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Thyroid UK
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Finally have Blue horizon results can anyone help with advice on next steps please

Hi all

I wrote a while back with my GP results and they differ wildly from these?

I'm sure the NHS must have fiddled my earlier results !

From this test does it look like I am Hypo ?

Many thanks in advance


11 Replies

Dexterpuppy I can't see them very well on my tablet.

It looks like your B12 and ferritin are low, and those were pointed out in your last thread. If you want suggestions for supplements and dose, please confirm the results and I'll be happy to recommend something.

I can't read Vit D but it's only 2 digits which means it's under 100 so not at optimal level.

TSH looks to be over range and FT4 looks to be under range, and both TPO and TG antibodies are high so you have autoimmune thyroid disease aka Hashimoto's.

I can't see any NHS results in your previous thread so can't compare, but they could be different for a couple of reasons eg were both done at the same time of day, did you fast overnight and have water only? Hashi's causes fluctuations as and when antibodies attack.

Adopting a gluten free diet can help reduce antibodies, as can supplementing with selenium L-selenomethionine 200mcg daily.

Gluten/Thyroid connection - chriskresser.com/the-gluten...

Hashi's information:




Reverse T3 is low, I'm surprised there's no ratio, but there doesn't seem to be anything to worry about, high rT3 is a problem.

Optimal levels of nutrients:

B12 - very top of range, even 900-1000

Folate - at least half way through it's range

Ferritin - minimum 70, better half way through range, best for females 100-130.

Vit D - 100-150nmol/L

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Hi Susie

That's brilliant thank you so I definitely have Hypo ? Will my doctor now accept this do you think ?

B12 is 377

Vit D is 63

Ferritin 36

Reverse T3 11 ratio is 10-24

Many thanks for all your advice x


Dexterpuppy "Reverse T3 11 ratio is 10-24"

That's not the ratio, that's the rT3 result and reference range. The ratio would be given as something like

FT3/rT3 ratio: XX

(and over 20 is good)

But as I said, your rT3 is low, and it's high rT3​ that's a problem. You'd expect to see high rT3 when FT4 is high and FT3 is low.


Your over range TSH and under range FT4 mean you are hypo, unfortunately most NHS doctors want to see TSH 10+ before they will diagnose and treat.

Your over range antibodies confirm Hashimoto's or in doctor language "autoimmune thyroiditis".

From ThyroidUK's main website > Autoimmune Thyroid Disease > Thyroid Antibodies:

"The antibodies that appear most frequently are

Antithyroid Peroxidase Antibody or TPO Ab (Ab is short for antibody) this is also known as Antithyroid Microsomal Ab

Antithyroglobulin Antibody or TG Ab

Thyroid Stimulating Immunoglobulin or TSI Ab

The first group, the TPO Ab, are found raised in Hashimoto's disease - otherwise known as autoimmune thyroiditis. Here the cells of the thyroid gland are attacked and slowly destroyed. Patients with these antibodies present either have Hashimoto's, or are going to have it with subsequent reduction of thyroid function. (Elevated levels are found in virtually all cases of Hashimoto's disease and they will also be raised in 65% of patients with Graves' disease).

The next group is the TG Ab. These levels rise as well as the TPO Ab levels in autoimmune thyroiditis, but to a lesser degree.

The third group, the TSI Ab, exert their effect by targeting the TSH (thyroid stimulating hormone) receptors in the thyroid gland, and activate them abnormally, thus stimulating the thyroid gland to overproduce thyroid hormones. This of course is Graves' disease and these Thyroid Stimulating Immunoglobulins are the chief cause of it."

I honestly don't know if your GP will accept this. Some will, some won't. If he won't do anything then I would ask for a referral to an endocrinologist, but email louise.roberts@thyroiduk.org.uk for the list of thyroid friendly endos first. Whoever is in your area, ask for feedback from forum members and ask for a referral to one that you get positive feedback for.


B12 is 377 - anything under 500 can cause neurological problems. You can supplement with sublingual methylcobalamin lozenges 5000mcg daily. When the bottle is finished, usually around 60 lozenges, buy the 1000mcg strength and take 1 daily as a maintenance dose. Jarrow's is a popular one amazon.co.uk/Jarrow-Methylc... . There is also Solgar but one member reports that hers are not proper sublingual lozenges as they don't dissolve under the tongue.

When supplementing with B12, we need a B Complex to balance all the B vitamins.


Vit D is 63 - I would suggest you buy some D3 softgels like these bodykind.com/product/2463-b... and take one daily for 6-8 weeks then retest. If you've reached the recommended level of 100-150nmol/L then reduce to a maintenance dose, winter you might need 5000iu alternate days, summer you might need less.

When taking D3 there are important cofactors needed vitamindcouncil.org/about-v...

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 if you are prescribed any).

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 again) naturalnews.com/046401_magn...


Ferritin 36 - for any thyroid hormone to work properly (our own or replacement) ferritin needs to be at least 70. You can get some iron tablets but they can cause constipation and tummy upset in some people and they need to be kept away from other supplements (and medication) by two hours, thyroid meds four hours. Also they need to be taken with 1000mg Vit C to aid absorption and help prevent constipation.

A much easier way to raise ferritin is to eat liver once or twice a week. This can a meal of liver and/or minced and put into casseroles, cottage pie, curry, bolognese, etc. I've read that you shouldn't exceed 200g a week.

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Susie, you are absolutely amazing wow thank you so much for all the advice and so easy to understand! I'm just so glad my tests came back like this as both doctors seem to think 'it's in my head' and think I'm anxious!

So if I could get to see an endo would I be looking at thyroxine and T3 or NDT as my mum and an have that or something different for the hashimotos? How on earth can the doctor not accept ? What can't speak can't lie and it's all there in black and white (and red!)

You seem so knowledgable, maybe you can shed some light for me on why Drs are so reluctant to have people diagnosed and then even more reluctant to help? I, along with prob hundreds of people on here have been existing not living, and saving that tiny bit of energy I don't have for having a shower or something ! I've put on over 2 stone yet have no energy or motivation to exercise at all, even putting my shoes on wears me out and breathless ! Thank you again for your response I will absolutely be going and getting everything you recommended x


Dexterpuppy Nah, I'm not amazing and, honestly, I don't know that much. There are many members here who know so much more than me. I just know about things that have affected me which I have had to look into to help myself. Other bits and pieces I've read about and some of it sticks :)

I think it's because so much of my life has been wasted to Hypothyroidism with no help or understanding from doctors who neither understand or care. I wish I had known 20 years ago what I know now.........

Your plan should be

1) Secure a diagnosis

2) Start treatment with Levothyroxine and see how that goes. The greater majority of hypo patients do well on Levo, you could very well be one of them.

3) Optimise your vitamins and minerals and once your levels are where they should be then maintain those levels. Don't just stop supplementing because eventually your levels will drop again.

4) Address the Hashi's. Go gluten free diet, many members have found this helps enormously. Gluten contains gliadin which is a protein thought to trigger antibody attacks. Supplement with selenium as mentioned. Selenium not only helps reduce antibodies but it also helps with conversion of T4 to T3.

Why are Drs are so reluctant to have people diagnosed and then even more reluctant to help? Well, who knows. For some reason they believe it's an easy disease to treat. Unfortunately it affects more women than men, and I think they can bully us more than men, tell us we are depressed, menopausal, or some other sh1te they tend not to fob men off with. In my case I was mid 20s with a toddler and a baby so of course there was nothing wrong with me other than I was a young mum with young children, of course I can expect to be tired! It took two years and an irate husband demanding my GP 'do something with her because I've had enough" for my GP even to test my thyroid. That was back in 1973, so nothing much has changed!

The more you read on here then you will see we have to take responsibility for our own health, be assertive, learn as much as we can as it will probably be necessary to educate our doctors about thyroid disease or challenge them when they want to reduce our dose of thyroid meds and keep us ill.

It's frustrating and so many of us have had to resort to trying to help ourselves when our doctors won't :(


oh Susie, how awful for you :( I've only been trying to find out what's wrong for about a year, so hopefully, i will have more luck! thank you once again for all your advice, I will start acting immediately x



Out of interest what were your NHS results? How far apart were the tests? Did you do them at different times of day/fasting?


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hi yes, 5 weeks apart and NHS after fasting at about 10am and BH at 130pm no fasting


OP's NHS results (image not clear, some numbers in comments): healthunlocked.com/thyroidu...

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The previous set of results look like secondary hypo - normal TSH and low FT4 (but just in range) I wonder if they were done in the afternoon?

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Yes, it does look as though you are hypo. TSH too high (but not 10 as the NHS want) and FT4 under range, plus positive antibodies

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