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24 hour urine thyroid versus blood thyroid results please help

I have had 2 thyroid panels done-1 blood , 1 urine. I thinks the blood shows normal thyroid function, but am I right in thinking the urine results seem a bit low, particularly the T3:T4 ratio? Could these results give me hypothyroid symptoms? Which would you say are more accurate? Have been diagnosed with M.E but I'm not convinced. Any help greatly appreciated.

Thyroid bloods:

TSH 1.06 REf range: 0.27 - 4.20 IU/L

T4 Total 130.8 64.5 - 142.0 nmol/L

Free T4 21.58 12 - 22 pmol/L

Free T3 4.25 3.1 - 6.8 pmol/L

CRP H 6.40 <5.0 mg/L

Ferritin 88.9 20 - 150 ug/L

Anti-Thyroidperoxidase abs 8.5 <34 kIU/L

Anti-Thyroglobulin Abs 11.3 <115 kU/L


Vitamin B12 374 Deficient <140 pmol/L Insufficient 140 - 250

Consider reducing dose >725

Serum Folate 29.29 10.4 - 42.4 nmol/L

Vitamin D Total Vitamin D : 137.4 nmol/L ADEQUATE (range greater than 50)

(25-hydroxyvitamin D 3 134.6 nmol/L

25-hydroxyvitamin D 2 2.8 nmol/L)

24 Hour Thyroid urine results

Urine Volume 1,600

Triiodothyronine -T3 : 1,030 (range 610-3380 pmol)

T4 Ratio Thyroxine (T4) 1,920 (range 1,030-8,240 pmol)

T3: T4 ratio: 0.54 (Range 0.50-2.00)

4 Replies

tickeyland You can't compare the two tests, as Eljii says blood test just shows how much thyroid hormone is in the blood, the urine test tells you how much is getting into the cells.

Your blood tests show:

Free T4 21.58 12 - 22 pmol/L - 95.8% through the range

Free T3 4.25 3.1 - 6.8 pmol/L - 31.08% through the range

FT4:FT3 ratio = 5.07 : 1 (good conversion takes place at 4:1 or less)

You are not converting T4 to T3 very well according to your blood test.

Urine test:

Thyroxine (T4) 1,920 (range 1,030-8,240 pmol) - 12.34% through range

Triiodothyronine -T3 : 1,030 (range 610-3380 pmol) - 15.1% through range

This shows some conversion is taking place at cellular level.

Your B12 is deficient at 374. Anything under 500 can cause neurological problems. Recommended is top of range, even 900-1000. You could supplement with Solgar or Jarrows sublingual methylcobalamin lozenges, say 5000mcg daily for a month to boost the level then reduce to 1000mcg daily as a maintenance dose. We need to take a B Complex when taking B12 to balance the B vits.


Thank you for the breakdown in %. Do you think taking T3/NDT would be helpful with these results? Or should I just steer clear. I know by B12 is lowish so have been supplementing for the last 5 weeks.


tickeyland I've just looked at your previous posts and see that you haven't had a diagnosis of hypothyroidism so aren't on Levo. I also see that your cortisol test came back with all four samples marked High and over range.

If you had a diagnosis and had been on Levo for some time with those results, and adrenals addressed, and everything else optimal, then I would have said maybe give NDT or a Levo/T3 combo a try. As I'm not medically trained I can't advise what to do in these circumstances.



Your thyroid blood results are euthyroid (normal) and thyroid antibodies are negative for autoimmune thyroid disease (Hashimoto's). There really doesn't appear to be any thyroid dysfunction.

B12 may be sub optimal. You could supplement 1,000mcg methylcobalamin to raise it plus a B Complex vitamin.

Folate is good.

VitD is excellent.


I am not a medical professional and this information is not intended to be a substitute for medical advice from your own doctor. Please check with your personal physician before applying any of these suggestions.

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