Thyroid UK
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Can anyone help with my test results?

I just got my results back from Medichecks and I want some guidance in the potential implication of my results before I see my GP. I am on 100mg of levothroxine. I was previously on 125mg but moved onto super healthy diet as had shingles twice in 3.5 weeks in December. The doctor thought there was a problem with the immune system and i was being over medicated and so meds dropped to 100mg after 3 months. I am coeliac and follow a strict gf diet and I also have pernicious anaemia and have b12 injections every 3 months. I am still not sleeping properly ie a solid night sleep and feeling tired and brain fog despite still having followed a diet to repair the gut and immune system. I know something is not right. The summary was my that my dosage may be too low which can be associated with hashimotos and I have borderline vitamin D deficiency- which may account for some of my symptoms. Also said have high iron stores which maybe due to dietary supplements but not taking any so recommended an iron deficiency check.My medi check results came back with the following:

TSH 3.77 (0.27-4.20)

Free thyroxine 13.9 (12.00-22.00)

Total t4 78.2 (59.0-154.0)

Free t3 3.89 (3.10-6.8)

Reverse t3 14 (10.0-24.0)

Reverse t3 ratio 18.09 (15.01-75.0)

Thyroglobulin antibody 155 (0-115) flagged as needs attention

Thyroid per oxidase antibodies 11.6 (0-34.0)

B12 102 (25.1-165)

Folate (serum) 5.5 (2.91-50)

25 OH vit D 53.7 (50-200)

CRP - high sensitivity 0.44 (0-5)

Ferritin 160 (13-150) needs attention

Iodine - serum 48 (40-80)

TIBC 48.62 (41.0-77.0)

Transferrin saturation 35.83 (20.0-55.0)

Iron 17.42 ( 6.6-26.0)

Magnesium 0.9 (0.6-1.0)

Sorry for so much detail but I think someone may be help point me in the next direction. I am feeling suboptimal and at 75% but not sure what to do/ check next. I did the candida saliva test and all clear. Can some please help? Thank you so much in advance as just want to feel better.

16 Replies
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Hi Debra,

Welcome. It's good that you posted all your results, even though it probably took an age to type them all in :-)

I'm sure one of the experts will be along tomorrow, but it seems to me that you are undermedicated. TSH should be near 1, and free T3 and free T4 should be towards the top of the range, whereas they are quite near the bottom.

Do you have blood test results from when you were on the higher dose previously? I'm just wondering why your doctor thought you were overmedicated then. You don't need to type the whole lot in, just FT3, FT4 and TSH if you have them.

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Hi thank you so much for responding.the previous results are:

Jan2018 I was on 125mg results were

Plasma free T4 19.9 (7.7-15.1)

Plasma TSH 0.28 (0.34-5.6) and meds were adjusted to 100mg of levothyroxine

In April my results were

Plasma free T4 14.5 (7.7-15.1)

Plasma TSH 0.68 (0.34-5.6)

No t3 test was conducted.

I look forward to your response.

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Yes I agree why on earth did your GP reduce your thyroid meds!! Definately need to put them back up and then retest in 6-8 weeks. Your thyroid hormones need to be in the top third or near the top of the range and your TSH below one. Your thyroid hormones are hovering at the bottom of their ranges & your TSH is too high. I suspect your doc went in the wrong direction and should have raised not decreased!

Low vitamin D does increase the likehood of infections and persistant ones too. So be a good thing to address. The vitamin D Council has good advice on this.

Low vitamin D cause non retorative sleep & fatigue.

You have a lot to deal with. Do you have access to a functional doctor? -Im wondering if such a doctor could help you with balancing nution as due to your conditions I wonder how well you absorb nutrients from the food from your stomach?

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Hi thank you so much for responding.the previous results are:

Jan2018 I was on 125mg results were

Plasma free T4 19.9 (7.7-15.1)

Plasma TSH 0.28 (0.34-5.6) and meds were adjusted to 100mg of levothyroxine

In April my results were

Plasma free T4 14.5 (7.7-15.1)

Plasma TSH 0.68 (0.34-5.6)

No t3 test was conducted.

I have tried to hunt down a functional practioner with specialties in coeliac and thyroid but all lists are closed for at least 6 months. I am very interested to explore this option so any recommends will be gratefully received.

I look forward to your response.

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Hi Debra. The main direction to point you is that you have Hashimoto's, as shown by your high TGab. You are also quite under medicated. The treatment for Hashimoto's is to suppress your TSH and to elevate your FT3 and FT4 into the optimal zone of their ranges. The doctor is correct: you have a problem with your immune system and not just by having shingles. He does realize that Coeliac Disease is an autoimmune disease, I hope? Hashimoto's is also an autoimmune disease.

Your FT3 and FT4 are practically non existent. Optimal free's means both FT3 and FT4 will be over 50% for both frees but not over 75% of range. This will suppress your TSH. Many well medicated people with Hashi's have suppressed TSH below 0.5. Your FT4 is currently 13.9, when it should be at least 17. Your FT3 is 3.89, when it should be at least 4.95, if not higher.

What does this mean? "The doctor thought there was a problem with the immune system and i was being over medicated and so meds dropped to 100mg after 3 months.". What does an immunity problem have to do with over medication and dropping dosage? It would be helpful if you could post your labs from when this doctor said that you were over medicated.

Folate, very low. Are you taking any folate? Your level is much too low. Folic acid is synthetic. It can be toxic for some people with malabsorption issues. Methyl folate is a better choice. It's co-enzymed and not synthetic.

Vitamin D, very very low. Do you take any D supplements? Your insufficient level will make you feel very poorly. It should be at least over 150, ideally over 175, and closer to 200. You'll need to take a loading dosage of D and then take daily high dose D, and retest in several months.

Ferritin, over range. If you're not taking an iron supplement, are you eating a lot of iron containing foods? Do you supplement high levels of Vitamin C? Vitamin C increases uptake of iron from food. Taking even 1,000 mg (which is a decent sized dosage) vitamin C every day can increase your iron uptake from food to the point that your ferritin could double (mine did). If none of this applies to you, then it's your high ferritin or iron overload could be caused by haemochromatosis.

Magnesium. Is that rbc or serum? If that is serum at that level, the amount of magnesium getting into your red blood cells will be much lower. Low magnesium will cause all sorts of symptoms and will need supplementation if RBC is too low.

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Hi ShootingStars,

You said " Your FT3 and FT4 are practically non existent. Optimal free's means both FT3 and FT4 will be over 50% for both frees but not over 75% of range"

Can you please explain why the frees should not be over 75% of range.

We often read on here that they should be near top of the range so this could bring them over 75% of range.

Thank you.

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Hi lucylocks! Sorry, I started writing my response on my phone, gave up and waited until I got to my computer. :-) If both hormones were over 75%, there would be a lot of hypo symptoms. Even if one is over 75%, certain symptoms will accompany this level. Low range and high range is where the most symptoms exist. The lower in the range, the more hypo symptoms. The higher in the range, the more hyper symptoms. Over 75% of range starts to make the thyroid operate too fast. Below 50% of range and the thyroid operates too slow.

It's not quite that simple because the thyroid is complex and there are two separate thyroid hormones that work together. T4 is converted into T3, the active hormone and the one that influences many bodily processes and particularly regulates metabolism. TSH regulates the production of T3 and T4. TSH and T4 work together. When TSH is released by the pituitary gland, it stimulates the production of T4. Conversely, these T4 levels dictate the amount of TSH that is released. If a thyroid can't produce enough T4, it will never be able to produce enough T3 either.

FT3 and FT4 work together and need to be closer to being in balance than having one hormone a lot higher than the other (Straight T3 supplementation is a separate conversation that causes high FT3 levels and low FT4 levels and comes with it's own risks.). Supplementing too much T4 will offset the balance, and especially if there is a conversion problem or Hashimoto's autoimmune attacks to the thyroid occurring. That's why you see people on this site who are only prescribed T4 having too high FT4 and still being very hypo. If they are only receiving supplemental T4, no amount of T4 is going to raise their T3 without further raising T4. They will remain hypo until this imbalance is corrected by adding T3.

This is why you would not want your FT3 and FT4 to be up over 75% of range, just as why you wouldn't want them below 50% of range. Either is inviting symptoms that you don't want.

:-)

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Many thanks for your reply,

do you mind having a look at results. Both were done through Medichecks.

Taking 125mcg. levothyroxine.

December 2017

THYROID STIMULATING HORMONE *0.014 mIU/L 0.27 - 4.20

FREE THYROXINE 19.4 pmol/L 12.00 - 22.00

TOTAL THYROXINE(T4) 91.4 nmol/L 59.00 - 154.00

FREE T3 5.04 pmol/L 3.10 - 6.80

THYROGLOBULIN ANTIBODY 103.000 IU/mL 0.00 - 115.00

THYROID PEROXIDASE ANTIBODIES 20.8 IU/mL 0.00 - 34.00

Do you think these levels look good?

Still getting symptoms so had another test.

April 2018

THYROID STIMULATING HORMONE *0.021 mIU/L 0.27 - 4.20

FREE THYROXINE 17.8 pmol/L 12.00 - 22.00

TOTAL THYROXINE(T4) 78.5 nmol/L 59.00 -154.00

FREE T3 4.1 pmol/L 3.10 - 6.80

THYROGLOBULIN ANTIBODY 115.000 IU/mL 0.00 - 115.00

THYROID PEROXIDASE ANTIBODIES 21.1 IU/mL 0.00 - 34.00

25 OH VITAMIN D 54.5 nmol/L 50.00 - 200.00

Three weeks ago I increased by 25mcg. levo. so now taking 150mcg.

Going by the results would I have been better adding a small amount of T3 instead of the 25mcg. levo.

I have been getting swimming dizzy feeling and feeling nauseous and really tired.

Any advice would be really appreciated.

Thank you.

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Hi lucylocks. I’d be happy to. Can you do a fovor and create a new post with your same results? I don’t want to take over DebraL’s post. You’ll also get more views and responses that way.

If you’ll send me a message when you post, I’ll know go look for your post and when to respond.

😊

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Hi thank you so much for responding this is a really good explanation and despite being diagnosed for 17 years this is the first time anyone has explained what I need to look for in my results. I am now actively keen to take control and not just accept that because a computer says its normal that I should accept it as that is quite obviously not the case!

My previous results were:

Jan2018 I was on 125mg results were

Plasma free T4 19.9 (7.7-15.1)

Plasma TSH 0.28 (0.34-5.6) and meds were adjusted to 100mg of levothyroxine

In April my results were

Plasma free T4 14.5 (7.7-15.1)

Plasma TSH 0.68 (0.34-5.6)4

No t3 test was conducted.

I am not taking folate and I was taking 25ug of vitamin d3 but stopped 10 days before the last blood tests. I am not taking any iron supplements but I have been having lots of spinach in a smoothie with a kiwi (vit c) and a supplement babaob powder with flax and chia seeds, blueberries and nut milk. Also lots of veg and oily fish 2-3 times a week so it would seem my vit c is really increasing absorption which I thought was a good thing but now not so sure.

I'm not sure what the magnesium measure was but I do take a supplement for magnesium citrate to try and help me sleep.

I look forward to your response shooting star- you are a shining star!

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Hi DebraL. Thank you! :-) I'm a little confused by the dates of your results. In your original message, what is the date of those results? April results were 6 weeks before?

Why did you stop taking D3 before your blood tests? You don't need to. I hope you've resumed your Vitamin D? How long had you been on that level? Your D is very low. It should be close to 200. It will take a long time to get it there if you're only taking 25ug.

Your ferritin level is concerning because it shouldn't be so high when you're eating whole foods. When you say you've been having a lot of smoothies, what is a lot? Spinach and kiwi both contain iron and C, but not so much that daily or even 3x a day smoothies would make you have iron overload. Are there any other sources where you'd get C and iron?

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Hi shootingStars. Jan results were taken 16th Jan, April results were mid April and medichecks were taken on 8th may. My last b12 injection was 24th march. Until Jan I used to take my meds in evening and would have no caffeine or milk in the eve to reduce malabsorption. I then switched back to am but nothing to eat or drink for 1 hr after taking them except lemon and warm water. It is possible as can’t remember that the April result may have been taken after I’d had meds in morning as previously not a problem as took them in evening. May bloods were taken after fasting and no meds. My doctor will not retest thyroid before 12 weeks so it’s taking a long time to get sorted.

Thanks

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Sorry only read half message before responding! I only started taking vit d in Jan as read that could be an issue as coeliac so went to Holland and barret to get some as my doctor would not test for vit d. I stopped taking them to see if my diet was suffice to as eat oily fish etc nuts seeds. My adjusted calcium level was low in January but doctor decided not to pursue but I think that makes sense if low vit d. I have a smoothie 3/4 times a week other than than it’s eggs and salmon or full fat yogurt with nuts seeds and blueberries. I have a low sugar diet so may have an apple but other than fruit or veg and meat all mostly organic no other supplements.

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I have started taking them again. In winter I go to work in dark come home in dark and don’t leave the office. But I am outside cycling to work and exercising outside now

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Your folate needs to be higher as it’s needed to process the B12 you are getting from your injections. So trying to find a methyl folate supplement could help.

Your VitD is also low.

Others have responded very well on your thyroid results.

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Thank you for this as it really helps!

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