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Thyroid UK
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Tsh 6.28, can I ask advice about improving this and thyroid health/ book recommendations please?

Hi, I posted last week about my TSH rising from 3.18 in March to 6.28 now, although the 2 Nd test was done at 7.15, a private pinprick one. I'm 3 months into b12 injections, have taken iron again recently to get my low level up to 80's, folate seems to be OK after briefly supplementing? And although low vit d in past am not sure of current status. (M.E diagnosis 17 years ago)

My dr has advised to retest in 6 months, although Im considering rechecking privately again, prob in about 3 months? He feels at the mo that my symptoms are due to the b12 def. but it's likely I will need thyroid treatment in the future and wants to monitor it 6 monthly.

Having just! getting to grips with b12 def and the great help of b12 healthunlockers, looks like I have another direction to check out :) im just wondering if anyone can recommend any good books in particular as I start out and whether there is anything I could be doing at this stage to improve the tsh please and general thyroid health. I've been advised Brazil nuts for selenium.

Many thanks...

16 Replies

Jo5454 Is that 7.15 am or pm?

Regarding brazil nuts for selenium. The nuts have to be grown in selenium rich soil to contain any selenium. I doubt whether any packs of nuts actually give that information. A measured amount in a good quality supplement and you'll know exactly how much you're taking.

Finding out your Vit D level will be helpful. You can get this done privately for £28 with City Assays (NHS City Hospital in Birmingham), it's a blood spot fingerprick test, easy to do and results back within a week.

I like Dr Peatfield's book Your Thyroid and How to Keep it Healthy, very easy to ready and dip in and out of. I'm sure others will recommend some more.


Hi seasidesusie...thanks very much for your reply. I mentioned selenium to my Dr and he said to be aware of selenium toxicity and to research before taking?

Thanks for the info about vitamin d test, that's the one I did before on reccomendation from help on here :). Presuming it'll be higher at the mo with it being summertime?

Thanks very much for the book rec. will look for it.

It was 7.15 am. I thought I'd do an earlyish one compared to the 9 am at the Drs. I've had disturbed sleep for a long time, tend to wake early. Feel like I'm tireder when I get up than before I go to bed. Thought it could be down to the ME and maybe adrenal/ blood sugar and now perhaps the b12, but thinking perhaps it could be thyroid related?

take care....Jo


Jo5454 From what I have read 200mcg selenium should be fine, I certainly wouldn't go beyond that.

One article I've seen easy-immune-health.com/sele... states

Selenium Dosage in Studies

Many studies have attempted to determine the 'Just Right' selenium dosage, and while there are no clear cut answers as to the exact optimal dose for optimal health, the studies that HAVE been done give us some clues.

200 mcg (micrograms) is the most frequently used dose in studies that obtained beneficial results. Most of these studies were done over relatively short periods of time, but some were done over long periods of time, so it seems that 200 mcg per day is a relatively safe dosage to take for relatively long periods of time.

One study that analyzed many other studies on selenium found that dosages of about 300 mcg per day of selenium began to show ill effects on the thyroid gland as well as hair and nail weakening and loss.

So from this study, we can determine that 300 mcg per day of selenium is likely to be unnecessary and may cause harm over the long term. So, taking between about 100 mcg to 200 mcg seems to be the 'just right' selenium dosage that is beneficial for health, but that does not cause problems in MOST people. Again, this will be dependent upon how much you ALREADY get in your diet, your specific metabolism and other factors that science may not even know about.

If you read the article it tells you which are the best forms to take.

Your natural Vitamin D should, theoretically, be higher in the summer when we have more sunshine, but I think you have to expose some bare skin (arms probably enough) for about 15-20 minutes daily, without sunscreen, to get any benefit. I don't do well in hot weather, even 5 minutes of sun with trousers on and my legs feel as though they're burning.

Your disturbed sleep will affect your adrenals. My sleep has been dire for as long as I can remember, takes me ages to get off and I wake up then drift off again. Like you, I am more tired when I get up than when I went to bed, my sleep is totally unrefreshing. It is a form of stress, my 24 hour adrenal stress test with Genova showed my cortisol levels all at the top end of the range from the early morning one throughout the day, the only one mid range was the evening one. Thyroid and adrenals are connected.

I've just looked at a previous post of yours where you put your BH test results

TSH 6.28 (0.27-4.20)

T4 total 119.6 (64.5-142)

Free t4 16.15 (12-22)

Free t3 5.29 (3.1-6.8)

Antithyroid peroxidase 9.0 <34

Anti thyroglobulin abs 16.1 <115

and comparing to previous TSH results of 0.95 (August) and 3.18 (March), your TSH does seem to be dancing around a bit. Also your FT4 has dropped from 14 to 12 previously and now up to 16.15. Of course the ranges might not be the same so it would be interesting to see the ranges for the older tests.

From that test your conversion appears to be OK with FT4:FT3 ratio being 3.05 : 1, good conversion is 4:1 or lower. Selenium helps with reducing antibody attacks and conversion. I'm wondering why you are considering supplementing with selenium? Have you ever had antibodies tested before to compare those with?

Have you show those BH test results to your GP? If so, what did he say about your raised TSH?


Hi SeasideSusie

Thanks so much for taking the time with such a detailed reply, it's really helpful.

It was suggested on here that I take selenium to support thyroid function, when I was recently concerned if the b12 injections had caused a rise to 3ish. Thanks for the research info.

Sorry to hear you have sleep problems too. I have t done a recent adrenal test, last 1 about 5 yrs ago. My morning cortisol was a bit higher, the rest a bit under range. I had a cortisol blood test at the Drs last summer and it was 700nmol, with normal being between 101-536, was told I was prob stressed doing the test? I'm a bit better at falling asleep now, used to keep half dropping off then legs or arms would jerk and wake me up in a panic, like I wouldn't switch off. It's ok providing I don't overdo it, for eg had a hosp apptment last week, BP and pulse was high then couldn't sleep that night. Like you say, they're all connected, I used to be really chilled out, but it's like I'm just going the wrong speed, too fast inside, although is improving a bit, guess the b12 is giving me a bit of power back!

Liked the phrase, dancing around a bit, sounds far less worrying:) the range for March & August were

Tsh 0.35-3.50

Ft4 8-21. These were taken at the Drs at 9am.

I guess the t4 is improved because the tsh is higher and making it work better, is that the case?

Yes, I've given these to my dr as I wanted to check the antibodies and he refused so after all the fighting to self diagnose the b12 thought it easier to check them once and for all! Also it mentioned on my results from St Thomas that MMA could be raised due to thyroid issues as well as b12, so thought I'd rule antibodies out.

He has said he will check 6 monthly to keep an eye on it. he says my t4 is good at the mo, but will prob need treatment in the future. I feel much better knowing I have support on this issue, compared to the b12. I just want to see if there's anything I can be doing to slow this down really, so will swop my reading to thyroid now! :) still on the up I have slightly! More brain power than I did whilst trying to sort out the b12, but then this sounds as if it could be more complex!

Thanks for that ratio, I had no idea about that. Could you tell how you worked it out please?

Once again, thanks heaps...jo :)


Jo5454 For the ratio you just divide FT4 by FT3 ie 16.15 divided by 5.29 = 3.05, a little nugget shared by member diogenes a while back :) .

Looking at your results then


TSH 0.95 (0.35-3.5) = 19% through range

FT4 14 (8-21) = 46% through range


TSH 3.18 (0.35-3.5) = 89.8% through range

FT4 12 (8-21) = 30.7% through range


TSH 6.28 (0.27-4.2) = 152% of range

FT4 16.15 (12-22) = 45% through range

FT3 5.29 (3.1-6.8) = 59% through range

They're not making much sense, not that I can see unless someone else knows. The only thing I can think of is Hashimoto's but your current antibody test doesn't indicate that (but see below also). I would have said that your antibodies at that level would rule out Hashi's but thinking about it, a positive (high) antibody result confirms Hashi's but a low one doesn't confirm you haven't got Hashi's, just that they're low at the time the test was done. Unless there's a reason for your TSH to be fluctuating like that, I'd be inclined to repeat the antibody test at some point to see if they've changed. If ever you're feeling particularly cr*p with hypo type symptoms that would be a good time to repeat the test.

If your TSH goes higher, indicating you're going more hypo, normally your FT4 would go lower. Looking at the percentages, your TSH is rising quite dramatically. Have a look at this article nhs.uk/Conditions/Thyroid-u... and you'll see that it says

A high level of TSH and a low level of T4 in the blood could mean you have an underactive thyroid.

If your test results show raised TSH but normal T4, you may be at risk of developing an underactive thyroid in the future.

Hopefully you can follow all that.


Hi SeasideSusie, thanks again for some more helpful info...that ratio sum is clever. Thanks very much for taking the time to work out all those helpful percentages, yes the tsh is increasing quite rapidly. In fact the one I thought was 0.95 on checking was actually 0.42, making it a bigger leap. I checked tsh on an earlier test a year previously and it was 1.8.

Do you think the f4 has improved this time because the tsh has gone up and is helping it?

Have ordered the book you rec from my library, so am looking forward to reading that thanks. I expect it's a really good one to own, but it's all so expensive with these tests, etc, isn't it! Will keep eye out for a 2nd hand copy, as, as you say they're good to keep dipping into, wouldn't be without my b12 ones.

Symptom wise it's really difficult to know what's what at the mo, time will tell I guess, what is going to improve with the b12, early days yet. Started reading about pituitary gland problems causing raised tsh, but then perhaps the thyroid issue is very early stages, so at least have spotted it and can keep an eye.

Think I'll prob retest myself in 3 months to recheck antibodies as you suggest...

Thanks again...jo :)


Jo5454 You asked

"Do you think the f4 has improved this time because the tsh has gone up and is helping it?"

No, and this is what I find puzzling. The norm is as TSH rises (more hypo) the FT4 goes down (more hypo). Your FT4 has gone up (an improvement) and I would have expected to see your TSH go down (an improvement) but your TSH has risen (more hypo).


Thanks SeasideSusie...bit of a mystery that one then! Don't suppose you know if a raised tsh can cause spots do you? I've been getting increasingly more of them since my 6 th injection and know this can happen to 1 in 10 on b12 but much worse now, lots of small ones joining to make large very sore lumps on my face and wondered if this is due to the tsh? Oh the joys, eh:)


Jo5454 No, sorry, I don't know anything about raised TSH causing spots. Sounds very sore :( .


Thanks anyway, bit reluctant to ask my dr I case he says it's too much b12! Just when I thought I'd finally grown out of spots! Oh well, minor detail in the grand scale of things I guess...:) just have to put up with them because the injections are steering to work on some symptoms which I'm eternally grateful for! :)


Hi there

With tsh at those levels do you have hypo symptoms? If so print out the NICE guidance on giving people with high tsh (which you have) but sub clinical levels and symptoms a trial of levo.

Link to NICE guidance is on the bottom of my profile

Good luck


Hi TupennyRush, thanks very much for your reply. My symptoms have been put down to ME, and more recently a diagnosis of functional b12 deficiency from St Thomas hosp. So it's hard to distinguish what is due to what at the mo!

The balance probs are def improving and things like remembering where my feet are, also migraines, pins needles and vision probs much better. Brain fog is improving couldn't remember names or even work out what clothes to put on and finding myself doing alsorts if strange things like trying to put the washing up bowl in the freezer,Lol! Still foggy headed and memory not good, but assuming this will improve! Very tired, muscle aches which somehow feels worse in the mornings, like I'm wading through mud to get going. I'm underweight, feel the cold. Persistent infections of sinusitis have improved, but often still a blocked nose. Have spells of breathlessness. have become much more anxious over past few years, like system overreacts to small things, but general mood is improving now with these injections...

Thanks for the link will have a read of them...jo :)


Look for info on Izabella Wentz - she has a website, a Facebook page, and a popular book. She calls herself the "thyroid pharmacist". She's a Hashimoto's sufferer herself.


Many thanks again human bean...I will look her up...:)


I assume you're unmedicated? Just a thought, ask your gp if they'll accept a private test. If not, will you consider self-medicating? If you're going to self-medicate I wouldn't worry about waiting until your tsh goes above 10, which I assume is what your gp is waiting for. If they're only going to test once every six months it may take a very long time indeed for your gp to put you on meds.


Hi, thanks puncturedbicycle, my dr didn't seemed to have a prob with the private test, but I'm going to retest myself again after 3 months I think. I've had quite a long battle and finally private active b12 test to get these b12 injections, so was hoping to get settled into them before starting something else? He seems to think that the t4 is ok at the moment and none of my symptoms are down to a raised tsh? Not really sure myself...thanks for your advice.


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