Blue Horizon blood results, what do I do now? - Thyroid UK

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Blue Horizon blood results, what do I do now?

I was diagnosed hypothyroid about 15 years ago and given levothyroxine, told to take tablets once a day. that is all I was told. I am currently taking 125 mcg a day.

All this time I have felt exhausted, put on 7 stone in weight, and a whole other bunch of thyroid symptoms. got usual response from dr's, - "bloods are in range so eat less & move more."

So now I am taking control of my condition starting with blood test thyroid plus eleven, these are my results, any advice would be very appreciated.

blood sample was taken about 7am, 25 hours after previous dose and after fasting 12 hours.

CRP H 5.10 (<5.0)

Ferritin 46.0 ( 20 - 150 )

TSH L 0.05 ( 0.27 - 4.20 )

T4 total 141.0 ( 64.5 - 142.0 )

Free T4 21.50 ( 12 - 22 )

Free T3 4.90 ( 3.1 - 6.8 )

Anti-Thyroidperoxidase abs H 335.8 (<34 )

Anti-Thyroglobulin abs H 677.7 (<115 )

Vitamin D (25 OH) L 18 (Deficient <25, Insufficient 25 - 50, Consider reducing dose > 175 )

Vitamin B12 L 195 (Deficient < 140, insufficient 140 - 250, consider reducing dose >725 )

Serum Folate L 6.55 ( 8.83 - 60.8 )

15 Replies

You are failing to metabolise your thyroxine because of your poor co- factors. And you have Hashimotos thyroiditis.

1) Go gluten free to try and damp down the Hashimotos disease

2) You may have low stomach acid which might account for the low co factors. Search on here for low stomach acid and take ACV or betaine if you think that is likely

3) Supplement with folate/ folic acid, sub lingual B12 lozenges, Vitamin D and Vit K2, magnesium and ferrous fumarate.

4) Try to change your diet, cut out sugar completely, up your green veg, eat liver once a week.

Easy, eh? Don't expect miracle improvements, but things should pick up in a few months. Sorry this is the short answer, I am on my phone. Sure others will be along to amplify soon.


Ruthi, thank you for your reply.

when I saw these results it was obvious I have hashimotos disease, but doctors never tested for antibodies.

I will definitely go gluten free immediately, and start with some supplements to boost my system. I think the only problem with my diet comes from refined carbohydrates which I will now eliminate.

I am expecting it to be slow progress, but progress is all I am after whatever the speed.


The more I think about you the more I think there is something else going on to cause such poor absorption, and probably make you feel rough. Before you give up gluten ask your doctor to test for coeliac disease, and also pernicious anaemia. Both AI diseases associated with malabsorption. Blue horizon do the tests, but they aren't cheap!


Just double-checking. You aren't on any medication for heartburn or such like, are you? Omeprazole, lansoprazole or any other -azole?


Hi, the only medication I am on is Levothyroxine.

I think I will Phone GP surgery in the morning and try to get an appointment, I am fed up with feeling so rough


Good luck!


How can I know if I am converting T4 to T3 adequately, and is it likely to improve when vitamins etc. are more optimal.


I would want to know why the B12 is so low. Are you a vegan/vegetarian ? Do you have gut issues preventing the uptake of the vitamins and minerals ? Folate and B12 work together in the body and BOTH are VERY LOW.

Do you have anyone in the family with Pernicious Anaemia ? - it may be worth asking your GP to test for this condition which is more common than Docs realise. There is an excellent website for the PAS - take a look and check out the symptoms list to see if anything rings a bell for you. There is also a PAS forum here on HU. Having one auto-immune illness - could pre-dispose you to another. PA is also auto-immune :-)


Hi Marz, Thank you for replying I am not vegan or vegetarian I eat meat, fish, eggs, cheese , I thought I ate quite a healthy diet I buy organic fruit and veg, organic pasture raised meat free range eggs I also eat fish and shellfish, I am now thinking it may be the gluten in wheat based products ie. bread and crackers.

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Glad you are enjoying a good diet. Sadly it is not what we eat but what we absorb that improves our health. Do you have any gut issues ?


I do get bloated when I eat anything with wheat and I love fresh bread but I will have to learn to live without it from now on. However if it makes me feel better and less zombie like then it is a sacrifice I am willing to make.

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I have been GF for over 3 years. You can click onto my name above and read of my journey to wellness ... still bumpy at times. Maybe you could complete yours - it saves lots of time for everyone 😊



As for the Hashi's, as Ruthi says adopting gluten free diet can help reduce the antibody attacks. Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks.

Also, supplementing with selenium, L-selenomethionine can help reduce them, as does keeping TSH very low or suppressed.

Some reading about Hashi's:

and Gluten/thyroid connection:

Your total T4 is high, so plenty sloshing around, but as Eljii has mentioned it doesn't seem to be converting well enough. Good conversion takes place when the FT4:FT3 ratio is 4:1 or less (Eljii often quotes 3:1) and yours is 4.38 : 1 . The aim of a hypo patient is for TSH to be 1 or below (tick :) ) and FT4 to be in top third of range (tick :) ) and FT3 to be in the top quarter of range so 5.8+ - all this being appropriate if that is where you feel well. Your FT3 falls a lot short of that so again it points to maybe adding some T3 as Eljii has mentioned.

However, your vitamins and minerals are far from optimal and thyroid hormone can't work properly unless "all our ducks are in a row".

Ferritin: 46 (20-150. This should be half way through it's range so 85. I've seen it said that for females it is best around 100-130. You need to supplement with iron or eat liver once a week.

Vit D: 18 - dreadfully low. Recommended level is 100-150nmol/L You need to start supplementing with D3 and personally I would start with a loading dose. I started with 40,000iu daily for 2-3 weeks then reduced to 5000iu daily. Not everyone is comfortable or can handle that much to start with so maybe start at 10,000iu daily for a month then reduce to 5000iu daily. Retest in the spring to see where your levels lie, aiming for 100-150. My preference is for softgels (I used Doctors Best) as there are no fillers, only D3 and usually olive oil, nothing else.

When taking D3 we need to take it's important co-factors K2-MK7 and magnesium. D3 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 can cause problems like calcification of the arteries, kidney stones, etc. D3 and K2 are fat soluble and should be taken with the fattiest meal of the day.

Magnesium comes in different forms, check these out here and decide which is best for you . Magnesium is calming so best taken in the evening.

B12 is extremely low so I would do as Marz says and discuss this with your GP. You could very well need B12 injections.

Folate is under range, again discuss with your GP.

For more advice on B12 here is the link to the Pernicious Anaemia forum


A big thank you to all who have replied, you are extremely helpful.

My first Thyroid function test all those years ago came back with a TSH of 20 so GP diagnosed Hypothyroidism, never tested antibodies for hashimotos.

I think that I need to go to see my current GP to discuss these results and hopefully get extra test as you recommend.

I lost 1 stone with weightwatchers in about 1 year then put on and lost the same 3 - 4 lbs for the next 6 months so I left weightwatchers. I now do intermittent fasting, only eating lunch and dinner and I have lost another 12 lbs over the last 6 months.

I am now going to go gluten free and make sure I eat liver every week.

I need to get my energy and my life back. I will be 50 at the end of this month and I remember telling my GP very cold and painful hands and feet when I was a teenager and was told it was vasodilation so my veins were letting the heat out instead of constricting and keeping the heat in. looking back I have had symptoms for many years before anyone ever tested for thyroid function.


thank you, I will try to read through that latter, and hope the brain fog will let me make some sense of it.


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