Thyroid UK
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No further action required

Can someone please help me to understand what I need to do about results, I have been told no further action required. I feel like I am going mad or on the verge of a breakdown. I currently take 25mcg of Levo for hypothyroid diagnosed in 2012. Dose has been moved about so many times because of where TSH is in range.



Ears ringing

Dry skin


Legs cramping after running

Weight gain

Looking unwell

Puffy eyes


Aches and pains

Difficult swallowing

Low appetite

Brain fog.

Thanks in advance.

Thyroid peroxidase antibodies 35.1 (<34)

Thyrogobulin antibodies >1000 (<115)

Ferritin 28 (30 - 400)

Folate 3.1 (4.6 - 18.7)

Vitamin D total 25.6 (25 - 50 vitamin D deficiency)

Vitamin B12 231 (180 - 900)

2 Replies

Martine_K Your doctor needs shooting! He is a liability, he is keeping you very, very ill. Find another one quickly.

"No further action required" generally means that the result has come back somewhere within the range. But look at the range for ferritin, for example - 30-400. 31 is 'normal', so is 399. But you would feel very different at 31 than you would at 399, and you would have many symptoms and require supplementation. And yours has come back at 28 - under range - and you have been told no further action required. This doctor will slowly kill you.


Thyroid peroxidase antibodies 35.1 (<34)

Thyrogobulin antibodies >1000 (<115)

These are high and mean that you are positive for autoimmune thyroid disease aka Hashimoto's. This is where antibodies attack the thyroid and gradually destroy it. Hashi's isn't treated, it's the resulting Hypothyroidism that is.

You can help reduce the antibodies by adopting a strict gluten free diet which has helped many members enormously. Gluten contains gliadin which is a protein thought to trigger antibody attacks.

Supplementing with selenium L-selenomethionine 200mcg daily and keeping TSH suppressed also help reduce antibodies.

Hashi's information:


Ferritin 28 (30 - 400)

Absolutely dire. Talk to your GP. Do not accept that no action is required. Tell him that it is under range and ask why they have ranges if he takes no notice of them. Ask for an iron panel and full blood count to see if you have iron deficiency anaemia.

You can discuss iron infusions and iron supplements. If you are given iron tablets then take each tablet with 1000mcg 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.

Recommended level for ferritin is half way through it's range (it must be at least 70 for thyroid hormone to work properly). Once you have reached the recommended level with supplementation then you need to maintain it either with lower dose supplements or by eating liver regularly. Eating liver once a week will help raise ferritin. Look for other iron rich foods too.


Folate 3.1 (4.6 - 18.7)

Vitamin B12 231 (180 - 900)

And here you have another example of how your GP is being downright negligent. Your folate is under range, again ask him why he is ignoring the ranges. You are folate deficient. It needs treating.

Folate and B12 work together. Your B12 is very low. Anything under 500 can cause neurological problems. Do you have any signs of B12 deficiency? Check here:

Read the NICE treatment summary:

I would take your results over to the Pernicious Anaemia Society forum here on Health Unlocked for further advice. They are the experts and can guide you. See what they say and then ask your GP what he intends to do.

Don't take any supplements for either of these until you have had guidance from the PA forum.


Vitamin D total 25.6 (25 - 50 vitamin D deficiency)

And here we are again. A proven deficiency which your GP should be treating. NICE treatment summary:

"For the treatment of vitamin D deficiency, the recommended treatment is based on fixed loading doses of vitamin D (up to a total of about 300,000 international units [IU]) given either as weekly or daily split doses, followed by lifelong maintenance treatment of about 800 IU a day. Higher doses of up to 2000 IU a day, occasionally up to 4000 IU a day, may be used for certain groups of people, for example those with malabsorption disorders.

Several treatment regimens are available, including 50,000 IU once a week for 6 weeks (300,000 IU in total), 20,000 IU twice a week for 7 weeks (280,000 IU in total), or 4000 IU daily for 10 weeks (280,000 IU in total)."

You can see this here

Each health authority has it's own guidelines, you can Google for yours but it will be very similar.

Speak to your GP, ask him to follow the treatment guidelines for Vit D deficiency and insist on a loading dose followed by a maintenance dose.

You can always do it yourself by buying your own (frequently better than what is prescribed). If you want to do that then ask and members can give guidance and suggest supplements.

When taking D3 - and your doctor won't know this because they're not taught nutrition - there are important cofactors

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


After such an excellent reply from SeasideSusie my only other comment is to underline the importance of gluten intolerance in Hashimoto's

Unlikely to be coeliac (but if GP is helpful, which seems very unlikely, ask for coeliac blood test) If not just change to gluten free.

It takes a bit of getting use to, what you can & can't eat, but increasing amounts of gluten free options in shops these days.

Also best to avoid soya, but one step at a time.


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