Thyroid UK
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Blood results looking for advice on T3/NDT etc

Blood results looking for advice on T3/NDT etc

I am reposting my blood results from Blue Horizon as I posted them at a funny time and although I had two excellent responses from Heloise and Katepots I think they got buried in all of the posts and weren't seen by lots of people who might be able to help even more. I was looking for some further clarification of my best course of action and where to obtain the t3/ndt I might try.

Can I just confirm that I'm right in thinking that I would probably benefit from some form of t3 or NDT as my free t3 is almost at the bottom of the range?

Also, should I just jump in with that or should I try to sort out my vitamin d, b12 etc as advised by Heloise and Katepots and see if that leads to better conversion first? (I do know I need to try to sort those things regardless of if and when I try different treatment, just not sure if I should see if sorting them means I can manage on just Levo).

I'd be most grateful if people could share with me their experiences of t3 and t4/t3 only/NDT. Is there a way of knowing which one might be best or is it trial and error and also how easy are they to get online. Any PMs regarding that would be gratefully received!

11 Replies

Harrisan I agree with the replies to your previous post. Your nutrient levels are very low, you need to get them up to optimal levels for thyroid hormone to work properly. These are:

Vit D - 100-150nmol/L

B12 - very top of range, even 900-1000

Folate - at least half way through it's range

Ferritin - at least 70, half way through range is recommended, and for females 100-130 is considered best


Vit D - 31nmol/L - you have a long way to go. My suggestion would be to buy some D3 softgels like these and take 10,000iu daily for 6.8 weeks then reduce to 5000iu daily. Retest after 3 months. When you've reached the recommended level then reduce to a maintenance dose of 5000iu alternate days, you may need less in the summer.

D3 has important co-factors which are needed - read about them here

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 get 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 hormone.

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


Ferritin - 46 so no chance of thyroid hormone working until it reaches 70. You can either supplement with iron such as ferrous fumerate, taking each iron tablet with 1000mg Vit C to aid absorption and help prevent constipation. Or you can eat liver once a week which is how I raised mine because I couldn't tolerate iron supplements. Liver can also be 'hidden' by mincing and using in meat dishes such as casseroles, cottage pie, curry, bolognese, etc. If you take iron tablets, take them 4 hours away from Levo and two hours away from other medication and supplements as it affects their absorption.


Folate - 15.42

B12 - 264. Anything under 500 can cause neurological problems. You can supplement with sublingual methylcobalamin 5000mcg, take one daily, finish the bottle then buy the 1000mcg as a maintenance dose.

When taking B12 we also need a B Complex to balance all the B vitamins. If you buy one with 400mcg methylfolate then that will help raise your low folate level.

B vitamins can be stimulating, so best taken in the morning, no later than lunchtime so that it doesn't disturb your sleep.


TPO antibodies - 248.9

TG antibodies - 305

Both are over range so you are positive for autoimmune thyroid disease aka Hashimoto's, which is where antibodies attack and gradually destroy the thyroid. There's no treatment for Hashi's, it's the resulting hypothyroidism that's treated.

You can help reduce the antibodies by adopting a strict gluten free diet, which has helped many members here.

Read about Gluten/thyroid connection:

Supplementing with selenium, 200mcg daily also helps reduce antibodies and helps with T4 to T3 conversion. Keeping TSH suppressed helps reduce antibodies too.

Read Hashi's information here:


When introducing the supplements, start with one, give it a week or two to see if any reaction, if none then add the second one, give it a week or two, etc. If you have a reaction then you will know what caused it.

I would give the supplements time to start working and maybe retest nutrients in 3-4 months to see how they're going.

At the moment your FT4 is 43% through range and FT3 is 16.5% through range and your conversion rate is 4.4 : 1. A small increase in Levo should increase your FT4 and FT3 which could help.

If there are no sign of improving after optimising your nutrients and adding Selenium then it would be worth considering alternative thyroid hormone.


Thank you so much for such an informative and well referenced response. It really is so kind of you to go to such trouble!

I guess I'm about to clean out Holland and Barretts of a bunch of vitamins and supplements!

Do you think it's worth talking to my new doctor about whether they'll give me the big dose of Vit D that I had before and then the maintenance dose and also whether they can give me B12 treatment or is it just as effective to buy my own?

Oh and I forgot to ask if there is a folate supplement (I assume it's vit b9) or if that has to come from a doc?

I just want to check I'm understanding right in that you're saying if I sort these things out to the levels you have so kindly suggested and ask the doctor to increase my Levo a little I should feel better. It seems sensible to try this before jumping to T3. What conversion rate would you say would indicate that I wasn't converting properly and need t3? How do you calculate that? I'm blown away by your knowledge!

I have had selenium, D3 and been gluten free before without any apparent or considerable improvement. Do you think that I should keep trying to get it all in the right place?

Sorry to reply to such a great reply with so many questions, just really really relieved that this is not all in my head as the Endo's said and feeling motivated to try to sort myself out as I can't keep feeling the way I do!

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Harrisan Don't buy H & B own brand, they're generally full of cheap ingredients, the wrong form and lots of unnecessary ingredients. If you want suggestions for decent brands I'm happy to help there, I buy all mine on the internet from tried and trusted suppliers.

You can ask your GP but don't hold your breath. General guidelines for Vit D Deficiency where loading doses are given suggest that the level has to be below 30.

There is a folate supplement but if you buy something like Thorne Basic B which contain 400mcg methylfolate you shouldn't need a separate folate supplement. I don't think your folate level is low enough to be prescribed folic acid. I got my folate up from bottom of range to top of range in two and a half months with Thorne Basic B.

Good conversion takes place when FT4:FT3 ratio is 4:1 or less, some say 3:1. You take your FT4 level and divide by FT3 level, so yours is 16.36 ÷ 3.71 = 4.409 : 1

Gluten free works for a lot of people but isn't always an instant fix. I would keep going with the selenium and get your nutrient levels optimised. And definitely try an increase in Levo, there's plenty of room with your free Ts and most treated hypo patients do best when TSH is 1 or below, even suppressed. A suppressed TSH isn't a problem, you can't be over medicated as long as FT3 stays within range.


Hi Susie,

I'd be most grateful if you could point me in the direction of good quality supplements to buy online. I naively assumed that H&B were quite posh and therefore reputable!

So my conversion is ok but could be better as I'm at the upper limit for 'good' conversion? I'll see what it's like when I have gotten all of these supplements on the go then!

Yeah, I've felt 'better' but not 'well' before when my TSH was under 1 but the Endo was concerned when it went to 0.07 and made me alternated 125/100mcg daily. I'll be upping that to 125 daily for definite!

Thanks again (and in advance for as many links as you have for good supplements!)



For D3 the supplement I linked to is a very good one, it contains only D3 and extra virgin olive oil, nothing else. The price is possibly the best on the internet. The company is excellent, despatched same day (second class) if you order before 4pm, and they are very good with communication

Have a look around that site, they have lots of brands and prices are usually very good.


For K2-MK7, if you want as few ingredients as possible then look at

Jarrow's MK7 and Healthy Origin's K2-MK7 here

Best value is the Healthy Origin's 180 size. Excellent company, very quick to despatch but there is a postage charge with them.

Big Vits specialises in USA brands.


Selenium, my choice is Cytoplan as it's a nice small tablet that has no odour, quite a few selenium supplements have an unpleasant odour

They're on 3 for 2 at the moment and when you register with them they send a voucher code for next time. It is only a 100mcg supplement, I get my other 100mcg in a mineral complex.


B Complex - Thorne Basic B looks quite expensive at the moment, the cheapest UK supplier seems to be Amazon.

I've now changed to Metabolics B Complex (180 capsules, 90 days supply), bioavailable forms of ingredients and no fillers


Magnesium depends on which form you want. I use this magnesium citrate powder because no unnecessary ingredients and makes a nice little drink with orange juice. Price varies on Amazon and it's usually cheaper to buy the 16oz size


Those are my favourites, there are other decent brands. Look at labels, look for words like bioavailable, bioactive, fully active, food state, whole food. You won't find the most bioavailable forms of ingredients in cheap/supermarket brands and that includes H&B own brand, Boots own brand, etc.

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Thank you sooooo much I'll have a nosey at these tomorrow. Just woke up on the couch so bed for me just now.

Thanks for all your help and advice!

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Why don't you increase Levothyroxine to 125mcg daily? That will raise FT4 and FT3.

Thyroid peroxidase and thyroglobulin antibodies are positive for autoimmune thyroid disease (Hashimoto's). There is no cure for Hashimoto's which causes 90% of hypothyroidism. Treatment is for the low thyroid levels it causes. Many people have found that 100% gluten-free diet is helpful in reducing Hashi flares, symptoms and eventually antibodies.

Good vitD levels aid conversion of T4 to T3 so I would certainly supplement D3. I would supplement 10,000iu daily for 6 weeks then reduce to 5,000iu daily and retest in August. Take vitD 4 hours away from Levothyroxine.

B12 is low. If you have symptoms of B12 deficiency outlined in go to for advice.

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Hi Clutter,

I have gone back to 125mcg daily since I got these results the other day, could kick myself for listening to the Endo and alternating but I had a friend who said she felt loads better doing that.

I knew I had Hashi's but I did think that those numbers were pretty high on the blood results. As I said above I've been gluten free before for about 4-6months but didn't notice any difference really. Do you think given that everything is low my new doctor might be more inclined to treat the ferritin, folate and b12 or is it likely to be the usual - it's in range so we won't treat it? If I have to buy supplements myself I obviously will but if I can get them on presecription it'd be much better.

I've been waking up with tingling in my arms and cramps in my legs for months and months now - I think your b12 information is probably spot on, hopefully I can get them to treat it.

Thanks so much for your advice. Need to get onto the HealthFood websites and order me some supplements! I'm going to be rattling!

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NHS doesn't usually prescribe when results are within range except perhaps vitD but they'll probably only prescribe a paltry 800iu unless your GP understands about vitD.

I recommend you go to PASoc for advice before supplementing B12.


Thanks Clutter,

I thought that might be the case. Hopefully I'll get the vitamin D as it's 'insufficient' even if not deficient yet!

I'm about to post there as I have had troubles sleeping and have been waking up with tingling and numbness in arms and cramps in legs along with a bunch of other things such as muscle fatigue and breathlessness which I had attributed to my thyroid.



Cramps in legs can be due to low magnesium. You can supplement magnesium citrate, use magnesium spray oil on your legs and feet, and take Epsom Salt baths to improve cramp and aching muscles.


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