Thyroid UK

Thyroid Blood tests and Cholesterol Levels- Can anyone translate please??


I am in the midst of trying to stabilise my Thyroid- I have been been under-medicated for years as my GP refuses to believe the blood tests I have done. My latest was :

TSH 0.38


Free T4 28.2


Free T3 4.0

( 3.1- 6.8 ) pmol/L

I am on - now 100mcgs Levo - I was on 150mcgs but as the T4 is a mahoosive 28.2, they have reduced me to 100 (was on 75mcgs before and TSH was 29.....

Am also concerned re the high Cholesterol but the GP again is not overly concerned....Can anyone who can make sense of it - please please give me a steer....

Cholesterol 7.3 (>5)

Triglycerides 0.74 (<2.30)

HDL Cholesterol 2.77 (1.2-1.7)

LDL Calculation 4.23 (<3.0)

HDL/Cholesterol Ratio 0.38 (>0.25)

Cholesterol/HDL Ratio 2.64

Non-HDL Cholesterol 4.5

The numbers just blind me and I can make no sense of it all :(

Much appreciated

3 Replies

luley Those figures are fairly like mine were - I had a suppressed TSH, my FT4 was way over range and my FT3 a bit higher than yours.

Here's my interpretation (and it's what mine was)

TSH - basically ignore that, you're on thyroid meds, doctors are TSH obsessed but it's not the TSH that matters, it's the FT3.

Free T4 28.2 (12-22) - that is 162% of range (should be in the top third ie 19+)

Free T3 4.0 ( 3.1- 6.8) - that is 24.3% through range (should be in the top quarter ie 5.9+)

FT4:FT3 ratio is 7.05 : 1 (should be 4:1 or less for good conversion)

Basically you are not converting T4 to T3 very well, neither was I, and I also had that confirmed with a private thyroid urine test.

What I did, and you could consider, is add some T3. I wouldn't have reduced from 150mcg Levo to 100mcg, I would have reduced from 150 to 125 and added in a quarter of a tablet (6.25mcg if privately sourced, 5mcg if NHS) T3 for two weeks, then add in another quarter so a total of 12.5mcg or 10mcg depending on source. Then see how things are and tweak meds again if necessary.

I repeated my urine thyroid test after a while on T3 plus Levo and my results are much better, the T3 has made a real difference. I've yet to do blood tests to compare with my old ones.

Once optimally medicated, cholesterol should sort itself out.

What about your vitamins and minerals - Vit D, B12, folate and ferritin? Are they all at optimal levels (not just in range) as this is what is needed for thyroid hormone to work properly. Have you had them tested? If not then ask your GP or get them done privately and supplement where necessary.

In any case you could supplement with selenium as that helps with conversion of T4 to T3.


Please do NOT be concerned about your cholesterol - it is very much needed in the body in order to produce efficient hormones. Also the brain is over 25% cholesterol. Cholesterol is also involved in the metabolism of the suns rays into VitD. Many years ago when people had raised cholesterol - they had their thyroids treated :-)

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That was quite a big drop from 150mcg down to 100mcg. You might have found 125mcg was nearer the mark. Some of us need very fine adjustment in dosage.

As Seasise Susie says....what about levels of Vit D, B12, folate and ferratin. All these need to be at very good (not just average) levels for thyroid hormones to work. They are often very low with thyroid issues - possibly due to low stomach acid and/or gluten intolerance, especially if have Hashimoto's

If vitamins not been checked recently ask GP to do them. If they won't, then like many of us here, you can get them checked privately

Blue Horizon - thyroid plus eleven test will check all these plus both types of thyroid antibody

Easy to do finger prick test at home, post back and they email you the results.

Recommended all thyroid tests are done as early as possible in morning, don't take thyroid hormones in 24 hours beforehand, no food or drink (other than water) before test. Take thyroxine immediately after.

Do you know if you have Hashimoto's? (High antibodies) if you do, then adopting a 100% gluten free diet may help reduce symptoms. Selenium can also help.

Also assume you know that thyroxine always needs taking on empty stomach, no food or drink (including tea or coffee) for at least hour after. Many take on waking, but some of us find taking at bedtime suits or works better. Trial and error to see which you prefer.

No other medication at same time as Levo - especially iron or magnesium must be at least 4 hours away .

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