Thyroid UK
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Help with blood tests please

Have just received my blood test results and wonder if anybody could help me with what's going on. I have been on levothyroxine 50mg for a year but have felt so exhausted recently wondering if I still have thyroid problems.

Results are

CRP 1.00 Normal range <5.0 mg/L

Ferritin 182.4H Normal range 20-150 ug/L

TSH 2.07 Normal range 0.27-4.20 mlU/L

T4 Total 83.2 Normal range 64.5 - 142.0 pmoI/L

Free T4 14.71 Normal range 12 -22 pmoI/L

Free T3 3.10 Normal range 3.1 - 6.8 pmoI/L

Anti_Thyroidperoxidase abs 7.9 Normal range <34 kIU/L

Anti Thyroglobulin Abs <10 Normal range <115 kU/L

Vitamin D(25OH) 47L Deficient <25 nmoI/L

Insufficient 25-50

Consider reducing dose >175

Vitamin B12 498 Deficient <140 pmoI/L

Insufficient 140-250

Consider reducing dose >725

Serum folate 28.13 Normal range 8.83-60.8 nmoI/L

Many thanks

3 Replies

KM59 Yes indeed, you do still have thyroid problems. I'd say your GP doesn't know too much about treating hypothyroidism if he's kept you on 50mcg since September 2015.

The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it is needed for FT4 and FT3 to be in the upper part of their respective reference ranges.

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

If you email she will let you have a copy of the article which you can print out and show your GP and ask for a dose increase.


Your ferritin is over range so I would ask about that too.


Vit D at 47 is to low. Recommended level is 100-150nmol/L. You can buy some D3 sofgels like these

and take one softgel daily. Retest after 3 months and if you've reached the recommended level then reduce to one softgel alternate days. Keep an eye on your level to keep within the recommended range. Testing is recommended once or twice a year and we can get that done easily with a fingerprick blood spot test from City Assays if you're not repeating a Blue Horizon test.

D3 has important co-factors needed when supplementing

D3 aids the absorption of calcium from food and K2-MK7 directs it to bones and teeth where it is needed rather than arteries and soft tissues where it can cause problems. A good K2-MK7 is this one

D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 needs to be taken four hours away from thyroid meds.

Magnesium comes in different forms, check here to see which would suit you best and as it's calming it's best taken in the evening


With B12, anything under 500 can cause neurological problems, the recommended level is very top of range, even 900-1000. You may want to consider supplementing with Solgar sublingual methylcobalamin lozenges 1000mcg, one daily.

When taking B12 we also need a B Complex to balance the B vitamins. Choose one containing methylfolate rather than folic acid. That will help raise your folate level which is a little on the low side, recommended is at least half way through it's range which would be 35+


Thank you so much for this amazingly conprehensive reply. I shall be in touch with my Gp to discuss further. Any ideas what could be causing high ferritin - am bit worried it's something serious!


Without doing some research (which I'm afraid I don't have time to do now), I don't know what causes high ferritin levels. You should discuss with your GP or look for a reputable website for information so you will know what questions to ask your GP.


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