Thyroid UK
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First BH blood test- help interpreting results please

Hi all

It's my first post so here goes! :)

I was diagnosed hypothyroid in 2013 following birth of my 2nd child (TSH 9.9) . Maternal grandmother had Thyroid problems- goitre in younger life then hyperthyroidism when elderly.

I've been on gradually increasing doses of Levothyroxine, now on 100mg/125mg alternate days. Take at night time with water on empty stomach. Last GP blood test was Sept '16 TSH 1.92 (0.27-4.20) taken in the morning non fasting, GP said normal and no further action despite being symptomatic- fatigue, aching joints, swollen hands/feet, weight gain, tinnitus, slight hair loss, breathlessness, brain fog, occasional dizzy spells, gastric probs. GP won't test T3, Free T3 etc nor refer me to an Endo (said not needed).

I've just had my first Private blood tests done by BH and here are my results. Analysis says my TSH is high, antibodies high and B12 low.

CRP 4.90 (<5.0)

Ferritin 42.5 (20-150)

TSH 6.30 (0.27-4.20)

T4 total 111.7 (64.5-142.0)

Free T4 17.57 (12-22)

Free T3 4.31 (3.1-6.8)

Anti-Thyroidperoxidase abs 212.4 (<34)

Anti-Thyroglobulin abs 25.8 (<115)

Vit D (25 OH) 71

Vit B12 216 (insufficient 140-250)

Serum Folate 13.95 (8.83-60.8)

Can you help me decide what to do next please? Discuss with GP- will he discuss non NHS results? Get B12 supplements- if so which ones? Request increase Levothyroxine dose or request T3? Does this mean I've got hashimotos? I've never really felt well since diagnosis and have modified my lifestyle to accommodate my condition- limited social life, walking and get outdoors as much as I can but get regular sleep and rest otherwise I feel like a total zombie!

Many thanks in advance, I've tried to be as detailed as possible and sorry for the long post! :)

2 Replies

Hi Stokie and welcome.

Yes, you do have Hashimoto's, your high TPO antibodies confirm that. Hashi's isn't treated, it's the resulting hypothyroidism that is treated. You can help reduce the antibody attacks by adopting a strict gluten free diet which many members have found helps. Gluten contains gliadin which is a protein thought to trigger the antibody attacks. Some people also need to be dairy free. Supplementing with selenium also helps reduce the attacks, L-selenomethionine 200mcg daily is the normal dose. Keeping TSH very low or suppressed also helps.

Here's some reading about Hashi's:

B12 is too low, anything under 500 can cause neurological problems, it should be at the top of the range, even 900-1000. You could take Solgar or Jarrows sublingual methylcobalamin lozenges 5000mcg daily for 3-4 months then reduce to 1000mcg daily as a maintenance dose. Dissolve under the tongue for absorption directly into the bloodstream, don't chew or swallow as stomach acid destroys it. As it's sublingual you can take it without food.

When taking B12 we also need a B Complex to balance the B vits. Thorne Basic B or Jarrows B Right both contain 400mcg methylfolate which will help raise your very low folate level, this needs to be at least half way through it's range. Take B vits in the morning, no later than lunchtime as they can be stimulating.

The recommended level for Vit D is 100-150 so you could supplement with D3, 5000iu daily for a couple of months then reduce to 5000iu alternate days as a maintenance dose. Retest after 6 months to ensure you don't go too high.

When taking D3 we also need K2-MK7 and magnesium, both important co-factors. Vit D aids absorption of calcium from food and K2 directs the calcium to bones and teeth where it is needed rather than arteries and soft tissues where it causes problems.

Magnesium comes in many forms, you can read about them here and see which would be most suitable for you

Ferritin is also too low, it needs to be at least 70 for thyroid hormone to work properly, preferably half way through it's range. You could supplement with Ferrous Fumarate (buy from Amazon) and take one tablet twice a day. Take each tablet with 1000mg Vit C to aid absorption and help prevent constipation. Take iron 4 hours away from thyroid meds and other supplements as it affects their absorption. Finish the packet (usually 84 tablets) then retest.

Don't start all supplements at the same time. Start with one, give it a week or two to see if there are any adverse effects, if not add in the second one, give it another week or two, if no adverse effects then add in the third one, etc. This way if there are any problems you will know what caused them.

The aim of a hypo patient is for TSH to be 1 or below and FT4 and FT3 to be in the upper part of their respective reference ranges. You need an increase in your Levo.

Your GP may not may not accept your Blue Horizon results. If he won't then ask him to do those tests himself.

If he refuses to increase your levo then email and ask her for a copy of Dr Toft's article in Pulse Online magazine and show it to your doctor.

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, wrote this in the 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)."

I am not medically trained, my reply is based on personal experience, reading and research.


Many thanks Seaside Susie some useful information and next steps for me to consider! I'll update once I've seen GP.


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