Results in. Confused? You will be!

Results in. Confused? You will be!

Hi All,

my BH Thyroid10 results are in, and it appears I'm in robust health. :S Maybe the GPs are right; it's all in my head. Well it doesn't bloody well feel like it's all in my head! 

These results come from a test done on Tuesday morning.  An NHS test was taken last Friday morning, and the results are all different! Any idea how or why this could happen? 4 days apart, both taken at 8.20am, no food and only water taken beforehand. 

Any advice on what any of this means, and how to proceed will be gratefully received.

NHS results:

TSH: 5 [0.3-4.7]

FT4: 13.1 [9.5-21.5]

B12: 508 [196-771]

Folate: 11 [4.6-18.7]

29 Replies

These results are very similar except that the TSH is a bit different.  When you allow for different reference intervals and error margins there's little difference between the two sets of results.

OK. I'm not used to reading blood test results. They just seemed different. People here seem to be able to interpret results very well and see things in them that I certainly can't!

I wouldnt call a tsh of 3.5 or 5 robust health.....  Most of the world would give you thyroid medication with a tsh this raised.....   Sure your free t4 and free t3 are in range but for some reason your thyroid is having to be driven hard to make the hormones......    It might get better on its own, or it might get worse.....  Who can tell?    I would insist on some medication to get the tsh down to a more normal 1 -1.5.

The difference in results seems to just be the two different labs.....  They dont have the same reference ranges, so they have used different tests.

You can either go abroad to a more sympathetic country. ( most if them) for treatment, you can argue with your doc and beg for a trial of meds to alleviate your symptoms, or search for a sympathetic endo......

Good luck!


Oh sorry, forgot to mention b 12  could do with a boost.    Getting hold of some sub lingual  b 12 lozenges would be your best bet...  ( amazon)


Different machines for testing can have different ranges. Your TSH is high in the 'normal' range, your FT4 and FT3 too low on BH. Accompanied by your clinical symptoms you'd be hypo.

The British Thyroid Association says we shouldn't have prescribed meds until TSH 10 but I don't know what planet they're on. Before the blood tests we were prescribed on our clinical symptos alone.

Thank you galathea and shaws. There's not a tiny chance the GP will medicate on these results. She does however, want to re-test in 3 months to see if the TSH score has progressed.  Do you think there's a case for waiting for that next test, or using B12 supplements now, and possibly even self medicating for thyroid and mucking up the results of that test?

That's the 24 dollar question. If you feel you can go another 12 weeks feeling as you do, then wait. Some TSHs never reach a high enough point for diagnosing. Some will when it reaches just over the range whilst others stick to 10. Remember get the earliest possible appointment and don't eat before it.

For example, it took my TSH seven years to rise from 1.6 (when I felt well) to 4.2 (when I felt awful).  I waited nine years in all for treatment.  I wouldn't want anyone else to have to go through that.

Definately start the B12 suppléments now. Anything Under 500 can cause irrepairable neurological damage - but your doctor doesn't know that, so will never prescribe B12 for you. And if she did, it would be the wrong one! 

If I were you - and I have been where B12 is concerned! - I would take 5000 mcg sublingual methylcobalamin daily for a couple of months, to give you a boost, then reduce to 1000 a day for the forseeable future. You cannot over-dose on B12.

With that, take a B complex, containing methylfolate rather than folic acid. The Bs need to be balanced because they all work together. :) 

I don't think your results show you are in robust health. You clearly aren't on your last legs, but your results aren't optimal either.

CRP : For a reference range of 0 - 5, then your result is in the upper half of the range i.e. the wrong half. CRP is an indicator of inflammation or infection somewhere in the body, but doesn't tell you where. You clearly don't have a major problem, but if you could get it lower it would help.

Ferritin : This is quite good. Optimal would be around 80 - 100 for the reference range you've given. Note that high inflammation can have a knock-on effect of making ferritin look rather better than underlying iron might suggest.

TSH : This is too high. Most people with a poorly functioning thyroid feel at their best with a TSH around 1 or even a bit less.

Free T4 and Free T3 : Both of these are in the lower half of the range. Optimal would be upper half of the range, or even top third or quarter. Increasing the Free T4 and Free T3 would lower your TSH.

Thyroid antibodies : Currently negative, which is good. You can have Hashimoto's Disease (aka autoimmune hypothyroidism), without having positive antibodies. Sometimes it can take several tests before a positive result shows itself.

Vitamin B12 : The Japanese consider levels under 500 to be deficient. The Pernicious Anaemia Society recommends a level of 1000 pmol/L to be optimal. Vitamin B12 is not poisonous and can't be overdosed. You would probably feel better with a higher result. If you supplement try methylcobalamin which is already in a form that the body can easily absorb. The most popular supplements on this forum are Jarrow Formulas and Solgar methylcobalamin, 1000 mcg or 5000 mcg per day. The lower dose should be sufficient. Take one a day, stick it in your mouth, and allow it to dissolve as slowly as possible - no sucking or chewing.

Folate : Your result is in the lower half of the range. Personally I prefer to get mine into the upper half of the range, and preferably into the top quarter of the range. You need good levels of folate for the body to process B12. The best form of folate for most people is methylfolate. It is in a form that the body can readily absorb. It is a good idea to take methylfolate in a B Complex along with methyl-B12. The one I use personally is Thorne Research Basic B Complex, 1 a day. It is a good idea to keep the B Vitamins in balance. Having enough of one, and being deficient in others is not a good idea.

Vitamin D : You haven't got a result for this. If you can get one it would be helpful. Deficient or low vitamin D can lead to muscle and joint aches and pains and depression.

It is often noted on this forum that symptoms of hypothyroidism can precede positive blood tests by a long time, maybe even years. In the meantime, try to get your vitamins and minerals to optimal levels, and try to work out what might be causing CRP to be a tiny bit higher than desirable. Gluten? Lactose? Dairy? Low stomach acid? There are probably a few possibilities. If you get everything optimal  then your thyroid levels may improve. Your only other option is to self-medicate. It really depends on you, how ill you feel, and how desperate you are.

Gosh, thanks so much for such a comprehensive reply, humanbean, it's really really helpful.

I have done a Vitamin D test, but results aren't back yet.

Hi humanbean - the Vitamin D test result came back today - it's 51 [>50 is adequate, with various degrees of deficiency below that]. So that too is borderline. I have no idea what this means in terms of thyroid function though.

If I knew more, I could possibly have a stab at this, but I don't know enough. All I do know is that optimal levels of vitamin B12, vitamin D, folate and ferritin (iron stores) are all supposed to help the body to process thyroid hormones and to convert T4 to T3.

The one I particularly noticed myself was that better levels of iron improved my conversion. Improving the levels of the others just made me feel better, which is a desirable outcome in its own right, as far as I'm concerned. :)

I'm assuming your Vitamin D is 51 nmol/L (UK units of measurement) not 51 ng/mL (US units of measurement).

My level was similar to yours, but I now try to keep it up to about 100 nmol/L.

To get my level up to about 100 I supplemented with 3000 iU vitamin D3 per day. This raised my level fairly slowly, but obviously a higher dose would have raised my level more quickly.

There are various things to be aware of to do with supplementing vitamin D :

1) Supplements must be vitamin D3, not vitamin D2.

2) Supplementing indefinitely is not a good idea because Vitamin D is toxic in overdose. Occasional re-testing is a good idea.

3) Take vitamin D with your fattiest meal of the day to help absorption.

4) Vitamin D raises calcium in the body as a side effect. To help that calcium go into the bones and teeth rather than lining your arteries take vitamin K2 with it.

5) Separate taking thyroid meds and vitamin D supplements by at least four hours.

6) Some people don't tolerate vitamin D. If that happens, stop taking it.

Some links that are worth reading - some are pro-vitamin D and some are anti-vitamin D :

Hi, please would you be able to advise what brands of B12 and methyl folate do you take? Or a good B complex? I have been searching forever and feel like I always have to compromise on something... None of the ones I founds so far have what I want them to have.. :-) Thanks!!

I take Jarrow Formulas methylcobalamin (vitamin B12)

Solgar do the same B12 supplements as well, and they are also popular.

Do you have any test results for B12? If your levels are very low it would be a good idea to get tested for pernicious anaemia before supplementing. Once you start supplementing it can be difficult or impossible to get reliable results.

If there is no chance of you having pernicious anaemia but your levels are below optimal (which is around 1000 ng/L), then go ahead and supplement. B12 is not poisonous and excess is excreted in urine.

For the other B vitamins I take Thorne Research Basic B Complex, one a day. It contains methylfolate which is what I was interested in.

There are other B Complex products which contain the vitamins in their active forms. I think Pure Encapsulations sells a similar product.

All the things I've linked to are easily sourced on Amazon.

Thank you so so much!! I have been supplementing B12 for quite some time... I take Better You 1500mcg Methylcobalamine, because the B complex I take has only 50ng of B12...

Yeah, my B complex has folic acid, rather than folate, thank you for the B complex you recommended!!

I'll post to ask questions about what supplements to take, when and how much, so I don't high jack someone else's thread here :-)


Having now read one of your earlier posts I suspect you may be hypothyroid.  Our symptoms are more important than the blood tests but it's very difficult to get doctors, especially endocrinologists, to acknowledge this.

In your previous post your mentioned major depression. In fact hypothyroidism can cause depression.  Depression can lower the TSH and lead to the production of TSH that is detected by the blood test but has reduced bio-activity.  The end result is that fT3 and fT4 are low, perhaps still within their reference intervals and the TSH doesn't rise as it normally would in these circumstances.  The doctor thinks the blood test results are normal but they are not.  It is not normal to have fT3 and fT4 both low down in their reference intervals.

I would suggest you ask your GP to give you a trial of levothyroxine, say 50 mcg which is a mild dose to see if you respond.   I suspect you will need a medication called liothyronine (L-T3) but it is very difficult to persuade doctors to prescribe it.  I don't know if you are on anti-depressants but there is evidence that anti-depressants are sometimes 'refractory' (don't work) until the patient is given liothyronine.  Nobody knows why this is so.  So, if you are under the care of a psychiatrist they might be more willing to prescribe liothyronine.

I would urge you not to spend more money on tests, you have the most important results and so it's not worth stretching your resources.  I'd focus your efforts on getting a trial of levothyroxine initially and if that helps but doesn't fully work insist on a prescription for liothyronine after a few months.  You will have a battle on your hands so make a list of the effects on your life and if possible take someone with you for support when you visit doctors.

Thanks you jimh111 that's very helpful, especially the info about depression. I've always seen it as a symptom rather than the main issue the doctors think it is. 

Once it becomes a symptom the depression reduces your TSH a little leading to a bit of a catch 22 situation.  The answer is for your doctors to pay attention to your fT3 level and above all your symptoms.

the only option seems to be to take someone with me to the doctor's, to help persuade them I'm not just a hysterical lunatic. :(

"I don't know if you are on anti-depressants but there is evidence that anti-depressants are sometimes 'refractory' (don't work) until the patient is given liothyronine."

Is it not possible that anti-depressants do not work at all, and they just seem to work when the patient is given T3, but it is actually the T3 that is relieving the depression, not the anti-depressant? If you see what I mean.  

I think both are possible.  Certainly depression arising out of hypothyroidism often does not respond to antidepressants, which is often good news as the patient then eventually gets the correct diagnosis.  Also, patients suffering from depression without signs of hypothyroidism sometimes respond to liothyronine supplementation.

If linesandlines is on antidepressants it would be a means of enabling a precription of liothyronine as it is so difficult to persuade doctors to give it.  The antidepressants could then be slowly titrated back, or possibly eventually discontinued.

Yup greygoose & jimh111  - over 10 years on ever increasing doses of anti-depressants, none of which have ever made any difference. I've tried most of them! They've even chucked in mood stabilisers and anti-anxiety drugs to make them work. Of course they haven't. All that's happened during that time is that I've got tireder, fatter and achier. The thing is, when you are depressed (because you're always tired and fat and neither use nor ornament to your family or in your careers) you can be persuaded that it's just depression, and that physical symptoms and looking for a physical cause for them is simply an expression of the depression. It's a massive catch 22.

I decided to start coming off Anti depressants in November, when I was at rock bottom - what was the point of taking them, along with all the side effects, if they didn't help at all? The dose is so high it'll take over a year to be completely off them, but 6 months on and down to just over half my original dose, I feel WAY WAY better mentally than I have done in some time, whilst still feeling just as physically rubbish - further evidence that the AD's don't work and that the depression is not causing physical symptoms. If only they'd listen!

Surely a trial of thyroid medicine is easier and cheaper for the NHS than more psychiatrist and psychologist appointments?

Well, you'd think so, wouldn't you. But the whole of the NHS seems to have been so brain-washed by Big Pharma that they now seem incapable of independant thought.

It's not in Big Pharma's interests to have us get well. As you say, antidepressants are expensive, but that's how BP makes its money. Then, there are statins. And weight-loss pills. And blood pressure pills. And goodness knows how many other pills our doctors can prescribe us to treat our symptoms, rather than handing out one cheap little pill that will get to the root cause of the symptoms. That's not how BP does business.  

Not like.

Get someone to go to the doctors with you.  Make a brief note of this history, of anti-depressants not working.  Ask for an initial trial of levothyroxine to bring your TSH down to around 1.0 or 0.5 and fT4 up to around 18-20.  If you get this see how you do after three months.  I suspect you will need liothyronine but levothyroxine is a better option if it works.  Try and get this done and then you can push for liothyronine if the levothyroxine doesn't work.  Point out that there is a large body of evidence that anti-depressants are refractory in hypothyroidism.  Levothyroxine is a much safer and cheaper option than antidepressants.

Hi Line, I agree you must have used two different labs and the ranges are different but your FT4 is barely above minimum.  Your thyroid is not producing enough hormone.  You don't seem to have an immune attacks so something else is slowing down production. 

You could get some advice here:

Fab, thank you Heloise 

Your TSH looks too high, and your Ft3 and Ft4 too low (not in top quarter of range). Your B12 is low, but ferritin OK.

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