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Thyroid UK
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Test results

Hi there,

My tests results below:

Thyroid Function

TSH 3.50 0.27 - 4.20 mIU/L

T4 Total 76.7 66 - 181 nmol/L New range

Free T4 13.80 12.0 - 22.0 pmol/L

Free T3 4.11 3.1 - 6.8 pmol/L


Anti-Thyroidperoxidase abs H 196.0 <34 kIU/L

Anti-Thyroglobulin Abs H 306 <115 kU/L


Vitamin D (25 OH) L 43 Deficient <25 nmol/L

Insufficient 25 - 50

Consider reducing dose >175

Vitamin B12 513 Deficient <145 pmol/L New range

Insufficient 145 - 250

Consider reducing dose >569

Serum Folate 16.10 8.83 - 60.8 nmol/L

I'm currently on 75 of levothyroxine and gp refuses to increase it. I'm constantly shattered, can't sleep, can't concentrate. I've also gained 1 stone in weight and can't shift it. I've been on the mirena coil for over a year now and, not sure if it is a coincidence, the symptoms got worse since I started. Help please!!! Thanks Livia

3 Replies

Mirena coils do seem to cause problems fir thyroid patients but irrespective your results scream underactive ...your GP is nuts

Correctly treated your TSH should be 1.0 or below

Free t4 should be more like 19

Freet3 should be more like 5.5

Find the research paper from Dr Midgeley on this forum and take that to your GP ...tell him that NHS choices website have given you the advice of how to correctly treat hypothyroid


You need dose increase

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: at


Official NHS guidelines saying TSH should be between 0.2 and 2.0 when on Levothyroxine

See box

Thyroxine replacement in primary hypothyroidism


Your vitamin D is far too low. You will need to self supplement to improve. GP would only prescribe 800iu, not enough for a hypothyroid mouse.

What about ferritin levels?

Do you suffer heavy periods?

Detailed supplements advice on Low vitamins and how to improve


Also your antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).

About 90% of all hypothyroidism in Uk is due to Hashimoto's

Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels

Low vitamin levels affect Thyroid hormone working

Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten

According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

But don't be surprised that GP or endo never mention gut, gluten or low vitamins. Hashimoto's gut connection is very poorly understood

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies

Ideally ask GP for coeliac blood test first









Thank you both for the really thorough and informative advise! I will follow up again with my GP but I'll go armed with your NHS guidelines this time....


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