Confused by recent Bloods: Hello everyone, When... - Thyroid UK

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Confused by recent Bloods


Hello everyone,

When the bloods were taken I was on 2 grains of NDT and still feeling very symptomatic. I added 25mcg of T3 the last two days and I am actually starting to feel better for it.

I am now thinking of reducing to 1 grain of NDT and keeping the addition of the 25mcg of T3 as I seem to feel better on it than just the NDT.

From the most recent results I think its safe to say I do not have Hashimotos?

My Iron and Vit D B12 are still on the low side- could this be why I still do not feel optimal or could I be overdosing and going Hyper?

All thoughts would be greatly appreciated!


The combination of low TSH and free T4 levels, with a normal T3 level, would be unsurprising if you are taking T3 form of thyroxine - is this the case? If so, it might be a good idea to discuss your ongoing thyroid medication dose requirement with your usual doctor. If not, and you were unaware of any thyroid problem, the low TSH level might indicate a developing hyperthyroid (overactive thyroid) state, or (with the low free T4 level too) even pituitary gland underactivity. Again, discussion with your doctor would be wise if this is the case.

TSH L 0.04 0.27 - 4.20 IU/L

T4 Total L 63.1 64.5 - 142.0 nmol/L

Free T4 12.53 12 - 22 pmol/L

Free T3 6.52 3.1 - 6.8 pmol/L

Anti-Thyroidperoxidase abs 6.7 <34 kIU/L

Anti-Thyroglobulin Abs 14.3 <115 kU/L

R xx

(had to delete last one sorry!)

17 Replies

Rhsana I don't use NDT so my knowledge of how results should look when optimally medicated when taking NDT is not as good as someone experienced with it; however, I'll do my best.

Iron, Vit D and B12 are low - yes that would contribute to why you're not feeling optimal. Ferritin needs to be 70+, Vit D needs to be around 100+ and B12 is recommended to be 1000 by the Pernicious Anaemia Society. It sounds like supplements are probably necessary. If you have the results, you could post them and suggestions can be made. All your vits and minerals need to be optimal for any thyroid hormone to work properly.

As for your thyroid results, firstly, your antibodies are well below the range so your current result shows no problem with Hashimoto's. Have you ever had them tested before and if so what were the results then? Were any ever close to the top of the range? If so that would mean they do fluctuate, (mine probably do but the four times they've been tested they've never been high in range and I show no signs or symptoms of Hashi's). Were yours ever over range? If so that would be positive for Hashi's and the current result would show the fluctuation and that they are not high at the moment. I hope that makes sense :)

When on any form of medication with T3 (NDT or straight T3), this will suppress TSH so the fact that yours is at that level is no suprise. FT3 is high in range and FT4 low in range, this is what I understand happens when taking any form of T3 as T3 is the active form.

You say you had the bloods taken before adding the T3. I am not medically trained, and am cautious where T3 is concerned, and these are my thoughts only (other people may have different thoughts so go with what you feel comfortable with). Because T3 is such a potent medication, I (personally) would have started with a quarter of a tablet, ie 6.25mcg and see how I felt, building up by 6.25mcg each time if I felt the need to increase, and I would have given it at least two weeks to see what difference it made.

You don't actually know what difference the addition of the T3 has made, it will certainly push your FT3 up more so you could now be over range. It's generally felt that this is the one test that should be in range, other T3 users wont always agree, as I say, go with what you are comfortable with.

You are feeling better for adding 25mcg T3 to 2 grains NDT. If you reduce your NDT then you will be getting less T4 so your FT4 will go down. Instead of halving your NDT, I (personally) would reduce in smaller amounts. I think it's all about experiementation to find what suits. Big changes in dose could mean big swings in how you feel, gradual changes should be less of a shock to the system, if you see what I mean. Maybe you could try reducing by a quarter or half a grain??

Am I right in thinking you are self-medicating and your GP is not involved?

Sorry, that seems a bit confusing when I read it back, I hope you follow what I mean.

Rhsana in reply to SeasideSusie

SeasideSusie thank you thank you!! ok so I shall try and reply as best I can. These are my most recent nhs results... so from what you are saying its very possible that I am now optimally medicated for thyroid and just need to wait for my levels to catch up? This could be why I still feel very hypo?

Plasma vitamin B12 level510ng/L (200 - 900)

Serum folate7.4ug/L (2 - 17)

Serum ferritin 60ug/L (15 - 250)

Serum total 25-OH vit D level66nmol/L (75 - 200)

I expected my TSH to be low, from what I have read that seems to be ok, though I can't really interpret what low FT4 means? You are most probably right about lowering the NDT. I haven't tried yet and so far two days on 2grains of NDT and 25mcg of T3 I actually feel pretty good! But I am wondering if that is because the T3 has finally had time to build up in my system? I'll reduce the NDT by half instead of a whole and gradually more over time.

My doctor has prescribed the NDT, the T3 I am self medicating.

I forgot to mention the Estrogen Dominance. I am in my 2nd month of progesterone supplementation, I suppose I could still be feeling the symptoms of that as well?

Thank you so much for taking the time to look over this for me! xxxx

Rhsana in reply to Rhsana

I forgot to reply re: hashi's. My result two months ago was

TPOab (Blood Spot)* 92IU/mL 0-150 (70-150 borderline)

and today

Anti-Thyroidperoxidase abs 6.7 kIU/L<34

Anti-Thyroglobulin Abs 14.3kU/L <115

So could this mean I still might have HAshis? :( hope not! xx

Justiina in reply to Rhsana

You might have been unfortunate with timing and your borderline is from time antibodies have been going low. Now that your TSH is suppressed it might prevent the flare ups and antibodies stay low.

So in your case it's hard to say at this point if it is hashi or not.

SeasideSusieAdministrator in reply to Rhsana

Rhsana You've had other replies so they've answered your points.Your TPO Blood spot test certainly indicates Hashi's - I'm assuming blood spot tests are reliable, this is what my practioner is wanting me to do but I'm hanging back at the moment - and your current serum test shows low antibodies, so there you have some fluctuation which is the nature of Hashi's. The advise is always to go 100% gluten free so you could try that, give it a few months at least, and see how things go. Supplementing with selenium apparently helps reduce antibody attacks as well.

Clutter has made suggestions for your low vits and mins, exactly as I would have said. The only thing I would add is when taking Vit C with iron I'd take a decent dose of 1000mg. Also, when taking Vit D3 we should also take K2. Vit D aids the absorption of calcium and K2 directs the calcium to bones and teeth rather than arterties and soft tissues.

Oestrogen dominance is out of my range of knowledge. My sex hormones are all in the basement and these are being addressed by supplements my practioner advises. My choice would always be for bioidentical hormones and I use a bioidentical progesterone cream in the dose recommended for post menopausal (very!) women.

It's good that your doctor has prescribed your NDT, not many are willing to do that. Does he know about the T3? Just wondering what he'll make of any future NHS tests if he doesn't.

I always read that with NDT it's a case of go by how you feel so tweak your meds when you feel it's right, give it time to see what difference it makes.

Rhsana in reply to SeasideSusie

Thank you!! Yes I am taking all the supplements you mention as well as the Progesterone cream. Though I only take it from days 14 to 24 of the cycle as directed by Dr. Yes, I think you are right its no use claiming I still don't feel great and not going completely gluten free! It looks like I need to do a little more research on it all as I still don't think I have a grasp of what it means to have Hashis. I have a thyroid scan tomorrow, hopefully that will shed some light on the issue. Am I correct in thinking that if my body is attacking itself it will show up in the scan? R x

SeasideSusieAdministrator in reply to Rhsana

Sorry Rhsana I don't know the answer to your question about scans, it's not something I've had done or have any knowledge of.

Basically Hashi's is where antibodies attack your thyroid until it is destroyed and then you have full blown hypothyroidism, but of course as and when the antibodies are attacking (they will fluctuate) so your symptoms will fluctuate. You can't treat Hashi's all you can do is try and reduce the antibody attacks, hence the suggestions for gluten free and selenium.

Not sure if you've been given links before but here are a few:

I'm sure there are plenty more.

Rhsana in reply to SeasideSusie

This is super helpful, thank you so much!

Thank you Justiina , I have reduced the amount of gluten I eat, I was gluten free for about a month but fell off the wagon. Could this have made an effect as well?

R x

Justiina in reply to Rhsana

I have no idea how fast antibodies could fall :/

Rhsana in reply to Justiina

oh dear, I really don't have a grasp on all of this! Sorry for yet another question, but is there anything else I can test/look at to see if it is Hashi's? Thanks Justiina x

Justiina in reply to Rhsana

As far as I am concerned it is tpoab and thyglab. Tho in some cases only FNA confirms it.


The blood spot test is positive for Hashimoto's, but the serum tests are negative.

Symptoms can lag behind good biochemistry by a couple of months. FT3 was close to top of the range on 2 grains NDT so adding any amount of T3 is likely to send you over range.

B12 is optimal around 1,000. Supplement 1,000mcg methylcobalamin with a B Complex vitamin to improve folate.

VitD is replete 75-200 and most people are comfortable around 100. If you can get sun on your face and arms 3-4 x 20 mins per week you should improve vitD naturally. If not, supplement 1,000iu D3 daily and increase to 2,500iu Oct-Apr.

Ferritin is optimal half way through range. Supplement iron with vitamin C.

VitD and iron should be taken 4 hours away from thyroid meds.


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.

Hi Hidden , thanks for your reply! I have never heard of the Impaired Sensitively, I will have to look into it, as you are 100 per cent correct, I have other members in the family who have those things you mention!. R xx

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