your's is  good. T4 is a storage hormone and needs to be converted to T3 to become active, so the T4 result is less important.

    It is unusual that you have hypothyroid symptoms with the good free T3 levels. With this level of Free T3 the TSH would normally be low. These results could however be caused by thyroid hormone resistance (impaired sensitivity to thyroid hormone). This is a genetic condition which means that the body needs high levels of T3 to function normally. If there are other close family members with hypothyroid/fibromyalgia/chronic fatigue/depression this would support the possibility of thyroid resistance.   

    The TSH level supports the idea that the body needs more thyroid hormones.

    I will send you a personal message about a book on thyroid resistance. 

  • Wow Thank you Sandy12! I've never heard of this before and yes my sister is hypo and my dad has several conditions that fit your categories!

    Look forward to reading more on this! 



  • Also this could tie in with the misdiagnosis of Chronic Fatigue 15yrs ago, which has been dismissed recently by an M.E. specialist because my symptoms do not fit the 'mould' for Chronic Fatigue/Fibromalgia either! 


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