Thyroid UK
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Blue Horizon results

Finally took the plunge and had bloods done with Blue Horizon! Here are the results. I am on 150mcg of Thyroxine. When I was on 125mcg I felt quite bad so GP agreed to me having 150 if "we keep an eye on your TSH". I am a little confused at the results as my TSH is now too low. I would be so grateful if some of the very clever people on here could have a look and give me their opinion please? I am still lacking energy and finding it almost impossible to lose weight. I was hoping the results would have been a bit more clear cut- I almost feel like a fraud now. Why do I still feel so yukky?

Biochemistry HbA1c-(IFCC) 35 20 - 42 mmol/mol CRP 0.50 <5.0 mg/L Ferritin 148.1 20 - 150 ug/L Magnesium 0.99 0.6 - 1.0 mmol/L

Hormones Insulin 30.8 0 - 88(Fasting) pmol/L

Thyroid Function TSH L 0.11 0.27 - 4.20 mIU/L T4 Total 119.0 64.5 - 142.0 nmol/L Free T4 19.88 12 - 22 pmol/L Free T3 4.48 3.1 - 6.8 pmol/L Reverse T3* 24.0 10 - 24 ng/dL Reverse T3 ratio L 12.15 Normal >15 Ratio Borderline 12-15 Low <12

Immunology Anti-Thyroidperoxidase abs H 38.6 <34 kIU/L Anti-Thyroglobulin Abs 24.9 <115 kU/L

Vitamins Vitamin D (25 OH) 51 Deficient <25 nmol/L Insufficient 25 - 50 Consider reducing dose >175

Vitamin B12 405 Deficient <140 pmol/L Insufficient 140 - 250 Consider reducing dose >725 Serum Folate 12.66 8.83 - 60.8 nmol/L

9 Replies


Your TSH is a little below range but that isn't at all important and you are not over medicated as FT4 and FT3 are within range. Read Treatment Options in Symptoms can lag behind good biochemistry by several months.

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.

HbA1C result doesn't indicate diabetes.

CRP indicates a lack of inflammation.

Ferritin is a little high in range but they may be due to Hashimoto's.

Vitamin D is insufficient, 100 is optimal. I would supplement 5,000iu D3 for 6 weeks then reduce to 5,000iu alternate days and retest in May. Take vitD 4 hours away from Levothyroxine.

B12 is probably fine but you could try supplementing 1,000mcg methylcobalamin to see whether it improves symptoms and energy.

Folate is fine.

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Thank you so much Clutter for such a prompt reply. If only my GP was as knowledgeable! :-)


Clutter, can I just ask your opinion on me switching to NDT instead of Levo? How do I go about it and where do I get it from please? Also, would you be concerned at my ferritin level? I have always been an active "outdoor worker", I am a 59 year old female and friends have always remarked at my upper body strength ( years of handling horses!) but of late I am feeling as week as a kitten and struggling to lift a 20kilo bag of horse feed. I was thinking "old age" had suddenly caught up with me, but maybe it's something else? Thanks in advance.



If you are suddenly unable to lift 20K bags you ought to consult your GP. There's nothing in your results which indicates why you are feeling weak. Ferritin is within range so there's nothing to be worried about.

If you don't feel well on Levothyroxine then it may be worth trying NDT. You will need to transition over a few weeks. 150mcg Levothyroxine is equivalent to 2.25 grains NDT. You can reduce Levothyroxine dose by 75mcg and add 1 grain NDT. 2 weeks later you could reduce by another 75mcg and add another grain NDT. 2 weeks later add 1/4 grain NDT.

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TSH L 0.11 0.27 - 4.20 mIU/L

T4 Total 119.0 64.5 - 142.0 nmol/L

Free T4 19.88 12 - 22 pmol/L

Free T3 4.48 3.1 - 6.8 pmol/L

Reverse T3* 24.0 10 - 24 ng/dL

Reverse T3 ratio L 12.15 Normal >15 Ratio Borderline 12-15 Low <12

You appear to have a problem with reverse T3. The ratio should be above 20. I have recently been looking into this because it's something that I thought could be my problem.

My TSH was always suppressed, my FT4 always over range but FT3 never more than half way through it's range. Yours are quite similar although your FT4 in range.

The normal advice when rT3 is a problem is to take T3 only for a few weeks to lower rT3 then reintroduce some Levo. Because I couldn't get my rT3 tested until recently, to try and lower FT4 and increase FT3 I reduced Levo and added T3, all done gradually over time with testing along the way.

Some explanation about rT3 here

Your TPO antibodies are over range, not by much but still over, indicating autoimmune thyroid disease. You can help reduce antibodies by going strictly gluten free and supplementing with selenium. I honestly don't know if you need to do it with your level of antibodies, but bear it in mind if you have fluctuations of symptoms and your antibodies test higher at some point, you could have tested them just when they were low this time as it's their nature to fluctuate.

Vit D is recommended to be 100-150nmol/L so you should supplement with D3 softgels 5000iu daily then retest in May. When you've reached the recommended level reduce to 5000iu alternate days as a maintenance dose.

D3 has important co-factors -

D3 aids absorption of calcium from food and K2-MK7 directs it to bones and teeth rather than arteries and soft tissues. D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, and D3 should be taken four hours away from thyroid meds.

Magnesium comes in different forms, check to see which would suit you best and as it's calming it's best taken in the evening, four hours away from thyroid meds

B12 and Folate work together, both are on the low side. B12 should be top of range, even 900-1000, anything under 500 can cause neurological problems, and Folate should be at least half way through it's range.

You can buy some Solgar sublingual methylcobalamin lozenges 5000mcg and dissolve one under the tongue to get directly into the bloodstream where it's best absorbed. When you've finished the bottle get some 1000mcg strength and take one daily as a maintenance dose.

When taking B12 we also need a B Complex to balance the B vits. Thorne Basic B is a decent brand containing 400mcg methylfolate which will help raise your Folate level.


Wow! Thank you so much Seaside Susie. I will need to re-read all this info and inwardly digest. You are very kind. Thanks again. :-)


Can I pose some more questions please? I am now on 2.25 grains of Naturethroid and have been for two weeks now ( I built up slowly over the past 6 weeks) . The past few days, I have been experiencing extreme fatigue again plus other symptoms like those experienced when I was under-medicated. I'm also getting raised pulse ( 104) in the evening. During the day, my blood pressure is fine ( in the green on my machine- 128 over 75 this morning with a pulse of 87) I am not particularly fit at the moment ( I always have been an active outdoor worker) due to the fatigue caused by under medication. I feel fine at the moment, even though I can feel my heart beating quite strongly. Should I be concerned? Would it be safe to increase the NDT? Am I being impatient and does it take longer for NDT to make a difference? Sorry for so many questions, but I have no faith in doctors any more.


Since the post you are replying to is 2 months old now, you are much more likely to get replies if you create a new post. People often ignore new replies to old posts.

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Thanks humanbean, I did wonder. I've made a new one now. :-)

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