I have my numbers, urgent comment

Today I have obtained the lab results for the following: I need your comments since I have an appointment after three hours, it's urgent. please respond.

Total T3 = 0.76ng/ml Range 0.58-1.59

Thyroxine =6.56ug/ml Range 4.5-12

TSH = 2.344IU/ml Range 0.35-4.94

Free T3=2.68pg/ml Range 1.71-3.71

FreeT4=0.86ng/dl Range 0.70-1.48

Vit D =9.8ng/ml Range 20-100

Iron = 74ug/dl Range 50-170

Folate serum=3.5ng/ml Range 3.1-20.5

Vit B12 = 203pg/ml Range 134-605

Ferritin = 42.80 Range 4.63-204

7 Replies

Hi - quick comment till more come in. You are under-medicated, you need a dose increase. Your vit d is severely efficient, you need loading doses. Your vit b12 and folate are bouncing along bottom and will be causing problems, but GP is unlikely to treat as within range so you will probably need to self supplement. Your ferritin is only about half optimum level, but again GP very unlikely to treat.

You need your thyroid antibodies testing to confirm wether you have Hashimoto's.

Hashimoto's is by far the most common reason to be hypo in developed world. (Are you in USA?)


Your low vitamins suggest you have Hashimoto's, it affects gut function, due to low stomach acid.

With Hashimoto's changing to gluten free diet is very often essential to start to improve and help gut heal



You will need a large or "loading dose" vitamin D to get your level increased. Also recommended to take magnesium when taking vitamin D


All of these are too low:-

Vit D =9.8ng/ml Range 20-100

Iron = 74ug/dl Range 50-170

Folate serum=3.5ng/ml Range 3.1-20.5

Vit B12 = 203pg/ml Range 134-605

Ferritin = 42.80 Range 4.63-204

If you are on levothyroxine your dose is too low as TSH should be around 1 or below.

FT4 and FT3 could be higher. You need an increase in levothyroxine.

This is a previous comment from SeasideSusie and she may be able to comment on yours when she reads it.


serkaddis Too late for your appointment I'm afraid, but my comments are

TSH = 2.344IU/ml Range 0.35-4.94

Free T3=2.68pg/ml Range 1.71-3.71

FreeT4=0.86ng/dl Range 0.70-1.48

As mentioned you are undermedicated. The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever is needed for FT4 and FT3 to be in the upper part of their respective reference ranges. You need an increase in dose.


Vit D =9.8ng/ml Range 20-100

According to the Vit D Council, the recommended level is 40-60ng/ml so you are severely deficient. As Startagaingirl has mentioned, you need loading doses of D3 followed by a maintenance dose when you reach the recommended level. I don't know where you live or what the protocol for treatment is there, but if you were in the UK the following would apply

(Your Vit D is measured in ng/ml. In the UK it is nmol/L so your level has to be multiplied by 2.5 to be the equivalent of ours. Your 9.8ng/ml is the same as 24.5nmol/L and would be classed as severely deficient)

Treat for vitamin D deficiency if serum 25-hydroxyvitamin D (25[OH]D) levels are less than 30 nmol/L.

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)."

Retesting is recommended once or twice a year when supplementing, to keep within the recommended range and maintenance dose should be altered as and when necessary to achieve this.

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.


Folate serum=3.5ng/ml Range 3.1-20.5

Vit B12 = 203pg/ml Range 134-605

Check to see if you have any signs of B12 deficiency b12deficiency.info/signs-an... If so please post on the Pernicious Anaemia Society forum here on Health Unlocked for further advice healthunlocked.com/pasoc

Folate should be at least half way through it's range and B12 at the top of it's range.

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."

If you self supplement then you need sublingual methylcobalamin lozenges, 5000mcg daily to start and when the bottle is finished change to 1000mcg as a maintenance dose. A good B Complex is also needed to balance all the B Vitamins, buy one that contains methylfolate rather than folic acid.


Ferritin = 42.80 Range 4.63-204

Ferritin should be half way through it's range. If you take iron tablets then take each one 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. You can also ferritin by eating liver regularly, maximum 200g per week due to it's high Vit A content, and including lots of iron rich foods in your diet apjcn.nhri.org.tw/server/in...


All nutrient levels need to be optimal for thyroid hormone to work.

Dear SeasideSuise

Thanks for your detailed & clear response. I went to my Endo yesterday and I showed her the results. Contrary to your response she said i need to reduce the dosage of levothyroxine from 100mcg per day to 100mcg 6 days a week i.e. 85.7mcg per day. Regarding results of vit D and others she said she needed to further see results of the undermentioned for next appointment which will be after 6 wks. If possible please tell me your opinion on her decision. Thanks again.

Serun Vit D

Serum calcium

Serum Phosphorous

Serum intact PTH

serkaddis What was your endo's reason for reducing your dose of Levo? Nothing is out of range. As mentioned in my previous reply, the aim of a treated hypo patient generally is for TSH to be 1 or below and the free Ts in the upper part of their ranges if that is where you feel well.

Here on the UK, Dr Anthony Toft, leading endocrinologist and past president of the British Thyroid Association, wrote in Pulse magazine (a magazine for doctors) the following

"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance.

But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."

This can be found here:

thyroiduk.org.uk/tuk/about_... > Treatment Options

If you would like a copy then email louise.roberts@thyroiduk.org and you can print it, highlight question 6 and discuss with your endo and then ask her what was her reason for reducing your Levo.


As far as Vit D is concerned check the Vit D website


"Blood Levels

The Vitamin D Council recommends maintaining serum levels of 50 ng/ml (equivalent to 125 nmol/L*), with the following reference ranges:

Deficient: 0-40 ng/ml (0-100 nmol/l)

Sufficient: 40-80 ng/ml (100-200 nmol/l)

High Normal: 80-100 ng/ml (200-250 nmol/l)

Undesirable: > 100 ng/ml (> 250 nmol/l)

Toxic: > 150 ng/ml (> 375 nmol/l)"

That information is from a page aimed at health professionals and you can see that they are saying 40-80ng/ml is sufficient and 0-40ng/ml is deficient. You can see which category you very obviously lie in. Discuss with your endo.

There's lots of other information on that site so have a look around, read and learn so you can discuss with your endo.

I imagine she is doing those other tests to check your parathyroid glands, you can read about that here vitamindcouncil.org/parathy...

Thanks, I will do all your recommendations.

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