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Thyroid UK
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Im newly diagnoised!

Just had my my results as follows and had the doctor shouting at me when I ask for some sort of explaination, instead I got given a perscription of 50mg Levothyroxine and tols to take in the morning.

Results as follows if anyone can tell me what they mean ..... also will never being seeing that Doctor again its really upset me.

Serum free T4 level - 6.4 pmol/L

Serum TSH level - 31.7 mU/L

Se thyroid peroxidase Ab conc - 401 IU/ml

No idea what this means , any help would be good

Thanks x

15 Replies

Your THS of 31.7 means that you are very, very hypo. Your thyroid is under active, and you need to take the levo, which is a thyroid hormone, to replace the hormone you thyroid gland can no longer make.

TSH is a piuitary hormone, that tells your gland to make more hormone. Yours isn't responding. FT4 is a thyroid hormone, and it is very, very low. Too low for you to be well. I expect you feel terrible!

Your doctor should not shout at you, that is very unethical. You should report him to the practise manager!


Thanks for explaining in " English" I didnt have a clue what it all means, hopefully I will feel better soon but have forgotten what its like to feel normal its been that long lol


Oh, I know exactly what you mean! Fingers crossed for you. :)


If you look at the thyroid Uk website you will find lots of helpful information.


As Greygoose has said your thyroid is struggling, as shown by the high TSH (this stands for thyroid stimulating hormone) and is the message sent from your pituitary gland to tell your thyroid to get working. The higher the TSH the harder/louder it is sending that message.

When you take you thyroxine this needs to be always on an empty stomach and no food or drink (especially no tea or coffee) for an hour after. Many take their medication on waking, but some of us prefer taking at bedtime. Again no food or drink at least hour before and hour after. We are all different, you will have to find which suits you best both for convenience and best results.

If you take any other medications these should be at least a few hours apart from the thyroxine (especially iron or calcium - minimum of 4 hours)

Different brands of thyroxine can suit some people better than others. Changing from brand to brand with each new prescriptions can, with some patients, vary how you feel and make getting better harder. So make a note of the brand you have, and assuming you get on with that one aim to always stick to it. Best to ask pharmacist and always check that it's correct brand before leaving the chemists.

You have high Thyroid peroxide antibodies. This means your thyroid problem is autoimmune and is called Hashimoto's. There are two sorts of thyroid antibodies TPO (thyroid peroxide) and TG (thyroglobulin) - you can have high levels in either or both. NHS almost never check TG ones.

You may well end up needing a higher dose per day than the 50mcg, but we have to start on low dose, for body to get use to it. stick on that for at least 6 weeks before another blood test to check your levels, and if necessary GP should only slowly increase up, usually in 25mcg steps. It has probably taken your body a long time to slow down and become hypo. You need to bring it back up slowly and carefully.

This link helps explain that process


When you go back to the surgery, it would be a good idea to ask for blood test to check your vitamin D, B12, folate and ferritin. When hypo, especially with Hashimoto's we can be low in these vitamins and minerals. They need to be at reasonable levels to help your thyroxine medication to work.

Definitely always aim to get printed copy of all your results (with the ranges - figures in brackets). Alternatively if your GP practice is organised, you can register for online access to your own medical records and this may give access to all your test results. (Not every surgery is able to do this yet, but it is planned /agreed that this should happen countywide ASAP)

By far the majority of patients get on fine with thyroxine, and pretty quickly start to feel better.

Obviously on a help forum you tend to get quite a higher % of more complex cases that are more difficult to resolve. Don't be alarmed, we are not all that tricky to sort out!



Make a written complaint to the practice manager or senior GP partner. It is unacceptable for a GP to shout at a patient.

Thyroid peroxidase antibodies are positive for autoimmune thyroid disease (Hashimoto's) which causes 90% of hypothyroidism in the UK, Europe, USA and Canada. 100% gluten-free diet may improve symptoms and reduce antibodies.



For maximum absorption Levothyroxine should be taken with water 1 hour before, or 2 hours after, food and drink, 2 hours away from other medication and supplements, and 4 hours away from calcium, iron, vitamin D supplements and oestrogen. Some people prefer to take Levothyroxine at bedtime (2 hours after any milky bedtime drinks or snacks).

It takes 7-10 days for Levothyroxine to be absorbed before it starts working and it will take up to six weeks to feel the full impact of the dose. Levothyroxine replacement is introduced gradually and slowly so 50mcg starting dose is unlikely to be an optimal dose and will probably need increasing in 25mcg increments every 6-8 weeks.

You should have a follow up thyroid test 6-8 weeks after starting Levothyroxine, and after any dose adjustment. Arrange an early morning and fasting (water only) blood draw when TSH is highest, and take Levothyroxine after your blood draw.

Your syptoms will improve as your FT4 rises and TSH drops. Most symptoms resolve after TSH drops to around 1.0 with FT4 in the upper range but symptoms can lag a couple of months behind good biochemistry.




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.


I am so shocked that your GP would shout at you when you are asking for information on your illness & when you are so hypo.What a bully!

I hope you can switch to a better doctor or a better practise.This doctor sounds as if he is minimising your illness.This is very common.This forum will support you & here you can learn what you need to know to regain well being while living with this misunderstood & shamefully neglected illness.

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Aww, Claire67 bless you. What a pig of a doctor. Reminds me of one at my surgery many years ago. I asked him to explain what the results of a DEXA scan indicated. He was very snappy and told me to "ask at the desk for a copy". It never got explained, I fathomed it out myself in the end!

He probably doesn't know enough to explain things to you. You've had good advice and information, I can't add to it other than to say as well as going 100% gluten free then supplementing with selenium is supposed to help reduce antibody attacks.

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The high TSH and low fT4 shows that your thyroid is not producing enough thyroxine (T4). The high peroxidase shows that it is due to autoimmune thyroid disease, where an immune reaction damages the thyroid gland. This is the usual cause and affects two or three percent of the population. Your starting dose of 50 mcg (microgram mcg, not milligram mg) is reasonable. You will need to be reassesed in a month or two and your dose probably increased. You should start to feel better in about a week but it may take six months or so before you are fully back to normal. Your doctor should have explained all this. Hypothyroid patients usually suffer temporary impaired cognitive function and occasionally depression so the doctor should have been extra helpful. I'm sure another doctor will be better. If you have any questions for them it is a good idea to write them down and take into the consultation. Good luck.

PS If you don't already get free prescriptions (I don't know your age) then you are now entitled to free prescriptions as you have to take levothyroxine for life. You need to ask your (nice!!!) doctor for a form to fill in.


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Thanks for the info to be honest its been that long feeling like this I dont know what normal would feel like ... Ive still carried on working fulltime in Retail running around lol but felt like colapsing the moment I got home. Brain foggy all the time so this explains alot . I thought I was losing my marbles as couldnt remember silly things (including spellings as above ...sorry)


It takes time for our bodies to absorb the meds into our cells. Don't expect to feel immediately better and if you feel worse on taking your meds cut the dose, hold it for a few weeks and then increase. You will need another blood test after 8 weeks and may well need more meds. Did the shouty GP tell you to come back for another blood test in 8 weeks when he was shouting at you? Definitely complain.


you should absolutely and most definitely REPORT your Doctor officially in writing


Thanks for the support I am definately going to report him x


I agree with greygoose..report that Doctor to the practice manager as soon as.

In the words of Catherine Tate 'What a bleeping liberty'. The moron. x


At the previous practice I was registered with, I saw a part time GP who told me that B12 rarely changes, that my rising CRP was not of concern, that I was just stressed out by moving house and that I was there under a false pretext (practice nurse had referred me due to abdominal discomfort with dramatic stool changes). She said she couldn't find this on my notes - eyebrow raised with a sickening smile. Ugh! She binned the stool sample I'd been asked by nurse to bring and never examined me. Five months later and I have rectal bleeding and at last have a colonoscopy happening next week. It took months for me to pluck up courage to mention this bowel related issue to my new GP.

When I requested transfer notes from one of the partners I found that this part timer GP had written this up in a terribly inarticulate, mean minded way and suggested I was suffering from health anxiety. Directly underneath her entry was the nurse referral she had told me I wa lying about.

So I fumed about this and then collected myself and wrote a ruthless account as a letter of formal complaint to the practice manager. I gave a copy of my letter to the new GP practice, requesting that it be put on my notes next to the relevant GP entry. I did eventually get a letter back from practice manager saying that this GP was sorry to have humiliated me in this way - not her intention. They said my letter would form part of the reflection of her practice and ways to improve on over the coming year - during reviews with the senior partners. I almost felt a bit sorry for her! But then again I think of all those whom she's humiliated in the past but who can't fight back and I know I did the right thing!


I am disgusted that your GP would shout at you, when you are only asking for information about something that is new to you. That GP ought to be reported.

Hopefully, you will find some knowledgeable folk on here who will offer advice and help. Certainly, no shouting!!

In time, once the medication works, you will begin to feel better.

Best wishes MariLiz


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