Advice please

I would be grateful for advice following latest tests. When the test was done I was taking 100mcg T4 and 12.5mcg T3. I have since increased the T3 to 25mcg

TSH 0.06 (0.27 - 4.20)

Free thyroxine 15.8 (12.00 - 22.00)

Total thyroxine 85.4 (59.00 - 154.00)

Free T3 4.64 (3.10 - 6.80)

Reverse T3 17 (10.00 - 24.00)

Reverse T3 ratio 17.7 (15.01 - 75.00)

Thyroglobulin antibody 21.00 (0.00 - 115.00)

Thyroid peroxidase antibodies 93.9 (0.00 - 34.00)

thank you in advance for any advice. All of these tests are as a result of T3 being withdrawn a year ago, when I was very well on 100mcg T4 and 20mcg T3

13 Replies

Ann -

Thyroglobulin antibody 21.00 (0.00 - 115.00)

Thyroid peroxidase antibodies 93.9 (0.00 - 34.00)

Your high TPO antibodies confirm autoimmune thyroid disease aka Hashimoto's which is where antibodies attack the thyroid and gradually destroy it. The antibody attacks cause fluctuations in symptoms and test results.

You can help reduce the antibodies by adopting a strict gluten free diet which has helped many members here. Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks. You don't need to be gluten sensitive or have Coeliac disease for a gluten free diet to help.

Supplementing with selenium l-selenomethionine 200mcg daily can also help reduce the antibodies, as can keeping TSH suppressed.

Gluten/thyroid connection:


It's difficult to comment on your other results, you haven't said how you were feeling, but with those results if I wasn't feeling good I would have also increased the T3.

thank you for reply. When the T3 was withdrawn a year ago, I felt very unwell and this continued until I started taking T3 again at the level of 12.5mcg. Although some symptoms reduced, I still felt quite unwell and so after the last blood tests were done I immediately started taking 25mcg of T3 along with the 100mcg T4 and now feel so much better and within quite a short time. One symptom that has not yet gone is the breathlessness on exertion. I am hoping that will reduce in time, but I wonder if because I have been without T3 for nearly a year, it will take a little time to be symptom free. And do I now try to reduce the dose or do you think I should stay on the 25mcg I am presently on.

Another thing, about 10 years ago I was diagnosed with frybromalgia - and on reading around the subject, I am wondering if that is caused by a badly treated thyroid. Maybe if I keep all the vitamins etc well up the scale that will help that. I was treated with amitryptaline, but have not been taking it since last spring. I always dropped the dose in the summer and increaded it in the winter months.

All food for thought. We are all so individual aren't we.

Ann Simpson

If it was me, I would wait until I'd been 6 weeks on 25mcg T3 added to my Levo then retest. Depending on how I felt and the results, particularly FT3, then I would decide whether to stay on 25mcg T3 or adjust.

thank you; and do I need the full amount of tests as before or is it possible to have fewer ones done, and which ones would that be including as you say FT3. I have used Medichecks for the blood tests.

Unless you particularly want anything else testing, the basic TSH, FT4 and FT3 will be enough

As you have Hashi's, quite often nutrient levels are low so it would be an idea to get them tested if not already done:

Vit D




All need to be optimal for thyroid hormone to work.

thank you very much for your reply. Having embarked on self medication after withdrawal of the T3 I do appreciate all your knowledge on this site. I have listed the B12 and folate results, the Vit D was 83 (50.00 - 200.00) I take 1,000 iu daily Vit D and ferritin was 59 (13.00 - 150.00) I would be interested to know what you think of these.

Ann - you posted some nutrient results 4 months ago in this thread when Folate was 6.7 (2.91 - 50.00), Ferritin 45.16 (13.00 - 159.00) and B12 311.4 (140.00 - 724.00) and suggestions were made. And in another thread you said Vit D was 94.58 (50.00 - 200.00). So something has happened to some of your levels, some better, some worse.


B12 127.9 (25.10 - 165.00) [ as 311.4 (140.00 - 724.00) ]

I take it the new result of 127.9 is Active B12 (which is what Medichecks now do in their test bundle) and the 311.4 was the Serum B12.

If the 127.9 is the Active B12 then the result is good. You can't compare Active B12 and Serum B12, they're measuring different things. You go by where they are in the range and don't compare the actual result of one against the other.


folate 11.79 (2.91 - 50.00) [was 6.7]

This hasn't improved much, it needs to be at least half way through it's range. Are you taking a good B Complex with 400mcg methylfolate, eg Thorne Basic B?


Vit D 83 (50.00 - 200.00) [was 94.58] I take 1,000 iu daily Vit D

For your level to fall then you're not taking a good enough maintenance dose. As it's now winter and we can't make Vit D from the sun, then you need to increase your dose. I would suggest 2000iu daily, along with it's important cofactors K2-MK7 and magnesium. Retest in April to ensure you are within the recommended range of 100-150nmol/L.

ferritin was 59 (13.00 - 150.00) [was45.16]

This is improving slowly. You need to get it up to an absolute minimum of 70 for thyroid hormone to work and conversion to take place. You said you were going to eat more liver as you didn't think you could manage an iron supplement, you need to increase it then, maximum 200g per week due to it's high Vit A content.

thank you so much for all your trouble in answering me. The B12 was the active one, so that is OK. I will up the dose of Vit D per day and introduce magnesium which I am not taking. and eat much more liver! And I am taking a B complex from Healthspan and when the next lot arrive I will check exactly what is in them. It is called the high strength B complex. So I do need an extra B12 which is good.


These are the values of the B vits in Healthspan High Strength B Complex:

Vitamin B1 20mg

Vitamin B2 20mg

Vitamin B3 20mg

Vitamin B5 20mg

Vitamin B6 10mg

Vitamin B12 250µg

Biotin 50µg

Folic Acid 400µg

Choline 200µg

Inositol 20mg

PABA 20mg

and the ingredients:

Bulking Agent: Maltodextrin, Folic Acid Prep. (Dicalcium Phosphate, Folic Acid), Bulking Agent: Microcrystalline Cellulose, Vitamin B12 Prep. (Maltodextrin, Cyanocobalamin, Trisodium Citrate, Citric Acid), Thiamin Mononitrate, Calcium Pantothenate, Riboflavin, Inositol, Nicotinamide, Para-Aminobenzoic Acid, Coating (Hypromellose, Talc, Titanium Dioxide, Iron Oxides), Pyridoxine Hydrochloride, Biotin Prep. (Dicalcium Phosphate, Biotin), Stearic Acid, Anti-Caking Agent: Silicon Dioxide, Croscarmellose Sodium, Magnesium Stearate, Choline Prep. (Choline Bitartrate, Silicon Dioxide).

I know that Healthspan is a fairly popular brand and I've never understood why. Look at the ingredients and there are so many bad things about them, the bulking agents and fillers, coating, etc. There are so many better brands without all these bad ingredients.

I've bolded Folic Acid and Cyanocobalamin because they are the wrong frm of the vitamins. They should be Folate (methyfolate) and Methylcobalamin.


I don't know what Vit D you are using but D3 softgels usually only contain 2 ingredients - the D3 and some kind of oil for absorption, a good one will contain extra virgin olive oil, eg Doctors Best and they come in different doses.

thank you and I will buy from your suggested sources in future. Ann

One symptom that has not yet gone is the breathlessness on exertion.

Being breathless is common in people on this forum. Low iron and ferritin (iron stores) and low B12 are common culprits.

thank you for that advice. Although medichecks said that my B12 and ferritin tests were normal, they were not that high B12 127.9 (25.10 - 165.00) and folate 11.79 (2.91 - 50.00) I am taking a B complex supplement, do you think I should add B12 in addition? And then eat more iron containing foods. And see how if my breathlessness improves.

You don't need extra B12 Ann, that is a good result, look where it is in the range. See my reply above.

List of iron in foods

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