Advice on blood tests pls: Hi there I've just had... - Thyroid UK

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Advice on blood tests pls


Hi there

I've just had Hashis confirmed after 10 yrs hypo and 100 mg Levo. Can anyone advise/comment on Optimum vitamin and iron levels?

B12 1061 (I supp with methyl b12, ok I think)

Folate 8.2 (supp with active, I'm told this should be nearer 15-18 for hypo)

Ferritin 13 - right at low end of range, and was same last year. I've read only recently this should be closer to 80 for hypo (doc didn't mention). I've recently started on gentle iron solgar but wonder if I may have a conversion problem and diet good and not veggie

I started on active b12 and folate as I also have ME and suspected MTHFR and I started to work for me within days

Doc reduced Levo to 75mg in October as showing as overmedicated, and I reduced myself until I stopped taking it altogether before Christmas due to ongoing hyper symptoms. Hashis not confirmed until after xmas, TPO 327 vs range 109. After much reading I now know hyper symptoms are likely to have been attack on thyroid gland releasing thryroid hormones and that symptoms can be similar for both under and over active. I struggle with headaches and jaw pain which I think comes fro teeth grinding/clenching at night due to intense vivid dreams which I have when feeling hyper

Dec16 test tsh 17.7 (range 0.27-4.20) and t4 6.8 (range 10.8-25.5) these results after taking nothing for a week. I've started back on 25mg for last week or so, but def not enough as legs very achy but I've read you should wait 6 weeks before increasing.

Just wanted some advice on how to get the vitamins and minerals going in the right direction which I try to get the Levo dose right

Many thanks in advance

19 Replies

You can get hyper symptoms while being hypo for lots of reasons :

1) Low iron

2) Low T3

3) Low or high cortisol

4) Going through a Hashi's attack.

Could you post all your results with the reference ranges as well as the actual results, please. Since you are hypo, testing after a week with no meds is almost guaranteed to show you are seriously under-medicated with a high TSH and low Free T4.

B12 1061 (190-669)

Folate 8.2 (>3)

Ferritin 13 (13-150)

Above as of 16/12/16

Dec16 test tsh 17.7 (range 0.27-4.20) and free t4 6.8 (range 10.8-25.5)

Oct16 test tsh 0.06 (range 0.27-4.20) and free t4 25 (range 12-22) was on 100mg when test taken, then doc reduced to 75mg

Anything else you need? T3 not tested, I did ask about t3 and cortisol test but no joy. Doc seems a bit clueless but mentioned endo referral which I thought might be pointless or maybe useful if they will do the tests?

Many thanks

Since you've had so much help from Clutter and SeasideSusie, I won't go through it all again. But I wanted to say a few things :

Doctors use TSH to determine whether someone is optimally medicated on Levo. Unfortunately this leaves lots of people under-medicated. Patients have worked out that the really important thing is Free T3. This correlates very well with whether people feel well or under-medicated or over-medicated. For most of us who are hypo, having Free T3 in the lower half of the reference range is too low and we need it at least half way through the range and many need it to be as high as the top third or top quarter of the reference range to feel well. We each need to find the point at which we feel well because it can vary from person to person.

If you want to have a Free T3 test without measuring anything else then you can get a finger prick test done with Blue Horizon :

Or you can get TSH, Free T4, and Free T3 all done with a finger-prick test :

There are various combinations of test you can get from Blue Horizon. Another company to keep tabs on is Medichecks. Both companies have special offers occasionally which could save you money.

Probably the most popular test from BH is the Thyroid Check Plus 11 :

Medichecks does a similar test, but I can't remember what it is called.


To measure cortisol, the best test is the adrenal saliva test from Genova :

For info on how to order this test and get your results, see this link and follow the Genova links :


Hope that helps. :)


Why haven't you resumed 75mcg Levothyroxine? 25mcg will obviously be insufficient.

It will take forever to improve Ferritin on Gentle Iron which has very little elemental iron in it. It would be better to take Ferrous Fumarate with 1,000mcg vitamin C which aids absorption and minimises constipation. Take iron 4 hours away from Levothyroxine.

Taking a B Complex vitamin will raise folate.

Thyroid peroxidase antibodies are positive for autoimmune thyroid disease (Hashimoto's). There is no cure for Hashimoto's which causes 90% of hypothyroidism. Treatment is for the low thyroid levels it causes. Many people have found that 100% gluten-free diet is helpful in reducing Hashi flares, symptoms and eventually antibodies.

Ask your dentist to make you a nighttime gumshield. Within a couple of weeks my jaw pain, temple and neck pain had resolved as the shield prevented teeth grinding.

Thanks clutter

Doc said to start again on 25mg :) I tried for a week, and then went up to 50mg and then the nightmares started (which i now think is causing the teeth grinding and related pain) so I went back down to 25mg. As a test I took 50 on Friday, and lo and behold, a night a freaky dreams and woke up with tight jaw and excruciating headache. I've since read on these forums others have had issues with bad dreams when increasing dose, so it looks like I'll have to grin and bear it until it settles down? And try the shield as you mention

Tried the gentle iron after reading some reviews on here and a research paper about it being as effective as fumarate (although study on pregnant women). No harm trying the fumerate I suppose.

Have been gluten free for 5 yrs as intolerant, have to be strict as it gives me migraines. Am curious therefore what triggered the Hashis! I think I may be cross reacting which would make sense given my immune system is going nuts at the moment (reacted badly to gf oats last week) so I've recently gone grain free and fully dairy free to rule out possible food intolerance symptoms from thyroid symptoms - the headache/pain issues are different


Totally unnecessary to resume Levothyroxine at 25mcg when you were previously taking 100mcg and 75mcg. It will take you months to become optimally medicated if you start again at 25mcg.

Hashimoto's causes 90% of hypothyroidism. It is likely you always had Hashimoto's but it has only been confirmed by your recent thyroid peroxidase antibody test.

Grinding teeth causes gum inflammation and tooth damage as well as jaw, head and neck pain and tension. See your dentist about a gum shield asap.

Might be a silly question but is the gum shield in one or two pieces? Reason I ask is that I have 'trays' from the dentist specifically made for me by the dentist a year or so ago. Would these help in the short term whilst I get one made?


Mine was to be placed over the bottom teeth only. Sorry I've no idea what 'trays' are or what they're for.

Forgot to mention they are for teeth whitening. They are soft plastic shields that are made after taking an imprint of your teeth (like getting a key cut). You then put a drop of the whitening paste for each tooth and wear over your teeth at night, one fir the top and one for the bottom. As such your top and bottom teeth are not in contact whilst you wear them


Not sure whether they'll be strong enough but you could try them.


msglutenfreeuk Have you had Vit D tested? That's another important one.

Also, if not vegetarian then eating liver once a week will be a great help in raising ferritin levels. If you don't want it as a meal on it's own you can add it to casseroles, cottage pie, curry, bolognese sauce, then there's pate.

Tested for vit d and calcium last week, waiting for results. I was searching fir organic sources of liver this morning so will also try liver as well

SeasideSusieAdministrator in reply to msglutenfreeuk

Oh, well done on the liver :) It's really helped me. My ferritin level wasn't as low as yours but I couldn't tolerate iron supplements so I started eating liver just a few months ago and now I've gone from originally 35 to about 90.

I can't get organic where I live but use the local butcher and know that it comes from Welsh lamb (I live in Wales). I checked Asda's liver when doing an online shop once, it was from Poland :(

That's good news on the increase and great you know where's it coming from :) I'm studying nutrition so would usually look for food sources first before supplementing but am keen to go organic where possible. Liver pate here we come!

I think the teeth grinding and jaw pain is B12 related.

Too much or too little? Mine is 1061

Too little, my daughter has a problem with her jaw. Tmj, it's helped by magnesium too.

There are two things (that I know of) you can try which might reduce or ease the muscle tension and teeth clenching and grinding you suffer from.

The first is magnesium. There are lots of different kinds of magnesium supplements and you have to choose the one that appeals to you most :

Magnesium is good for people with thyroid dysfunction anyway. If you do a search for posts about magnesium you'll see it gets discussed here a lot. You would need to take about 350mg magnesium.

Another possibility is potassium. If you choose to try potassium do it conservatively because potassium may affect the heart rhythm. Do your own research on this so that you know the risks.

Thanks, I'll have a read of those. I currently take 250g magnesium Dynomins which lists mag citrate ascorbate lysinate and oxide as ingredients. I didn't know there were so many types, maybe there's a bette one for me :)

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