Thyroid UK
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Blood results

Can anyone please give me some advice on my latest bloods?

I had my thyroid completely removed about 15 years ago and have been on 125 thyroxine daily for a good number of years. Currently going through waves of fatigue. Some days I am ok, other days just seem to have no energy. I also take methotrexate for rheumatoid arthritis, and folic acid. Other than that, just cod liver oil.

Serum free T4 level 20.9 pmol/L [11 - 22]

Serum free triiodothyronine level 4.4 pmol/L [3.1 - 6.8]

Serum TSH level 0.03 miu/L [0.3 - 4.5]

folate level > 23.2 ng/ml [2 - 18.8]

Serum vitamin B12 level 218 ng/L [150 - 1,000]

Serum ferritin level 82 ng/ml [12 - 250]

Serum vitamin D level 67 nmol/L [> 50]

Thank you.

4 Replies

Hi and welcome to the forum. Your fatigue is probably because your ft3 is very low and your conversion isn't very good. This could at least in part be due to your nutrient deficiencies. Your vit b12, ferritin and vit d are all too low and need to be supplemented. There are many posts about vitamins and minerals, check out our expert SeasideSusie, for instance in this post . Not exactly same situation as yourself but look at the advice on optimum levels, doses, etc. Only take good, single supplements.

You may struggle to persuade a GP to increase your dose of levo as your ft4 is fairly high already, but an increase may well help.

If this doesn't help, and when nutrient levels are optimal, then you may need to consider either adding t3 or taking NDT.


1 like

Thank you. Would it be advisable to ask GP about B12, ferritin & vit D initially?


You can ask, but because they are all in range the gp is unlikely to treat. NHS generally just treats anything below range, rather than bringing them up to optimum. That's even if they understand that optimum is a different thing - not very likely from experiences within the forum!

Much more likely that you will have to supplement for yourself.


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I'm not surprised you're fatigued. We mustn't forget people who've had thyroidectomys have lost around 20% T3 production which the thyroid itself produced. It now falls mainly on our livers to convert all of the T4 to T3 which our body needs and it may sound paradoxical but when Ft4 is on the high end, it hampers conversion of T4 to T3. You may consider dosing with T3 as well to increase T3 levels, but it would mean you'd need to reduce your FT4 levels or you'll end up suffering from tachycardia. If you go down that path, you'd really need an endo who knows how to dose with both. You'll feel so much better when your FT3 rises (and FT4 is reduced)


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