Help with understanding recent blood tests please!

Help with understanding recent blood tests please!

Could somebody please help me to understand my blood test results that were taken in April this year in photo below. I asked for Vit D to be tested due to pains/pins and needles in legs, buttocks and hands which although I have had for 4 years intensified following a recent minor operation with a ga. I have been put on vit d supplements Fultium D3 40,000 iu per week for 7 weeks. 4 weeks into supplements my pins and needles are no better in fact are getting worse. Trammadol only take the edge of the pain away. Gp says everything else is in range but wondered about Magnesium although don't think that was tested? Or even increasing my b12? I cannot live with this pain and keep going back to see gp. She retested my bloods on 15th May and these showed the following:

Free T4 13.4 (9-24)

TSH (on T4 RX). 7.1 (0.35-5)

25-OH Vitamin D 39 (75-200)

Calcium 2.28 (2.1-2.6)

Adjusted Calcium 2.22 (2.1-2.6)

Phosphate 1.27 (0.8-1.5)

Albumin 43 (35-50)

ALP 79 (30-130)

She then increased my Levothyroxine to 50 mg. I just want to feel well and be pain free, is that too much to ask?!

20 Replies

I have recently had loading doses of vit d and b12, it was about 4-5 weeks before i started to notice that fatigue levels were improving so you may not be seeing the benefits yet. I believe the pins and needles, hand pain etc are more from B12 and folate issues. I was advised on here to get my B12 over 500 and if possible to top of the range and folate to mid range, use the methyl cobalamin form of b12 and methylfolate rather than other forms as they are better utilised by the body. You also need to take a good b-complex as all the b's need to be in balance. B vits are all water soluble so unlike oil soluble vit D you can take quite a lot as you will just excrete what your body doesn't need. The advice I chose to follow was 5000iu sublingual methyl cobalamin and when i finish the tub will go on to 1000iu for maintenance. If you pop over tthe pernicious anaenia (pa) forum they are best placed to advise on b12 and folate issues.

Thank you Phoenix605. I forgot to mention that I have started a multi vitamin A-Z daily from Boots. Where do I get the b12 and folate supplements from that you mention? And which b complex vitamin supplement do I choose? Sorry this is all new to me - supplements I mean - not the hypo problems or pins and needle pain unfortunately! I really don't want to have to go back to the gp again about my leg pain but today I was actually reduced to tears (doesn't happen very often as I'm a strong person) but I actually said to my husband how I now see how people who live with terrible pain day in and day out resort to thinking about ending their misery. It's sounds dramatic I know but when this pain stops you sleeping and enjoying your life you do momentarily think foolish thoughts.

Don't bother with a multivitamin as it doesn't contain enough of each vitamin or mineral to sort out deficiencies. Take separate supplements.

If you go on to the main TUK site there us a link to Amazon.( If you buy via the link TUK get a small commission which helps offset the cost if maintaining the site. ) I bought from there at good prices.

Multi vits do not contain enough of what we need and can combine elements which interfere with each other, eg some minerals can stop the proper absorption of the bvits so many on here advocate taking individual supplements. I take all my b's together then my D and minerals later. You should take all of them well away from levo as again they can interfere with its proper absorption.

Solgar and Jarrows were recommended to me. I didnt have a recommendation for folate so just picked one! If you do a search on vitamins at the top of this forum you should find lots of threads where similar advice has been sought which may help you decide what would be best for your situation.

I've noticed stuff on your blood tests which the NHS won't help you to optimise.

Your ferritin should be half way in it's range. So if you supplement iron e.g. 1 x ferrous fumerate, ferrous sulphate, ferrous gluconate or ferrous bisglycinate with vitamin C and water twice a day. 4 hours away from levo and 2 hours away from other food, drink and supplements you will need to do your own private tests every 3 months to ensure you don't have iron overload.

Your folate should be halfway in its range. Take a good vitamin B complex daily to balance B vitamins.

Your vitamin B12 should be over 500 to be optimal. Take sublingual methycobalamin lozenges.

Get your supplements from Amazon as most high street shops sell junk or give you wrong advice.

In regards to vitamin D it took me 3 months before I felt normal. I actually felt terrible and in pain for the entire 3 months. Though my level was lower than yours. You should also be taking it with vitamin K2-MK7 and a bioavailable form of magnesium to help bone resorption and formation. It is also suppose to decrease pain. Again the NHS won't advise this or prescribe this as they do the minimum to get you not to be seriously ill. There is no point testing magnesium as the body keeps the levels tightly controlled.

I hope your doctor told you that you need to take vitamin D for life and the maintenance doses are normally 1,000-2,000IU daily. You also need to have a yearly test which the NHS probably won't pay for to check your vitamin D level once you get to around 75nmol/L. Have the test in early autumn.

Start with the magnesium and Vitamin K supplements. Wait a week and add the B vitamins then wait until you are out of pain and add the iron. Iron can cause constipation, diarohea and stomach cramps.

Finally if you are on levo your TSH should be around 1 and your Free T4 should be in the top quarter of its range.

Thank you for that advice bluebug. I am having another blood test in 8 weeks so we will see what my tsh is doing then. I don't understand what the Free t4 is or how that figure can be changed. Is it by an increase in Levo dose? Sorry I'm a relative newbie to this

Yep increase in levo. Levo = T4 hormone replacement.

If you do private testing - which you are likely to have to do to check your vitamin D and ferritin you can get finger prick tests that test TSH, free T4 and free T3. The NHS rarely tests free T3 as they think it is of no benefit to most people with hypothyroidism. T3 is the active hormone T4 is converted to. More information on this and where to go for private testing can be found on the main thyroid UK website -

You might want to read about the thyroid, Free T4 etc. on the website:

Bluebug, I haven't heard of K2-MK7. Why do you think I should be supplementing with this and also a bioavailable form of magnesium? You said in your post that the body keeps the level of magnesium very tightly controlled so does this mean I won't over dose my body if I supplement magnesium?

They are co-factors that the body needs more of when you start supplementing with lots of vitamin D. Most people's diets are low in them hence the advice to supplement to increase the amount.

In regards to testing - magnesium tests cannot tell you whether you are deficient or not. The only way you can guess are signs and symptoms. Luckily with magnesium if you take too much you end up with diahorea. This is what I mean by the body tightly controls the level.

Bioavailable forms of magnesium include magnesium citrate - I think solgar sells a form- , rubbing magnesium oil into the skin or taking a bath in Epsom salts. You only need to do one of these regularly e.g. rub magnesium oil into the skin as directed on the container to have sufficient magnesium.

Thank you bluebug. I'll add that to my shopping list!

I will email you, thank you Lucyacudr


This is a patient to patient forum and no one, including the Admin team, on this community should be assumed to have medical training of any sort.

Please be careful about emailing people who say they are medical professionals.

When we start supplementing to improve low vitamin D, apparently it can increase our need for B vitamins as body starts to repair.

Pins & needles is often low B12 & B12 is also often significantly lowered after an operation due to anaesthetic using up B12

Thank you SlowDragon. As I am not getting any help through my gp with my pins and needles pain I have decided that I am going to arm myself with information and help myself. I have been sent to see so many consultants in the last 4 years and it would appear that they are all (except the neurologist who picked up my thyroid problem through blood tests) are looking for diseases and illnesses when it would seem now that a lot of my problems could just be down to vitamin deficiencies and poor diet. Food does not play a huge part in my life but my sister recently said to me that "we are what we eat" and I know deep down she is right! So time for me to make some changes!

Well you have Hashimoto's, (raised antibodies) which trashes vitamins, upsets gut function and often causes food intolerances, usually gluten. So you really need to try strictly gluten free diet. Majority with Hashimoto's find it significantly improves symptoms and can help keep vitamins levels higher once gut starts to repair.

You don't need to gave any gut symptoms.

As you are supplementing vitamin D, it's definitely a good idea to also supplement magnesium. Vitamin K2 is also recommended

I had excruciating pain when first started vitamin D supplements. Medics said it was impossible it was the supplements, but if I stopped vit D supplements, the pain stopped. But really needed to be on as level was low & increasingly hypo when not on Vit D. The pain is apparently something to do with bones remineralising. It has since improved and I still take vitamin D.

But your sounds more like low B12.

Low B12 can cause lots of symptoms and seems almost as misunderstood & poorly treated by GP's as thyroid issues.

Are you supplementing B12, if not it is probably a good idea. Lots of us with Hashimoto's do. When taking B12 it's recommended to take also take good vitamin B complex too.

Folate is low, but if you are starting/taking vitamin B complex this will help folate improve.

Your ferritin is too low - needs to be around 70 for thyroid hormones to be able to work. Eating liver at least once a week can help

See SeasideSusie detailed advice on ferritin in lots of her replies


See The Thyroid Pharmacist website for masses of info about Hashimoto's

Thank you SlowDragon. I am finding the people on this site to be so helpful and have a wealth of information. I'm guessing this is self taught as the gp's don't seem to actually have a clue on thyroid and related issues. I WILL get better because I will do it myself with the help of good people like yourselves on this site! Yesterday was a very difficult day for me pain wise and lack of sleep. I am not a negative person usually it just seems never ending and I don't want to go back to the gp and have her roll her eyes at me as I walk into the room

Yep, we still get virtually no help from medics, they still don't seem to realise Hashimoto's is not just a thyroid problem.

Instead just want to stick a chronic fatigue label on you and/or dish out anti-depressants

In over 20 years no one tested my vitamin levels or suggested there might be a gut or gluten connection

I wouldn't have got anywhere at all without all the fantastic help on here

Make sure if you start taking a b complex you stop these 4/5 days before any blood tests as the biotin in them can give false results.

Thank you MiniMum97. I will remember that

You may also like...