Thyroid UK
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Help with test results please

Hello. Have had results from blue horizon and would welcome any thoughts/suggestions.

I was diagnosed about a year ago and certainly felt better now than at that point but am still easily fatigued and cold. Dosage is currently 125/150 mcg levothyroxin alternate days.

TSH 0.31 (0.27-4.20)

T4 total 95.2 (66-181)

Free T4 18.00 (12.0-22.0)

Free T3 3.89 (3.1-6.8)

ATP abs 214.0 (<34)

ATG abs 266 (<115)

Vit D (25OH). 62 (insufficient 25-50)

Vit B12 252 (insufficient 145-250)

Serum folate 5.88 (8.83-60.8)

Any advice about which supplements to take and when would be greatly appreciated.

Thank you.

Stumpy57

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Folate is below range so your doctor may be able to prescribe. If not, a good quality B complex with all the methylated forms of B could raise your folate level. Also, you can increase folate rich foods in your diet. You need a little folate from your diet every day.

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Thank you Nanaedake. Am seeing GP next week and will review my diet. I have gone gluten free and the effort of that has resulted in a not particularly varied shopping list.

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Your FT3 is too low and you may want to ask GP to prescribe some T3. I understand they've been told not to as it is now too expensive. You can source your own if you wish by putting up a fresh post asking for information to be sent to you by Private Message.

Your post will then be closed for answers on the forum but messages will be sent to you with information.

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Thank you shaws. Will ask the forum to PM after the GP has said no to T3.

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But why? Your too low FT3 on that level of levothyroxine shows that you aren't converting T4 into T3 very well. You need T3/liothyronine supplement in order to help raise your T3.

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I’m hoping for a positive response from Gp but am stealing myself for a lively debate.

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Your FT4 isnt too bad but your FT3 is out of sync with a ratio of 4.6:1, you are not converting well as you should. Good conversion is normally considered 4:1 or under as FT3 is what the body actually uses. Your nutrient levels are also bad. We need good levels in order for our bodies to convert and use thyroid hormones whether our own natural production or synthetic.

If you search SeasideSusie she gives very good nutrient advice including good levels (not just somewhere in the range), the best forms to take and which ones to take at what intervals to maximise absorption. She helped me fix my bad levels and my conversion did improve to slightly under 4:1and I felt noticeably better on the same levo dose. A lot of nutrient deficiency symptoms cross over with thyroid ones, I had fairly good thyroid levels but found what I thought were remaining hypo symptoms (fatigue, various aches and pains, sluggish thought et al) didn't finally resolve until i fixed my nutrients too.

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Thank you. Will search for SeasideSusie. There are so many supplements out there and I’m sure some are better than others. Seeing GP soon for the T3 debate. Not hopeful but can but ask.

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The main trick is finding the best absorbed forms, eg vit d is fat soluble so oil filled soft gels tend to be better absorbed than tablets. Iron, magnesium and calcium block uptake of each other and other nutrients (AND LEVO) which is why multivits are rubbish and you cant just take a handful of supplements all at once but may need to space some. Magnesium comes in a topical spray oil which doesnt interfere with anything else and b12 is good as sublingual lozenges. Obviously cost can be a factor so you want to get the most benefit without breaking the bank, my vit d is the most temperamental to thats where I spend the extra for a sublingual spray. It is definitely worth sitting down with pen and paper and working out what you need to take, what forms it comes in etc and the best way to space things to give you the least hassle and keep cost down

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That’s encouraged me to do just what you suggest - work it out on paper. And also to think through results and research info before seeing gp. Appt a week away so I’ve no excuse!

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I admit i like things visual and it does seem to help with GPs too, so if you get bored here is another suggestion you may find helpful (especially if you ever change gp in the future).

Go through the hypo symptom list on TUK and list all the ones you have ever had down one side. Put your dose, test results and dates at the top and score each symptom against each result. Mine is in nice primary colours. Red for bad, green for good, yellow for improved or worsening from previous state, gp acknowledged my approach was right and allowed my tsh to hit suppressed when it showed i need an FT3 of around 5.7 (3.1-6.8) to feel well and i firmly believe it was because she could see the sea of red transitioning to green and also what was not changing at all so posibly not thyroid related. I then added in nutrient results symptoms and voila a sea of mostly green she now argues far less about nutrient retesting too!

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And thanks for the T4:T3 conversion ratio. That will be a good conversation opener with doctor.

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You are welcome, the ratio is simply FT4 divided by FT3. Do not expect your GP to have any knowledge about good ratios or the effect of nutrient levels on thyroid hormones. They get half a days trainjng on thyroid and less on nutrition, this is why they are happy if you are just somewhere in the ranges. Your best bet is to get reading posts etc looking for useful links especially to research, I always leave a week between tests and GP to get advice here on what GP is likely to think and gjve me time to find the info to help steer her in the right direction, she is not very thyroid knowledgeable but is willing to listen to a reasonable argument, yours has at least got your tsh and ft4 at the right ends of the ranges which is a good starting point so hopefully they will work with you on everything else.

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