Thyroid UK

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Hi I was diagnosed hypothyroid 5 years ago and I am really not feeling good but GP says thyroid results have come back fine, so if my symptoms are not thyroid what can they be? I have trouble losing weight, have pins and needles in feet and legs, joint pain, feeling cold, eyelids feeling heavy, tiredness, muscle aches and pains, constipation, muscle weakness, hair loss. Taking 150mcg Levo. Thanks in advance.

TSH 3.60 (0.2 - 4.2)

Free T4 12.9 (12.0 - 22.0)

Free T3 3.1 (3.1 - 6.8)

6 Replies

Elizabethlouise If you post your latest test results, with reference ranges, members will be able to comment. If you haven't got them then just pop along to the surgery and ask at reception for a print out, it's our legal right in the UK, under the Data Protection Act, to be given a copy of our results.

Some of your symptoms could be indicative of low nutrient levels, so if you've had Vit D, B12, Folate and Ferritin tested, post those results also, if not then ask your GP to test them or do them privately.


Thanks for reply, I will do this now.


Post now has thyroid results


Ferritin 78 (30 - 400)

Red blood count 4.51 (3.80 - 5.80)

White blood count 6.13 (4.0 - 11.0)

MCH 28.7 (28 - 32)

MCV 73.4 (80 - 100)

MCHC 396 (300 - 340)

Haemoglobin estimation 125 (120 - 150)

Haematocrit 0.43 (0.37 - 0.47)

Platelet count 247 (140 - 400)

Neutrophil count 0.3 (0.2 - 1.0)

Monocyte count 0.5 (0.2 - 1.0)

Lymphocyte count 1.3 (0.2 - 2.0)

Basophil count 0.0 (0.0 - 0.2)

Eosinophil count 0.3 (0.0 - 0.8)

Iron 12 (6.0 - 26.)

Transferrin saturation 12 (10 - 30)

Folate 2.2 (2.5 - 19.5)

Vitamin B12 338 (190 - 900)

Vitamin D 60.9 (50 - 75 suboptimal)

Taking 1 iron tablet, I am sure I should be on 3 if I am iron deficient?

Taking 5mg folic acid once a week, shouldn't it be 1 a day?

Taking vitamin D 6000iu from 800iu GP prescribed, am I wrong in thinking the 800iu wasn't enough?



Ferritin 78 (30 - 400)

Ferritin should be half way through it's range

MCH 28.7 (28 - 32)

MCV 73.4 (80 - 100)

MCHC 396 (300 - 340)

These alone suggest iron deficiency anaemia. Your GP isn't treating you for this so you must ask him to do so immediately and point out the following

NICE Clinical Knowledge Summary for iron deficiency anaemia treatment (which will be very similar to your local area guidelines):

Have a read through but this is the treatment:

How should I treat iron deficiency anaemia?

•Address underlying causes as necessary (for example treat menorrhagia or stop nonsteroidal anti-inflammatory drugs, if possible).

Treat with oral ferrous sulphate 200 mg tablets two or three times a day. ◦If ferrous sulphate is not tolerated, consider oral ferrous fumarate tablets or ferrous gluconate tablets.

◦Do not wait for investigations to be carried out before prescribing iron supplements.

•If dietary deficiency of iron is thought to be a contributory cause of iron deficiency anaemia, advise the person to maintain an adequate balanced intake of iron-rich foods (for example dark green vegetables, iron-fortified bread, meat, apricots, prunes, and raisins) and consider referral to a dietitian.

• Monitor the person to ensure that there is an adequate response to iron treatment.

Take each iron tablet with 1000mg Vitamin C to aid absorption and help prevent constipaton. Always take iron 4 hours away from thyroid meds and two hours away from other medication and supplements as it will affect absorption.


Folate 2.2 (2.5 - 19.5) - taking 5mg folic acid once a week

Vitamin B12 338 (190 - 900)

You are correct, folic acid should be 5mg daily. Ask your GP to increase your prescription.

As for Vit B12 I have read (but not researched so don't have links) that BCSH, UKNEQAS and NICE guidelines recommend:

"In the presence of discordance between test results and strong clinical features of deficiency, treatment should not be delayed to avoid neurological impairment." Check for signs of B12 deficiency here and if you have any then post on the Pernicious Anaemia Society forum here on Health Unlocked

And an extract from the book, "Could it be B12?" by Sally M. Pacholok:

"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".

"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."

That's good enough for me and I keep mine around 1000. Sublingual methylcobalamin lozenges are what's needed to supplement B12 yourself along with a good B Complex to balance all the B vitamins. So if you have no signs of deficiency then you may wish to supplement to increase your level, maybe 5000mcg to start, followed by 1000mcg as maintenance. A B Complex is recommended to keep all the B Vitamins balanced.


Vitamin D 60.9 (50 - 75 suboptimal) Taking vitamin D 6000iu from 800iu GP prescribed, am I wrong in thinking the 800iu wasn't enough?

You are absolutely correct, 800iu isn't even a maintenance dose for someone with a reasonable level.

The recommended level is 100-150nmol/L so you could continue with your 6000iu daily if you wish, or you may want to reduce it to perhaps 4000iu daily, but once you reach the recommended level then you'll need a sensible maintenance dose which may be 2000iu daily, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. You can do this with a private fingerprick blood spot test with City Assays

There are important cofactors needed when taking D3

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 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 out the other cofactors too.


They are thyroid. You're still hypo with a TSH of 3.6. And your FT4 and FT3 are scraping along the bottom of the ranges. Not surprising you have symptoms! Stupid man.

But, as Susie explains, some of your symptoms are due to nutritional deficiencies. But, I don't suppose he knows anything about that, either.


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