Blood results back from Blue Horizon. Advice required on what to say to GP!

Before I launch into this post, I would like to offer my personal recommendation to Blue Horizon.

I'm not affiliated with anyone working there, nor anyone at Thyroid UK.

After getting nowhere quickly with my GP, it was recommended I get further testing privately.

Apologies because I don't know how to do the link thing, but please save yourself the hassle of arguing with doctors and go private!

The guys at BH are amazing and really took the time to listen and make sure I was buying the right tests.

It was expensive but how much does being sick cost you financially, socially and in other ways?

I hope this helps if you're in 2 minds about what to do. Good luck xx

Anyway, I am new to all this myself and would like some advice on what to say to my GP, as it appears I may be hypothyroid.

TSH. 1.43. (0.27-4.2)

TT4. 85.7. (64.5-14.2)

Free T4. 10.51. (12-22)

Free T3. 3.48. (3.1-6.8)

AT Peroxidase. 9.9 <34kIU/L

AT Globulin. <10.000. <115IU/L

Cortisol. 179. (150-600nmol/L)

B12. 400. (179-1162ng/L)

Folate. 5.2. (2.8-12.4ug/L)

Ferritin. 66. (15-200ug/L)

Vit D3 32. (50-100nmo/L)

Iron 16.9 (9-30.4umol/L)

GP has already prescribed Vit D3 800IU once per day.

Should I be taking higher dose?

BH recommend I retest in 6 months, however I can't wait that long to start feeling better. I feel terrible now and have done for well in excess of a year.

I've been taking Iron tablets and a daily berocca as well as B complex.

I will be ordering Selenium and a few other bits today.

I would be very grateful for any advice on how I can be best prepared for my GP visit as I would prefer to trial on Levo rather than wait.

Does it look like T4 is not converting?

Should I request T3 also, even though I've never had medication for thyroid before?

I'm such a novice!!

Thank you in advance xxxxxx

24 Replies

  • The low fT4 indicates hypothyroidism. It is unusual for the TSH not to be high in this case. However, you mentioned you were depressed in another post and depression can lower TSH. Ask your GP for a trial of levothyroxine, say 50 mcg, for three months. This is the only way to be certain and is a lot safer and cheaper than being continually ill. I wouldn't splash out on lots more tests, or supplements until your fT4 is around 18 or 20.

    As regards vit D3 I would rely on sensible exposure to the sun now the weather is better and supplement with vit D3 in the winter.

  • Thank you very much for your advice Jimh111.

    S70 x

  • Hi jimh111

    Is this 100% correct that depression can lower tsh ? Would you happen to know if antidepressants could also lower or raise TSH ? Sorry for intrusion on your post Sara70 .

  • No problem at all. It's a viable question.

    I began titrating down on Sertraline in February.

    I had been taking 50mg daily for 3 years. My GP recommended halving the dose for 6 weeks and then taking the reduced dose every other day for a further 6 weeks. That 12 week cycle ended mid April.

    I did wonder if the Sertraline had masked my hypo symptoms, as I felt wretched when I stopped completely.

    Since taking supplements, I feel a little better, but the blood test results cant deny that I'm hypo.

    As a side note, my T4 has been dipping consistently prior to me coming off Sertraline, but I wasn't aware of this until recently.

    Not sure if any of that is relevant 🙃

  • Thank you Sara70 This is interesting to me because I've taken anti Ds on & off, but mostly on for well over 20 years. First with Prozac & just a low dose first but gradually over the years the dose got higher. Then just over four years ago I had my ovaries removed because I'd also suffered with severe pmt. Suddenly the Prozac stopped working for me & I hit an all time low & was then prescribed sertraline & have been taking them for 4 years. I've tried to come of anti Ds on several occasions & the longest I've gone without them in all these years is about 8 months. I can't help wandering if these anti depressants drugs that are hailed as the 'cure' for all drug of drugs has been masking my thyroid symptoms. I've spent today with my daughter who was diagnosed hypo with goitre age14 at onset of puberty & we were discussing this very thing, she's never taken anti D's thank goodness but does have a lower mood in the winter. Her main symptoms before her diagnosis were Fatigue, weight gain & hair falling out, I'd notice it all over the house & was hoovering constantly. she shed hair faster than a dog & my symptoms are identical to hers but I'm not diagnosed as tsh at 2.6 & have low but in range t3 & t4 & anti tpo 20 but still waiting on more tests.

  • 100% depression CAN lower TSH (by reducing TRH) which is not quite the same as depression ALWAYS lowers TSH. Another more complicated issue is that low TRH leads to the production of TSH isomers with reduced bioactivity but a normal immunological response. The blood test picks up the TSH but the TSH has less bioactivity and so stimulates less T3 and T4.

    I don't know anything about how antidepressants affect TSH.

  • Thank you for this info jimh111

    It looks like i'll need to look into this at more depth because I had no idea.

  • Hi Jim

    Am I correct in saying that depression alone 'could' be responsible for MY blood results? And, if I successfully treat the depression with Councellling, new blood tests will show I'm euthyroid? Obviously I'm not asking you to make any generalised sweeping statements!

  • Depression could cause these sort of blood results along with clinical hypothroidism, so could a severely restricted diet. If you were depressed, perhaps from some traumatic event and it was treated successfully by councelling it should restore your TSH in time. If this were the case I would still argue for treating the current hormone deficiency as well. Hypothyroidism causes depression in some patients. So both issues should be tackled simultaneously. Antidepressants tend to be 'refractory' (don't work) in hypothyroidism.

    Looking at your later post, the doctor saying your fT4 is only just out of range, this is an appalling statement. With an fT4 below the lower limit the TSH should be markedly elevated. That's the way it works, or rather is not working in your case. If possible, I would take someone along with you to the GP and insist on an endocrinologist referral because your TSH is not responding to the low fT4. You probably won't get this but might get a prescription for levothyroxine (don't settle for just 25 mcg, 50 mcg is reasonable). You need to be polite but assertive. The 'guidelines' presume a normal thyroid axis (TSH response to fT3, fT4 levels) which you appear not to have.

    It is unlikely you need selenium but if you have already bought it there's no harm in trying it.

  • Again Jim, thank you for your explanation and for your time and support. Like so many others, it is invaluable to people like me. Xxxx

  • Well, you don't have positive antibodies so you don't have to worry about Hashimoto's, that's the good news.

    B12 is too low, needs to be around 900-1000. I don't think it's low enough for your GP to be offering injections, so you may want to supplement with sublingual methylcobalamin, Solgar or Jarrows.

    Folate is too low, needs to be at least half way in range so 10+ is what to aim for with that range. Leafy greens will help raise folate. Also you could take a B Complex, which is also needed to balance B Vits when taking B12. Get one with methylfolate (natural) and not folic acid (synthetic). Thorne Basic B is a good one.

    Ferritin could come up a touch. It's advised to aim for at least 70, preferably half way through range. An iron supplement will help, something like Solgar Gentle Iron which contains Albion Ferrochel Iron Bisglycinate and has 20mg elemental iron. Take with 1000mg Vit C to aid absorption and help prevent constipation.

    Vit D is way too low. Needs to be around 100ish. Our sun might not be enough to raise it as we don't have that much really. If you want to supplement then D3 cholecalciferol taken with the fattiest meal of the day, plus vitamin K2. Vit D3 aids absorption of calcium and K2 directs it to bones and teeth rather than arteries and soft tissues.

    Forget about Berocca, get yourself a decent quality vitamin C. Most absorbable is meant to be the liposomal variety such as Altrient C but it is expensive. Otherwise look for L-ascorbic acid (Nutribiotics do one), which is better than the D-ascorbic acid, although a lot of brands don't tell you which form they use. If ascorbic acid is too harsh for you then you can get magnesium ascorbate and calcium ascorbate and mixed ascorbate forms.

    Don't skimp on cheap supplements, they generally use lower quality ingredients and unnecessary fillers. Look for bioavailable, food state, whole food, where possible.

    Your T4 needs to come well into range, as Jim says, so ask for a trial of thyroxine. For any thyroid hormone to work properly then vitamins and minerals need to be at optimal levels and getting your Vit D, B12, ferritin and folate to decent levels will help.

  • Wow. You guys are amazing. Thank you. I'm on the brink of tears here literally. Thank you so much xxxxxxx

  • Hi SSS

    I've ordered all the supplements you recommend. Hopefully things will start to improve soon. I have read on lots of other posts that they help.

    I think I'd shave my remaining eyebrows off if I thought it'd help!!

  • Sara, a word of warning, do not start taking them all at once. If you do, and one of them doesn't agree with you - which can happen - you won't know which one it is, and you'll have to start all over again. Leave at least two weeks between starting each one.

  • Warning noted. I will do as you say. My husband wishes I'd be this compliant with him!!!

    Thank you Greygoose.

  • You're welcome. :)

  • My GP called me as a total coincidence, as she was looking into getting the advanced thyroid blood tests done on the NHS. She called to inform me that she was informed by the registrar, that as my TSH and T4 were within range on previous testing, that it was highly unlikely that my FT4 and FT3 will be out of range. On that basis, my request was refused.

    It was at that point that I informed her that I'd had them done privately and that my FT4 was below the normal range, to which she replied, 'Well it's only just a little bit below the normal range'.

    I pointed out that indeed, a fair bit of my results were either below normal or just within normal.

    Needless to say, my request for a trial of Levo has been denied.

    What more has a girl got to do??

    Should I continue down the GP route, or just cut my losses and buy it online?

    If the latter, I require assistance 🤔

    Thank you xxxx

  • 'Well it's only just a little bit below the normal range'.

    My jaw has just dropped. What a complete and utter twonk your GP is (and I am really holding back here, I don't want to get banned!)

    I bet my last penny that if one of her patients with diagnosed hypothyroidism and on medication had a TSH 'only just a little bit below the normal range' then she would declare them over medicated and give you them the atrial fibrillation/osteoporosis twaddle they like to peddle. Jeez, how did some of these people qualify?

    And as for the registrar saying your previous results were within range so it's unlikely that they'd be out of range now, well words fail me!

    Can you go private to, perhaps, Dr Peatfield if you can get to his clinic. Or ask for recommendations for an endocrinologist in your area who would be more sympathetic.

  • I don't think Dr P practices any more from what I can see.

  • Thank you SSS.

    My husband said he expected nothing else than that response from the GP.

    I explained to her that this forum exists because of responses like this.

    I can't understand why they feel they can get away with it. I honestly feel like we are systematically being let down by an institution, which needs to open up to the idea that it is neglecting and failing to help an entire 'race' or 'culture ' of people.

    For so many independent people to be complaining of the same kind of treatment, it almost comes across that this is institutional neglect of a sect in society.

    Surely there are international laws that prevent this kind of bias?

  • Why do they feel they can get away with it? Because they do get away with it! What are you going to do? Complaining gets you nowhere, they are convinced they know it all. And their excuse is that they are just following guidelines, and, as the guidelines say exactly what they're doing, they'd get away with it in a court of law.

    And, how they get round the fact that so many people are complaining, is to say that these people who are disatisfied with their treatment, are suffering from somatoform disorder - in other words, they're barmy!

    'institutional neglect of a sect in society'? No, just Big Pharma ruling the world, and buying off those in high places, so that they can continue making a fortune by 'treating' all our symptoms as if they were unconnected. That's all.

  • Oh, forgot to say, what you are suffering from is probably secondary or tertiary hypo. Which means that there is nothing wrong with your thyroid gland, but there's a problem with the pituitary or the hypothalamus. However, the results are the same : i.e. you become hypo. But doctors know nothing about that. If the TSH is in range, there's nothing wrong with you! Can't be doing with messing around with these fancy diseases! lol

  • Thank you GG. I'm not sure what to do with that info.

    Can you recommend a good endo? 🤓

  • Goodness no! I haven't seen an endo for years. And I've never seen a good one. I Don't live in the UK, anyway.

    Contact Louise Warville for a copy of the good endo guide. I believe her email address is :

    If that's wrong, perhaps someone will come along and correct it, please?

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