Advice on latest blood results please

Morning everyone, I am still feeling ill - having to lie down most of the day. Symptoms of fatigue, dizziness, tingling hands, wobbly legs and getting upset.

Here are my latest blood results from Medichecks, I have been taking Levothyroxine 50mcgs for the last 6 weeks and have an appointment on Friday with private endo. Would appreciate your wise thoughts please

TSH 2.78 (range 0.27-4.20)

Free Thyroxine 15.62 (12- 22)

Total Thyroxine (T4) 81.2 (59-154)

Free T3 4.34 (3.10-6.8)

Thyroglobulin Antibody 10.020 (0.00-115)

Thyroid Peroxidase Antibodies 10.43 (0.00-34)

Vitamin B12 230 (140-724)

Folate serum 7.36 (3.89-26.8)

Vitamin D 71.29 (50-200)

CRP- High sensitivity 1.1 (0-5)

Ferritin 68.47 (13-150)


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3 Replies

  • VP17,

    Ask your endo for a dose increase. TSH is a little high and both FT4 and FT3 could be higher in range.

    The goal of Levothyroxine is to restore the patient to euthyroid status. For most patients that will be when TSH is 1.0 or lower with FT4 in the upper range. FT4 needs to be in the upper range in order that sufficient T3 is converted. Read Treatment Options in Email if you would like a copy of the Pulse article to show your GP.

    Thyroglobulin and thyroid peroxidase antibodies are negative for autoimmune thyroid disease (Hashimoto's).

    B12 is low in range. If you have some of the symptoms of B12 deficiency outlined in go to the PAS forum for advice

    Folate is low in range but probably okay. PAS forum will advise.

    Vitamin D is replete 75-200 so if you are able to get sun on your face and arms a few hours a week yours is fine. If not, supplement 1,000iu D3 daily and take it 4 hours away from Levothyroxine.

    Ferritin is optimal halfway through range. Eating more iron rich food should improve ferritin.

    CRP is an inflammation marker and 1.1 is low which is good.

  • VP17

    Vitamin B12 230 (140-724)

    Folate serum 7.36 (3.89-26.8)

    This is part of your problem and the likely cause of your dizziness and tingly hands at least.

    B12 under 500 can cause neurological problems and the recommended level is very top of range, even 900-1000. Check here to see if you have any signs and symptoms of B12 deficiency

    Folate should be at least half way through it's range so around 16+ with that range.

    If you have any signs and symptoms of B12 deficiency then take these results over to the Pernicious Anaemia Society forum here on Health Unlocked for further advice

    If not it may be enough to supplement with sublingual methylcobalamin lozenges and a B Complex which is needed when taking B12 to balance all the B vitamins.


    Ferritin should be at least 70 for thyroid hormone to work properly, and for females I've seen it recommended that 100-130 is best. Eating liver once a week will nudge your level up and is much easier than the fuss of iron supplements. Other iron rich foods can be seen here which can help in addition to the liver


    Vit D is recommended to be 100-150nmol/L so if you're not supplementing with D3 you could buy some D3 softgels and take 5000iu daily for 4-6 weeks then reduce to 5000iu alternate days. Retest after 3 months to keep within the recommended range.

    D3 has important cofactors which you can read about 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 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

    Check the other cofactors too.


    Once your vitamins and minerals are all at optimal levels then thyroid hormone can work properly.


    CRP is fine.

    Antibodies are low so not indicative of autoimmune thyroid disease.


    TSH 2.78 (range 0.27-4.20)

    Free Thyroxine 15.62 (12- 22)

    Total Thyroxine (T4) 81.2 (59-154)

    Free T3 4.34 (3.10-6.8)

    You should now have an increase of 25mcg Levo as your TSH is still too high and free Ts too low. The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it is needed for FT4 and FT3 to be at the upper end of their respective reference ranges.

    See your GP for an increase, then arrange a retest for 6-8 weeks later, this should continue until you reach your optimal level of Levo and your symptoms abate.

    When having thyroid tests, always book the first appointment of the morning, fast overnight (water allowed) and leave off Levo for 24 hours. This gives the highest possible TSH which is what is needed when looking for an increase in dose or to avoid a reduction.

  • Many, many thanks Clutter and SeasideSusie for your advise and information, I might start to get somewhere now :)

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