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Thyroid UK
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Thyroid results

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Diagnosed 2012 with hypothyroidism

Symptoms slowly coming back - pins and needles, joint pain, feeling cold, dry skin, hair loss, tiredness, weight gain, puffy eyes and feet, feeling mentally slow, lowered confidence

Am I undermedicated

Felt better on T3 and was doing better in my job on the T3

Results below on 75mcg levothyroxine


TPO antibodies 296 (<34 IU/mL)

TG antibodies >1300 (<115 IU/mL)

TSH 4.60 (0.27 - 4.20 mIU/L)

Free T4 14.6 (12.0 - 22.0 pmol/L)

Free T3 3.8 (3.1 - 6.8 pmol/L)

9 Replies

So who prescribed T3 and when and why was it stopped?

You are very under medicated to have TSH this high. What has GP said? You need increase in dose.

Also your antibodies are high this is Hashimoto's, (also known as autoimmune thyroid disease). About 90% of hypothyroidism in UK is due to Hashimoto's.

Hashimoto's very often affects the gut, leading to low stomach acid, low vitamin levels and leaky gut.

Low vitamins that affect thyroid are vitamin D, folate, ferritin and B12. Important to test these. If they are too low they stop Thyroid hormones working.

Have these been tested? If so add results to this original post

if not ask that they are. Always get actual results and ranges.

As you have Hashimoto's then hidden food intolerances may be causing issues, most common by far is gluten. Changing to a strictly gluten free diet may help reduce symptoms and eventually start to lower antibodies. Very very many of us here find it really helps and can slowly lower antibodies, improving symptoms






Previous endo prescribed T3 due to an identified clinical need

Current endo stopped it and said he didn't care if it was helping me feel better, he considers it dangerous

GP just wrote comments on printout saying ?? Thyroid disease seeing hospital consultant and GP has not informed me about results

Vitamin and mineral levels checked and I supplement but feel no improvement


Your TSH is far too high, see GP and ask for 25mcg dose increase.

Retest after 6 weeks, ask for vitamin D, folate, ferritin and B12 to be rechecked

All thyroid tests should be done as early as possible in morning and fasting and if taking Levo don't take it in the 24 hours prior to test, delay and take straight after.

What are actual vitamin results and ranges. Just being in range is very often not good enough

Have you tried strictly gluten free. Many of us find it helps significantly, others don't notice much difference initially but even so their antibodies still fall slowly and as antibodies lower we feel better.

Suggest you find a T3 friendly endo. Email at Thyroid UK for list of recommended thyroid specialists, plus copy of this artclie by Prof Toft below


copy of Dr Toft's article from Pulse online

Dr Toft was president of BT ( British Thyroid Foundation)

6 What is the correct dose of thyroxine and is there any rationale for adding in tri-iodothyronine?

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).

Even while taking the slightly higher dose of levothyroxine a handful of patients continue to complain that a sense of wellbeing has not been restored. A trial of levothyroxine and tri-iodothyronine is not unreasonable. The dose of levothyroxine should be reduced by 50µg daily and tri iodothyronine in a dose of 10µg (half a tablet) daily added.


Ferritin 41 (30 - 400) confirmed iron deficient and taking 1 iron tablet per day since Feb this year

Folate 2.2 (2.5 - 19.5) confirmed folate deficient and taking 1 folic acid tablet per day since 2016

Vitamin B12 157 (180 - 900)

Vitamin D 50.6 (25 - 50 deficient) confirmed vitamin D deficient and taking 800iu per day since 2014

Results a month old

Not gone gluten free



No wonder you feel no different these are dire

Why has your GP not done full testing for Pernicious Anaemia and intrinsic factor?

Supplementing just folic acid in presence of low B12 is not advised. GP should know that


I have pinned this to

SeasideSusie so she can give you the full vitamin supplements advice

Really suggests that your gut is badly affected. Highly likely you would find strictly gluten free beneficial

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Ferritin 41 (30 - 400) confirmed iron deficient and taking 1 iron tablet per day since Feb this year

You have not been given the correct treatment for iron deficiency. Please see, and then discuss with your GP:

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.

Ferritin needs to be at least 70 for thyroid hormone to work, and it's recommended that it's half way through it's range.

You can help raise your level 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...


Folate 2.2 (2.5 - 19.5) confirmed folate deficient and taking 1 folic acid tablet per day since 2016

I would ask your GP why your folate is still deficient considering you've been taking folic acid for a year. Maybe you have an absorption issue which needs investigating (common with Hashi's).

Folate should be at least half way through range, but as SlowDragon has said it should folic acid should not be taken when B12 is so low.

Vitamin B12 157 (180 - 900)

This is dreadful and your GP has been extremely negligent if he has ignored this.

Please post on the Pernicious Anaemia Society forum for further advice healthunlocked.com/pasoc Quote your folate, B12 and ferritin results, mention your iron deficiency and any signs of B12 deficiency you are experiencing which you can check here b12deficiency.info/signs-an...

Supplementing with folic acid can mask symptoms of B12 deficiency so think back to whether you had any before starting you started the folic acid.

Whatever is advised on the PA forum, make an urgent appointment to discuss it with your GP. You probably need testing for Pernicious Anaemia and you probably need B12 injections.


Vitamin D 50.6 (25 - 50 deficient) confirmed vitamin D deficient and taking 800iu per day since 2014

3 years supplementing and you are just 0.6 away from Deficiency. I raised my level from severely deficient at 15 to 202 in 2.5 months with a sensible dose!

800iu D3 isn't anywhere near enough. It is hardly a maintenance dose for someone with a reasonable level.

My suggestion is to supplement withD3 softgels like these bodykind.com/product/2463-b... and take 5000iu daily for 6-8 weeks then retest. When you've reached the level recommended by the Vit D Council - which is 100-150nmol/L - then you'll need a maintenance dose which may be 2000iu daily (not the paltry 800iu prescribed), 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 vitamindtest.org.uk/

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.


You are entitled to have T3 if you have a clinical need. This Endo has jumped the gun and has decided he wont prescribe even if a patient has a need. He should change his job to another as his vocation has got lost somewhere along the road.

I would change this doctor as he is self-satisfied, it would appear. He isn't god and cannot visualise how difficult it is for us who need T3.

If you go to the pinned post on the right-hand side you will see that Thyroiduk.org.uk has a Campaign going on, just started about T3 and sign it and then make an appointment to see your local MP about the withdrawal of your necessary T3.


Can you see a different GP within the practice?

This one is either indifferent or out of their depth.


Yes I can see a different GP


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