Thyroid UK
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Can someone interpret results please?

Am told my TSH is suppressed with normal FT3 and FT4 levels. I still have symptoms and Endo has told GP that I am at risk of osteoporosis if I up my Levo too much. He says I can up to 125mg at my own risk but that GP should monitor and if on 125mg my TSH is suppressed and I have either a raised FT3 or FT4, then I am clearly over replaced and should not be given that dose. I insisted on all the tests as recommended by a kind person on this site and omitted my dose of Levo from the previous 24 hours. Can someone please interpret my results and give some feedback? As follows;

TSH <0.02 (0.3 -4-8), FT4: 13.8 (7.7 - 20.6), FT3 5.3 (4.2 - 6.9), B12 253 (145 - 914), Folate 10.0 (3 - 20), Ferritin 89 (11 - 307) (15.03.17)

Thanks in advance

4 Replies


TSH is suppressed but you are NOT over medicated because both FT4 and FT3 are within range. FT4 is mid-range and FT3 is just below half way through range.

B12 is low in range. If you have symptoms of B12 deficiency pop over to for advice

Folate 10 is halfway through range which is fine.

Ferritin is optimal halfway through range. You can supplement iron with 1000mcg vitamin C to raise ferritin. Take iron 4 hours away from Levothyroxine.


Rotterdam study shows that suppressed TSH is not associated with osteoporosis. I don't think there is any study that show a link between osteoporosis or heart disease and low TSH where Free T3 and Free T4 are normal. Ask for proof. If you are on levo only, it is possible that you need over range FT4 to get high enough Ft3 - there's a Pulse article explaining that, which you can get from Your low B12 is of far more concern than your TSH - needs to be over 500 to avoid nerve damage. Your Ft4 looks lower than I'd expect for someone with that level of FT3 on levo only; you must have fantastic conversion.

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High thyroid hormones & a low TSH can cause osteoporosis when bone absorption exceeds bone production with a net loss of bone mass. Bone is continuously broken down and replaced by cells known as osteoclasts and osteoblasts and each cycle of bone “turnover” takes about 200 days and excess thyroid hormone will hasted this rate. ....

BUT many require a suppressed TSH when medicating Levothyroxine in order to function normally and your FT4 & FT3 are within range and your FT3 ( active hormone) is GOOD...

An over range T3 level can cause SHBG to rise, encouraging the risk of osteoporosis and bone fractures but yours is not high. Sex hormones are balanced only with balanced SHBG and estradiol actually has a bone preserving effect, as does weight bearing exercise, a healthy diet, iron and nutrients and optimal thyroid hormones.

There is also a risk of osteoporosis with low thyroid hormone, with the reduction of bone resorption as production decreases enough to result in fragile brittle bones (osteoporosis, osteopenia) but yours are not low.

If you still have hypothyroid symptoms, work on your Vit B12 and iron deficiencies as for many, adequate levels of both are required to make thyroid hormone replacement work optimally.


b12 and ferritin are way too low they must be at least halfway in their ranges


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