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Thyroid UK
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New labs - can anyone interpret pls?

Hi All, Hope everyone's enjoying the warm weather. I recently took the Thyroid Plus test Genova and have my results to post. Any help interpreting would be very much appreciated. I am currently being treated by Dr Peatfield for low thyroid due to poor conversion and presently on T3 only (75mcg/day split into 3 doses). I've been on this dose for around 7 months but my symptoms have returned/worsened (basal temp is average <36.2 and main symptoms are low energy, fatigue, headaches, constipation, hair loss, facial puffiness and inability to lose weight despite all efforts). Wondering if this might be due to needing a dose increase perhaps? I thought 75mcg was quite a lot and so I wasn't sure whether I should raise further? I will be sending Dr P the new labs for analysis and further guidance on my treatment. However this takes time so in the meantime I wondered if you could interpret my results and advise accordingly.

Many thanks in advance.

My results are as follows:

Total T4 = < 13 L range = 58 - 161 nmol/L - Outside reference range

TSH = 0.51 range 0.40 - 4.00 mIU/L - Within reference range

Free FT4 = < 3.9 L range 11.5 - 22.7 pmol/L - Outside reference range

Free T3 = 9.3 H range 2.8 - 6.5 pmol/L - Outside reference range

FT4 : FT3 Ratio = 0.4 L range 2.0 - 4.5 Ratio - Outside reference range

Reverse T3 = < 0.14 L range 0.14 - 0.54 nmol/L - Outside reference range

TG < 20 range < = 40 IU/ml - Within reference range

TPO < 10 range < = 35 IU/ml - Within reference range

I also had some other blood tests which may be useful to know:

Serum total 25-hydroxy Vit D level = 89 nmol/L range 75.0 - 250.0

Serum ferritin level (XE24r) = 34 ug/L range 10.0 - 322.0 Note: this was a repeat test from one done in Jan this year when the result was 40 ug/L (same range).

Folate tested in Jan was 19.9 ug/L range 5.4 - 24.0 - Test wasn't repeated this time.

11 Replies


Did you take T3 before your blood draw?

Thyroid antibodies are negative for autoimmune thyroid disease (Hashimoto's).

VitD is in the replete range 75-200.

Ferritin is low in range. >100 to halfway through range is optimal. Supplement iron with 1,000mg vitamin C to aid absorption and minimise constipation. Take iron 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 Clutter, thanks for replying. I'll start supplementing the iron with vit C.

I'm already supplementing vit D.

I left 12 hours between my last dose of 25mcg T3 and the blood draw in order to give a clean sample. There wouldn't have been much left in my blood after that length of time. The half life of T3 is only 4-6 hours, I believe.

It does state that the ratio FT4 : FT3 is low - do you have any experience of this and what it could indicate? Is this the conversion problem showing up? Also, any thoughts on the low Total T4 and RT3?

I did understand the results for Hashimoto's - Genova had confirmed already. It was the above results that I could do with help on. I realise it's difficult to interpret as it's extremely complex. If you can't help with this it's not a problem as I'll be having phone consult with Dr P once I've sent him the results.

Thanks again for your time and advice.




You are over medicated. FT3 should remain <6.5. I would reduce T3 dose by 12.5mcg and retest in 8 weeks.

FT4, FT4:FT3 ratio, and rT3 are low because you are taking T3 only. Any conversion issue you may have had is overcome by adding T3 to Levothyroxine or taking T3 only.


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.


Okay, thanks for the analysis. I'll reduce my dose and see what Dr P suggests following consult. Do you think the conversion problem is no longer an issue for me then? Confused about what could be responsible for my continuing low thyroid symptoms then?

Many thanks.



You might have a problem converting T4 to T3 if you were taking Levothyroxine only but you bypass any conversion issue by taking T3 only.

You may find your symptoms are due to over medication. It will speed up washing out the high T3 if you halve your T3 daily dose for a couple of weeks.


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.


Your low iron stores may be responsible for your fatigue and possibly the hair loss. Low nutrients rarely happen alone - is there a clear reason for low iron, like heavy periods or vegetarian diet, extreme dieting, or could it be from a malabsorption problem?


Hi Aspmama,

I don't tick the box for any of those causes: I used to have heavy periods following the birth of my youngest child 6 years ago, but not any longer as I had coil fitted so now they're non-existent. I don't know anything about malabsorption problems or if I have one - how would this be checked? What supplementation do you recommend for dealing with low iron stores?


ok. I would use ferrous fumerate or bisglycinate .. not ferrous sulphate, or Solgar gentle iron, but that's expensive. Start with 200 per cent of the rda, and build up slowly, stopping if you have side effects. Do you drink milk? If you don't, and you diet is low in fish you may be short of iodine, since you don't have Hashis you could anyway try supplementing iodine or dramatically up your fish intake and see if that helps. You could also try some magnesium, if you haven't already, to see if that helps the constipation. It might be that for some reason your body is not absorbing minerals well. Low magnesium can link to constipation. Take all mineral supps away from each other and from thyroid meds - not easy. There's no easy answer to what is wrong. Do you have reflux or bloating?


I'll give the ferrous fumerate a try. I already take magnesium supp as it's helpful for reducing headaches. I drink milk in tea and coffee, and eat greek yoghurt daily, fish twice a week. I could upping the fish and or iodine. I'll try taking the mineral supps away from other meds to see if this helps. I do have bloating, yes. What test is there for checking malabsorption?


It's v difficult. One cause of malabsorption is celiac disease, if you haven't been tested you can get a cheap test on the internet. It is unlikely, but possible. Maybe a 1 in 50 possibility Worth excluding though.. check the match to your symptoms, quite close.

The test will only work if you are eating gluten. if it comes back negative it is still worth cutting gluten out completely for say eight weeks, and watching your symptoms carefully.

You could then test to exclude h pylori.


Thanks for replying. That's interesting and is an idea to pass on to Dr Peatfield. So my family does have history of metabolic disorders: My dad has Multiple Systems Atrophy, which is an aggressive form of Parkinson's, my mum suffers from chronic psoriasis & her cousin died of MS in her thirties.

I'll forward the info to Dr P to consider in his next review of my treatment.


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