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Thyroid UK
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Trying to understand test results, please can anyone advise how to read them?

I am new to the site and after reading very helpful guidance on this site, decided to send off for blood test.

My GP says the tests that they do are in normal range and does not advise increasing dose because of family history of heart disease, anuerism and strokes. I am on 50mcg Levothyroxine and have hashimotos.


CRP 2.70 <5.0 mg/L

Ferritin High 152.7 20 - 150 ug/L

Thyroid Function

TSH High 4.92 0.27 - 4.20 IU/L

T4 Total 108.3 64.5 - 142.0 nmol/L

Free T4 18.72 12 - 22 pmol/L

Free T3 3.60 3.1 - 6.8 pmol/L


Anti-Thyroidperoxidase abs High 156.9 <34 kIU/L

Anti-Thyroglobulin Abs 98.0 <115 kU/L


Vitamin D (25 OH) 54 Deficient <25 nmol/L Insufficient 25 - 50 Consider reducing dose >175 Vitamin B12 Low 187 Deficient <140 pmol/L Insufficient 140 - 250 Consider reducing dose >725

Serum Folate 21.96 10.4 - 42.4 nmol/L

13 Replies

rosw Do you have the results of the tests that your GP considers are in normal range? If you don't have the results, ask your surgery for a print out and put them on here (with reference ranges) as it will be a good idea to compare them with your BH tests.

As for these tests, your ferritin is high, are you supplementing with iron? If not it could indicate inflammation somewhere.

Your Vit D is too low, recommended is 100-125. You should supplement with D3. Take 5000iu daily for 2-3 months and then reduce to 5000iu on alternate days as a maintenance dose. Retest after a few months to ensure you don't go above the recommended level.

When taking D3 we need K2-MK7. Vit D aids absorption of calcium from food and K2 directs it to bones and teeth rather than arteries and soft tissues. Magnesium is another co-factor when taking D3 so you should also supplement with that.

B12 is dreadfully low but I don't think it's low enough for your GP to offer injections. The Pernicious Anaemia Society recommends 1000. You may want to ask over on the Pernicious Anaemia Society forum here on Health Unlocked for further advice on that as they may suggest you ask your GP to test intrinsic factor. I don't know enough about that to say any more.

If your GP doesn't offer injections then you need to supplement with Solgar or Jarrows sublingual methylcobalamin lozenges 5000mcg daily for a few months then reduce to 1000mcg daily for a maintenance dose. Dissolve under the tongue, don't swallow. When taking B12 we also need to take a B Complex to balance the B vits. Thorne Basic B or Jarrows B Right both contain methylfolate which is natural and the better form that folic acid.

Introduce supplements one at a time, with a week to 10 days before introducing the next one so that you can identify what causes any adverse reactions if you should experience any.

As for your thyroid tests your TSH is over range. The aim of a treated hypo patient is for TSH to be 1 or below or wherever it's needed for FT4 and FT3 to be in the upper parts of their respective ranges. Leaving you under medicated, as you are, is more dangerous to your health than giving you an increase in your levo to bring your levels to where they should be.

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, wrote this in a Pulse Online magazine article:

"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance.

But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."

Maybe your GP would be interested in this. If you email louise.roberts@thyroiduk.org.uk she will let you have a copy of the article which you can print out and show your GP because he seems to need educating.

As you already know you have Hashimoto's, are you addressing this by being scrupulously gluten free to help reduce the antibody attacks. Supplementing with selenium also helps reduce the attacks.




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Thank you so much for the reply. I will try and get my GP results. I have also had a frozen shoulder since January maybe this is the reason for the high ferritin result. I have received a delivery of B12 from amazon, but was waiting for my test results dosage is 1000ug 1 tablet daily, do you think I would benefit from taking more than 1?


See what happens when you discuss the B12 result with your GP. If you don't get any injections and go onto the sublingual lozenges then it may be cheaper to buy the higher dosage than use multiples of 1000mcg. You will need the lower dose eventually as a maintenance dose anyway so they won't be wasted.

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Your b12 is on the floor, and you are not converting the levlthyroxine you are taking into the useable hormone t3. Although the t4 looks to be a reasonable level, the tsh is raised. ( ideally it should be less than 1). This may well be because of the low t3, which is connected to to low b12.

More problems seem to arise with hearts due to undertreated hypothyroidism, than with over treated. An interesting book to read cocering this is hypothyroidism type II. by dr Mark Starr.

Is your doctor going to give you b12. Injections? If not, buy some sub lingual b12 tablets, And take them daily.... (Amazon do them)

Worth asking for a referral to a good endocrinologist, you could use a dose of t3 Atm. Ask on here if there are any recommendations fir endos in your area.

Xx g

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Thank you so much for the reply, I will ask my GP about the B12 injections. Should I wait to take the supplements until I have seen my GP? I will take the test results when I go to the GP.


As you only want to add one supplement at a time, and should wait a week to 10 days before adding another, you could start with the vitamin D.

Get appointment with GP ASAP to discuss B12 and the need to increase your Levo.

Going gluten free may help reduce your symptoms and might help slowly lower antibodies.

Selenium supplements can help lower antibodies and improve conversion of T4 to T3




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50mcg is only a small dose which many start on .It is nonsense to suggest an increase from there would have adverse future effects ,more likely the opposite.

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Before you take the B12 supplements I would suggest further tests. These should help with a proper diagnosis and proper treatment. Your doctor can do them but if not, have them done privately. St Thomas will do them for example. Methymalonic Acid (MMA) and homocysteine (hcy). Both will be elevated with B12 deficiency- high hcy in itself is a risk for strokes and heart attacks. (Should be round about 6-8). Should come down quickly after B12 treatment. Also have intrinsic factor done- dr- know that it's accuracy is lousy but if it indicates that if it comes bk +ve this would be right, only a -ve is about 50% inaccurate! If positive then you have the autoimmune pernicious anaemia.

Note that mine was at 198 (fortunately our range lower than yours). All my tests came back elevated. I have to inject every 4 days or so to manage. Lots of thyroid and B12 overlap.

Yes, your thyroid meds far too low as everyone says. That's just a starting dose I think. Can make matters worse being under medicated.

I also have high ferritin levels- and no I haven't discovered why - the dr just ignores it.

I'm trying to go gluten free to reduce anti bodies.....

Good luck

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frozen shoulder is not from high ferritin its from badly treated hypothyroid


Or can be low vitamin D combined with being under treated for thyroid

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Could be vit d3 but IMHEwith my husband who had 2 completely frozen shoulders its untreated hypothyroid

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When I slowly started vitamin D supplements, frozen shoulder appeared, until I increased Vit D to 6000iu.

When I experimentally dropped Vit D back to 4000iu, frozen shoulder came back. On 4000iu my Vit d level started dropping again too. ( I have coeliac so have malabsorption issues)

Currently back on 6000iu. Will be interesting to see if frozen shoulder reappears if/when I reduce Vit D again.

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That is interesting frozen shoulder is painful especially at night. I had a steroid injection last week which seems to be helping.


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