Thyroid UK

Hypothyroid and other blood results

Hi all, I posted last week following some private blood test to check my thyroid function which showed

Free T3 2.7 (3.10-6.80)

TSH of 1.88 (0.27-4.20)

Free thyroxine 12.4 (12.00-22.00)

T4 61.2 (59.00-154.00)

As advised I went to my GP and had my vit D and other things checked

Serum b12 - 569(211-911)

Serum folate - 6.47 (3.38-23.9)

Liver, kidney and bone profile all within normal limits

Haemoglobin 141 (120-160)

Ferritin 29 (10-291)

TSH 2.17 (0.55-4.78)

Vit D 25 OH 26 (50-374)

I am waiting the results of T3 and T4

Does anyone have any thoughts on the vit D, TSH and ferritin? I am currently taking 125mcg levothyroxine.

Thanks 😬

8 Replies
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Your ferritin and vitamin D are both very low

Vitamin D your GP should really give you loading dose, a high dose for several weeks

oxfordshireccg.nhs.uk/profe...

Ferritin, you need ferrous fumerate supplements. Probably 2 or 3 times daily

Detailed supplements advice from SeasideSusie on low vitamins in this post due to under medication

healthunlocked.com/thyroidu...

Your FT4, TT4 and FT3 private tests all show you are under medicated

FT4 should be near 20

TT4 at least over 100, ideally higher

FT3 above 5

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,

"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)."

You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor

please email Dionne:
tukadmin@thyroiduk.org

Prof Toft - article just published now saying T3 is likely essential for many, otherwise many must run suppressed TSH in order to get adequate treatment if on Levo only

rcpe.ac.uk/sites/default/fi...

You might consider trying gluten free diet, though your antibodies don't definitely say Hashimoto's

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Many thanks for all the info ( as said in my last post). My GP wanted all the bloods respected in a ‘reputable and accredited lab’ so that’s the recent ones. I have printed the articles to take but she did say about the possibility of referring to an endo depending on this T3 result.

I am confused as to how they all link together and whether I can demand treatment for my ferritin as it appears to be within range even though I feel rotten?

Reply

TSH is largely irrelevant. Free T3 and free t4 are too low - in fact free T3 is under range so you need an immediate 25mcg increase in levo. Ferritin is bad, should be taking 3 x 210 ferrous fumarate per day. You need a loading dose of vit D as you have a severe deficiency. Folate isn't great either. B12 is just OK.

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Many thanks for the info. I shall try and fight with the gp!

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You can self treat the ferritin if they won't

You could self treat the vitamin D, but really they should acknowledge and prescribe

Adding a good daily vitamin B complex (with folate, not folic acid) would improve folate.

If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 3-5 days before any blood tests, as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

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So it seems that they have only checked my TSH and not my T3 and T4 levels!!! How thoroughly unhelpful!

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So the GP has prescribed me a loading regime of Vit D 60,000 units a week ( I think). Says that my ferritin isn’t low enough to need supplements as my hb is good. Apparently the lab didn’t do the T3/4 despite it being requested so just waiting on those now.

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So Free T4 12.0 (10-18.7)

T3 3.2 (3.5-6.5)

What would you all advise as the next step?

Thanks

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