Thyroid UK

Positive DIO2 test and Hashimoto's

I had the saliva test carried out at Regenerus Laboratories and it came back as positive, i.e. I have a decreased ability to generate the active T3 hormone. Shortly after I had the Thyroid Check Plus Twelve test carried out at Blue Horizon Medicals (blood). [Incidentally this was straightforward to obtain being as I had permission from my GP for them to take blood at their surgery which was then forwarded to Blue Horizon in the special kit they send.]

The Thyroid Check Plus Twelve test came back with a high anti-thyroidperoxidase score of 74.2 (Normal being below 34) which is indicative of Hashimotos; Reverse T3 was high at 26 [10-24] and the Reverse T3 ratio was low at 9.39 [Normal more than 15].

Just wondering if anyone has any comment/tips to offer please and also to recommend any reading about same.

21 Replies

If you've had a Thyroid Check Plus 12, could you post all the results and reference ranges please. Just reporting the out-of-range ones isn't helpful in giving an overall picture of what is going on.


Thank you humanbean. Results and ref. range as follows:

CRP = 9.20 [<5.0]

Ferritin = 131.3 [20-150]

TSH = 2.57 [0.27-4.20]

T4 Total = 122.2 [64.5-142.0]

Free T4 = 19.73 [12-22]

Free T3 = 3.75 [3.1-6.8]

Reverse T3 = 26.0 [10-24]

Reverse T3 ratio = 9.39 [Normal >15]

Anti-thyroid peroxidase abs = 74.2 [<34]

Anti-thyroglobulin abs = 64.9 [<115]

Vitamins D, 25OH = 46 [Insufficient 25-50]

Vitamin B12 = 295 [Deficient <140, Insufficient 140-250]

Serum Folate = 18.35 [10.4-42.4]

Incidentally the TSH and Free T4 results were different from that taken with my GP a few months earlier which were TSH 1.45 and Free T4 18.9. This was the first year that they tested for FT4 but in 2015 the TSH was roughly the same. Anyone come across this before?


A lot can happen in 'a few months' thyroid-wise. Especially if you have Hashi's. But, were both tests done at the same time of day and fasting? Because that will make a difference.

One can see from your result, that you really aren't converting well. And, that leaves a lot of unconverted T4 hanging around, which is more than likely going to be converted into rT3. So, the high rT3 is not a surprise.

Are you taking any form of thyroid hormone replacement?

Your vit D and B12 are much too low, and need a bit of supplementation.


Many thanks for reply greygoose. Yes I can see what you mean by the unconverted T4. Maybe NDT will help? I understand Armour is no longer available on prescription? I need to see my GP with my results and ask her if she thinks it would be beneficial being referred to an endo. I've been taking 75mcg of Levothyroxine for the past approx. ten years.

I've already started taking Pharma Nord's Bio-Vitamin D2 capsules, 1000 (1 capsule daily). Is there any B12 supplement that you would say to take?


D2? That's the wrong one. It should be D3.

I have no idea if Armour is available on prescription or not. But, I'm not sure NDT would be any good for you, because it's mainly T4, that wants converting, with only a little T3. You'd end up in the same situation again. I would have thought that T3 only would be best for you - or perhaps with just a little T4.

Both Jarrows and Solgar do a good B12.


It is D3 I'm taking grey - it was a slip of the finger!


ah! That's ok then! lol

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If you want a good book on how the thyroid works then can I suggest the following book by Dr Barry Durrant-Peatfield - it is the book that really got me started on understanding how the thyroid works and what can affect it.

And on the subject of Hashimoto's Thyroiditis you should search for info by Izabella Wentz. She has a website, a Facebook page, and she has written a book on the subject. She is a fellow Hashi's sufferer but has managed to put her problems into remission. Her book gets good reviews on Amazon. (I've never read it, because I don't have Hashi's.)


There's so much information about thyroid problems that it's difficult to know what to read so that's great to get two recommendations. Thanks very much for taking the trouble to let me know.

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High (over the range) CRP (C-Reactive Protein), and ferritin (iron stores) which is in range but higher than expected for people with thyroid problems may be related.

You have autoimmune thyroiditis (also called Hashimoto's Thyroiditis), shown by the postitive result for Anti-thyroid peroxidase abs which could cause inflammation. Other causes (for high CRP, and higher than expected ferritin) are given in the links above and they may apply to you.

If you take any supplements which contain iron you should stop them now. Building up high levels of ferritin is not good for you. For anyone who is low in ferritin (which you aren't) the advice normally given is to aim for a mid-range result, and yours is already above this.

You haven't said whether you are currently taking any thyroid meds, but I'm guessing you aren't. Your TSH is higher than normal for a healthy person with no thyroid problems, and yet your Free T4 is quite good, so the higher than normal TSH is probably due to the poor level of Free T3 and the over the range Reverse T3. I doubt very much your doctor will treat you since the TSH, Free T4 and Free T3 are all in range.

Your Vitamin D is too low. Most of us feel at our best when vitamin D is around 100, although some people go up as high as 150. You need to supplement with vitamin D3 (NOT D2) at a dose of about 5000 iU for 2 or 3 months then retest. Once you have got your level up you will need to lower your dose (or take the same dose fewer days of the week) to maintain it at optimal. For best absorption take vitamin D with your fattiest meal of the day.

When people take vitamin D one effect of this is that calcium is better absorbed from the diet. This is usually desirable, but you want that extra calcium to go into your bones and teeth, you don't want it lining your arteries. In order to achieve this you must have good levels of vitamin K2, and supplementing is strongly advised. Please read posts on the subject by SeasideSusie who often writes about it. The Mercola website has articles on the subject that are worth reading.

Another essential ingredient for getting vitamin D and calcium where you want it to do the best job is taking magnesium supplements. They come in lots of different forms and have slightly different properties depending on which one you choose. Some can be chucked in the bath (epsom salts), some can be sprayed on the skin and some can be swallowed.

For guidance and advice on vitamin B12 and folate you should join the Pernicious Anaemia Society community here on HU - you can find them here :

Coming back to your thyroid, you may find that improving your nutrient status helps you feel better. You could take some T3 to see if it helps. What would happen (probably) :

1) You would have to buy it yourself. The NHS wouldn't prescribe it with your results.

2) Your TSH would reduce.

3) Your Free T4 would reduce.

4) Your Free T3 would increase.

5) The reduction in Free T4 would reduce your Reverse T3.

If you experiment, please do so very cautiously and don't rush to increase dose.

With regard to the subject of your positive antibodies you might want to try eating a gluten-free diet. It helps lots of people with thyroid problems.


Many thanks humanbean. Some good information there for me to ponder on. In answer to your question as to whether I'm taking thyroid meds., I've been taking Levothyroxine, 75mcg, for about ten years.


In that case you should get some T3 online and take a small dose in addition to your levo. Your thyroid results are not ideal for someone who is being treated.

Your TSH is too high.

Your Free T4 is fine. You wouldn't benefit from more levo because it would likely just boost your Reverse T3 even more.

Your Free T3 is too low. Mid-range is about 5 and your result is quite a bit under that. You should aim to get your result to the top third of the range which is about 5.5 - 5.6 or over, but it depends on how you feel personally. If you feel good with a mid-range result, then that is fine.

If you do well adding T3 to your existing dose of levo then you might want to leave it at that. But there are other options you could try.

1) Reduce your levo by 25mcg and increase your T3. This would reduce the raw material for creating Reverse T3.

2) You might want to consider switching to NDT which is the old treatment for hypothyroidism before levothyroxine was developed. Some people do far better on it than they do on anything else. Like T3, NDT can be bought online - write a new post asking for reliable sources.

3) Not something to jump into before trying the things mentioned above - you could try T3 only.

Be aware that as soon as you switch to any form of treatment other than straight levo the pattern of your blood tests will change. Doctors are only familiar with what to expect from Levo alone.

Keep very good records. Get a symptom list and score your symptoms, 0 for a symptom you don't have, and anything up to 10 for symptoms you do have, with higher scores the worse the symptom affects you.

When you get blood tests get a copy of the results, note what dosage and brand of thyroid meds you are taking and how long you've been taking it for, and keep a scored symptom list with it.

Be methodical.

Good luck. :)

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Fantastic - thank you for your time and trouble.


Excuse me for butting in but apart from the great advice already given, I think iron also needs some supplementation too?? Without good iron levels, the thyroid cant convert well.

As grey goose has already asked if you are taking any thyroid supplementation as you will need extra T3 given your DIO2 gene result and low FT3. I too have the DIO2 defective gene and have Hashimotos.


No problem Sticky - you're not butting in at all. It's always good to get help and nice that people take the time and trouble to reply. What would you recommend to take for the iron supplementation? Out of interest, how do you cope with having both the faulty gene and Hashi's?


I disagree with StickyBloodMentor , your ferritin level is 131.3 [20-150] and is more than adequate. Ferritin level is recommended to be half way through range, I've seen some people recommend 100. Too high levels is as bad as too low. humanbean has already mentioned that if you are taking any supplements that contain iron you should stop them now.

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I agree, I was looking at the serum folate!


Hi Val - This is how I have dealt with things and of course I can only speak for myself as I have medications and other autoimmune conditions to contend with. I had very similar results as you in as much as my FT4 and FT3. My TSH was already suppressed because I was already on Levo 125mcg daily. My RT3 was 0.29. I had high Thyroglobulin antibodies rather than TPO. My Endo put me on NDT and after a rather up and down 4 month period, I am now on 2 grains of WP Thyroid which I have found to be better than Nature Throid because of the fillers.

I am also Celiac so Gluten Free but was having continued stomach issues. I am working with an allergist and Dietician and have now found I'm sensitive to lactose and soya. Cutting them out has helped a lot and really not as bad as you might think.

I am also supplementing with Vit B-50 complex, Vit C 1000mg, Osteocare (Calcium, magnesium, Vit D & zinc) on the advice of the dietician and taking Optibac Probiotics extra Strength daily again on the advice of the dietician. I take a Spatone 3 times a week. I also have B12 injections from the GP every 2 weeks.

All of the above is now starting to make a difference and although I don't want to talk too soon, I think I have got the right balance. I am just waiting for some blood test results from the GP to see if I need to tinker with any of the supplements but will carry on until I get good results.

If I were me in your position I would try for a referral to a Endo or save up your pennies and go to a private one (mines private). I think you need to push your GP for B12 injections, probably need them indefinitely. Going GF will also help with your antibodies too in my opinion. The advice above is really good re T3/Thyroid meds which is why you need an Endo as it makes getting medication easier if its prescribed to you.

If you want to PM me anytime please do.

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Thank you for your helpful post Sticky which I will try to print out and put it in my ever-increasing thyroid file! Thank you also for giving me the option of PMing you. I may well need to do this in the not too distant future.

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Hi there

I also have Dio2. I felt better than I had pre diagnosis when I was on levo but still pretty rough. I found ndt did the trick for me but we're all a bit different. whatever the solution for you (t3 plus levo, ndt or ndt plus t3) you will need some t3 in the mix to feel well

Good luck

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It's always nice to get encouragement so thank you for posting Tupenny.

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