Hi, I'm a newbie to this site and am hoping someone can please give me some advice. I am 53 years old, I exercise every day, have low body temperature (35.5-36.7), low resting heart rate (52), low blood pressure (90/60ish), I suffer from constipation. My doc recently arranged for me to have blood tests including thyroid check which came back as normal (only tested TSH level and T4 level). I decided to get a more thorough test done with medichecks, here are my results. TSH 1.99 (0.27-4.20) Free thyroxine 12.4 (12.00-22.00) Total thyroxine (T4) 72.6 (59.00-154.00) Free T3 2.86 (3.10-6.80) Reverse T3 16 (10.00-24.00) Reverse T3 ratio 11.64 (15.01-75.00) Vitamin B12 272.9 (140-724) folate serum 8.68 (3.89-26.80) 25 OH VIT D 51.27 (50.00-200.00) Ferritin 41.81 (13.00-150.00). Any advice and comments would be greatly appreciated! X

19 Replies

  • Central hypo. That's where your TSH is lowish, and your FT4 and FT3 are also low, because there's nothing wrong with your thyroid gland, but there's a problem with your pituitary, or hypothalamus, which means that the thyroid doesn't get stimulated to make more hormone.

    Doctors know nothing about that - and often miss it due to not testing the FT3. But your FT3 is well under range, and can in no way be called normal.

    Have you shown these results to your doctor?

  • Thanks for the reply greygoose. No, I haven't but have an appointment on 26th April and guess I should show her the results and see what she says?!

  • Oh and don't know if this is relevant at all but despite a fairly healthy diet and exercising daily my cholesterol is high at 6.2.

  • High cholesterol is a symptom of low thyroid. It has nothing to do with what you eat. Do not let your doctor bully you into taking statins, they are dangerous things to take. Your cholesterol will decrease if and when your FT3 increases. At the moment it is below range, so not surprising your cholesterol is high.

    And, on that subject, stop the daily exercising. It must be making you feel terrible! It uses up your T3, and you don't have enough TSH or T4 to replenish it.

  • Ah thanks for the info, and yes I do tend to feel rather achey most of the time and despite exercising daily and knackering myself out still suffer from insomnia! I will take your advice and cut back on the exercise.

  • Your B12, Folate, Vit D and Ferritin are not optimal - they all help to convert the T4 to T3.

  • Ah, i didn't know this silver fairy. I guess the first step is to get all of these levels up with supplements? Thank you

  • jennystephens1 Just to add to Greygoose's reply

    B12 272.9 (140-724)

    Folate 8.68 (3.89-26.80)

    B12 and folate work together.

    With B12, anything under 500 can cause neurological problems. Recommended level is very top of range, even 900-1000. You can supplement with sublingual methylcobalamin lozenges 5000mcg daily. When you've finished the bottle (usually 60 or so lozenges) the reduce to the 1000mcg dose as maintenance.

    Folate should be at least half way through it's range, so 16+ with that range. A good B Complex containing 400mcg methylfolate will help raise your level, and when taking B12 we also need a B Complex to balance all the B vitamins. Thorne Basic B is a good one (one needed with that brand), so is Metabolics (2 needed) which I take at the moment.


    25 OH VIT D 51.27 (50.00-200.00) - the recommended level is 100-150nmol/L. You can supplement with D3 softgels like these and take 5000iu daily. Retest in 3 months. When you've reached the recommended level reduce to 5000iu alternate days as a maintenance dose, you may need less in the summer. Retest once or twice a year to keep within the recommended range. You can get a fingerprick blood spot test for £28 with City Assays

    When taking D3 there are important cofactors needed

    D3 aids absorption of calcium from food and K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems.

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


    Ferritin 41.81 (13.00-150.00) - this is to low. Thyroid hormone can't work properly unless ferritin is at least 70, recommended is half way through range and for females 100-130. You can supplement with iron, taking each tablet with 1000mg Vit C to aid absorption and help prevent constipation. Take iron four hours away from thyroid meds and two hours away from any other medication and supplements as it affects their absorption.

    An easier way to raise ferritin is to eat liver once a week.


    Don't start all supplements at once. Start with one, if no reaction within one to two weeks then add the second one and continue that way. If you do have any reaction then you will know what caused it if you introduce them like that.


    Once your nutrients are optimal then thyroid hormone can work better. And high cholesterol should sort itself out once you are optimally medicated thyroid wise.

  • Thanks so much for this info SeasideSusie. I wonder if once my nutrients are optimal maybe my T3 levels may increase too (really hoping I don't have to take any thyroid medication!)

  • Don't hold your breath Jenny :(

    It will help but I agree with Greygoose that your problem is most likely central hypothyroidism.

  • Wishful thinking eh?! 😊Thanks for your help X

  • Yes, you problem is not conversion. It's low production of T4 and T3 by the thyroid gland. But, the thyroid gland cannot make T4 and T3 if the TSH doesn't tell it to. TSH is made by the pituitarty, and the pituitary is told what to do by the hypothalamus. So, it's one of those two that is not doing its job.

    It's pretty certain you will have to take 'thyroid medication', but you mustn't think of it as 'medication'. It's hormone - thyroid hormone replacement - not at all the same as 'medication'.

  • Thanks for clarifying this for me greygoose. I really am pretty clueless on this subject, just hope my doc will be able to help when i present her with my blood test results!

  • She'll probably have no idea what you're talking about. You will have to explain it to her. So, best do your research first - google 'central hypothyroidism'.

  • Just been reading up on it..dreading going lol! Wonder if its worth trying to go and see an endocrinologist?

  • Jenny, before doing anything about an endocrinologist, email for the list of thyroid friendly endos and then ask for feedback on the forum (replies will have to be by private message). Then contact the endo's secretary and ask if she can find out if the endo is familiar with central hypothyroidism. This will save you wasting time seeing someone who doesn't know anything about it.

  • Brilliant thank you, I will email her now!

  • Hi Jennystephens

    I'm by no means an expert in this field but... I would say you are hypothyroid. Your doctor is using the old story of 'your results are within range' when for someone who has a thyroid problem they most certainly aren't. If I were you I would have a look at a Facebook group called FTPO (For Thyroid Patients Only) there's a lot of expertise there. BTW did your blood test give you an antibodies result?

  • Hi Dingdingdong! Yes my antibody results were as follows: thyroglobulin <10 (0.00-115.00), thyroid peroxidase antibodies <5.0 (0.00-34.00). I will now have a look at the FTPO group, thanks ever so much.

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