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Pls Help! Can You Go From Years Of Hypothyroid And Turn Hyper?? Total confusion with new Blue Horizon blood results

I'd be so grateful if someone in the know can decipher my current blood results. The Blue Horizon test laboratory states my results are showing as hyperthyroid with higher T4 and low TSH, my T3 is on the low end of normal range so must not convert well. I have been hypothyroid for 15 years with all the symptoms that go with it. If I am hyper why am I gaining weight and feel sluggish etc etc? I don't have hyper symptoms apart from the odd hot flush ( I am the younger end of menopausal age). People I have known who are hyper loose weight effortlessly, for me it's a real battle. They also say my B12 is elevated. I supplement so need to back off with that. Apparently, my antibodies are up too and say I could either have Hashimoto's or Graves (I don't seem to have Graves symptoms, but if I am not now showing as hypo how can I have Hashi as I thought that is a hypo condition??)

Anyway, here are the results as listed:

B12 963pg/ml 197-771

Folate 11.9 ug/L 2.9

Ferritin 40.0 ug/L 13-50

TOTAL T4 116 nmol/L 59-154

TSH 0.04 MIU/L 0.27- 4.2

FREE T4 23.4 pmol/L 12.0- 22.0

FREE T3 4.3 pmol/L 3.1- 6.8

VIT D 83 nmol/L 50-200



Note: I presume the ranges on the right are the so called 'normal' ranges!?

Please can anyone interpret these for me...


13 Replies

Once we have have Hashimoto's we continue to have it even after treatment and on Thyroid replacement hormone.

You need to read as much as possible about Hashimoto's, it's a difficult and complex disease

Gluten free diet helps many and can slowly lower antibodies







Your thyroid results don't show your hyper. Just treated about adequately, though your FT3 is on low side

Vitamin D is a bit low. Do you supplement?


Thank you so much for your comments. I don't know why the BH test doctor states I am hyper then. They didn't comment on the Vit D... I take a D3 supplement from the supermarket. What is the optimum then, I want to overdose as apparently it can be toxic at higher levels. As no comment was made on the Ferritin and Folate, I presume they were fine. I was pretty gutted to learn of Hashi possibility, going gluten free isn't an inviting prospect for me and on trying it before, I became terribly constipated.


Vitamin C and Magnesium should help with the constipation .... :-) Magnesium and VitK2-MK7 need to be taken with VitD to ensure improved levels of calcium obtained from foods are directed to bones and teeth and away from soft tissues - including the heart.


Thanks for your help! :)

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The reason the BH doctor says you are a bit hyper is because your TSH is below range and your Free T4 is above range. But in the opinion of many patients the important number is your Free T3, and that is quite low in range, suggesting that you are definitely hypo, not hyper, and you don't convert well.

What meds do you actually take, and at what dose?

In your shoes I would want to slightly increase my vitamin D. I try to keep mine around 100 nmol/L, but optimal is usually quoted as being between 100 - 150 nmol/L.

Personally, I think your B12 is fine, and I would want to keep it fairly close to the level it currently is.

I'm assuming your folate is 11.9 with a reference range of >= 2.9? I hate reference ranges like that - I prefer ranges to have a top number. When I've had tests done for Folate the top of the range has been either 18.7 or 26.8 ug/L, but I have seen top of range being as high as about 60. However, I couldn't tell you whether those ranges with a high of 60 were being used with the same units of measurement as your test.

Your ferritin isn't very good, although your doctor will tell you it is wonderful. Have you ever had a full iron panel or a full blood count? If your serum iron and other iron measures were low as well as your ferritin, then I would suggest you could supplement iron for a while. But at the moment I don't have enough information to be sure that is a good idea.


Thanks! I am prescribed 100mcg levo but take 112mcg as I have generally felt a bit more alert with that but feel it's not totallly working for me now due to an increase in some symptoms. I am more convinced now that I should requesting / or purchasing added T3 to try and level out my T3 level and reduce the T4 slightly. Is this the usual way of thinking? I have experimented with tiromel and ndt for short periods but felt it best to wait until I could purchase a fuller blood test to get a better picture so reverted back to levo until now after the test was done.


In your shoes I would suggest reducing Levo back to 100mcg per day, and taking, say, quarter of a tablet of T3 twice a day. You will almost certainly have to fiddle with your dose(s) though. For the first guess to be right would be highly unusual!

Bear in mind that T3 is (according to most patients) about three times as potent as Levo. So 25mcg T3 (1 whole tablet of most brands of T3 bought online) would be equivalent to about 75mcg Levo. But this equivalence is just an approximation.

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I've only had the folate and ferritin done through blue horizon recently. I have had b12 and iron deficiency test at at the GP within the last year and were told they were normal.


Your B12 was only over range as you had been supplementing - it is suggested that any testing whilst taking B12 is of little value as results are skewed. Also the B12 result is the amount circulating in the blood and only round 20% of that amount can make it to the cells where it is needed .... You may wish to take a maintenance dose. How much were you taking and which brand ?


I think there are possibly two things going on here neither of which are fully understood by your average GP ...

Firstly raised antibodies and low TSH, higher T4 indicate a Hashi's flare which means that your thyroid is under attack, basically disintegrating, and releasing hormone into the bloodstream.. this isn't being converted well, so your T3 remains low... If you're not already gluten-free then this should help reduce these antibody attacks significantly. I take selenium (low dose) without any ill effect to help reduce antibodies, but some people find that it is easy to overdo it, so take for a short period and then stop, if you're worried.

Secondly, and this is where things get very complicated and new, I suspect (unless you've been taking mega doses) you may possibly have an absorption issue with folic acid actually getting into the cells and it's just circulating in the bloodstream uselessly, which can lead to other problems.... (please see link) It depends which version you've been taking, but I'm suspecting folic acid rather than methylfolate?




Thank you, what should I be saying to my GP? They are only bothered about my T4 and will only say to lower my dose. I just take supermarket B vit complex with a high potency B12, vit c, zinc, D3, selenium, vit E, adrenal support, berberine and just started myoinsitol as recommended by Dr Westin Childs. I have ordered probiotics and considering T3 supplementation properly now I have the results.


I'd talk to your GP about Hashi's flare ups.... something could have set off an autoimmune response... if you've not already been tested for coeliac disease it's worth looking into.. also milk - casein can also cause issues.

Given that you also have digestion issues, then it's possible you've got problems creating the enzymes that absorb folic acid. Continue with the b12 only and ditch the cheap b-complex and note that biotin (also in b complexes) can skew thyroid panels. You would probably be better off with a methylated b-complex. B5 and B6 (ideally p-5-p form) are very good for adrenal health.


If magnesium isn't included in the adrenal support, then that's also very important to help you metabolise b12 and folate and for T4 - T3 conversion and keep adrenals happy. Your iron levels are not stellar. PM Seaside Susie for advice on increasing your iron levels that'll aid conversion and for vitamins advice in general.

Take Marz note about vitamin k2 if you're heavily dosing the vitamin D.


Many thanks for the advice :)


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