Blood tests results advice please... - Thyroid UK

Thyroid UK

117,068 members135,836 posts

Blood tests results advice please...


I would really appreciate any advice about these results from the GP... Not sure what I am looking at..

Many thanks in advance.

Serum free T4 level (XaERr) "above range" 16.8 pmol/L (7.0 - 16.0)

Serum TSH level (XaELV) 0.768 miu/L (0.38-5.33)

TPO antibody Thyroid Perioxidase antibody POSITIVE

(guess that means I have Hashimotos)

Serum Vitamin B12 level (XE24r) 246ng/L (150.0-900.0)

Serum folate level (42U5) 9.2 ug/L (3.1-19.9)

Serum ferritin level (XE24r) 207 ng/ml (15.0 - 400.0)

Serum 25- hydroxy vitamin D3 level (XaEQa) 36.9 nmol/L (with scales of recommended action: 25-50 nmol/L: VIT D deficiency consider replacement being applicable to this result)

17 Replies

These results show very low vitamin B12 an vitamin D

Low vitamin D, upsets B vitamins - see this link

(Vitamin D in America measured in ng/ml not nmol )

Low B vitamins and vitamin D both linked to Hashimoto's

So are you now supplementing vitamin D? Or B complex/B12

Vitamin D needs improving to around 100nmol. Many with Hashimoto's find vitamin D mouth spray is good as avoids poor gut function. Trial and error what each person needs to improve levels and then what needs as on going maintenance dose

Retesting after 2-3 months and then twice yearly.

Also look at importance of magnesium and vitamin K2 Mk7 when on vitamin D supplements. Lots of posts about this on here

Symptoms of low B12 includes tinnitus and balance issues

Very common with Hashimoto's due to poor gut function and low stomach acid

Before starting on any B vitamin supplements you really need to talk to GP and get tested for Pernicious Anaemia. Possibly need B12 injections

If GP won't test or offer this then a daily good quality vitamin B complex, possibly plus a sublingual B12, likely to help. Again masses of posts about this on here

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

As you have Hashimoto's are you already on strictly gluten free diet? If not you probably want to consider it

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)

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

Lastly only make one change at a time

Start with vitamin D

Getting futher B12 testing by GP before starting B vitamins

Then strictly gluten free diet

Would need to retest thyroid including FT3 (not tested here) in 2-3 months

If GP can't offer FT3 test, then like 1000's on here, you may need to test privately

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.

All thyroid tests should ideally be done as early as possible in morning and fasting.

If on Levothyroxine, don't take in the 24 hours prior to test, delay and take straight after. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)


I see from one of your posts a month ago you already take B12

In which case your true B12 level is likely substantially lower than this

The fact you have been investigated (for long time) due to balance issues and tinnitus strongly suggests low B12

You really need to have intrinsic factor and full testing for Pernicious Anaemia, but not sure if already taking B12 or B complex affects tests

Gambit62 may know the answer to that. She may be along with suggestions

Are you still on vegan diet? It can be difficult to be vegan, soya and strictly gluten free

Have you managed to get right off the propranolol yet? Or still slowly reducing dose? Last reduction can be the hardest.

Correcting low Vitamin D can increase our need for B vitamins as body starts to repair, the link from Dr Gominack's explains that well. Peripheral neuropathy can start or get worse about month or so after starting high dose vitamin D

Your not taking any omeprazole or Lansoprazole or similar PPI, for high stomach acid are you?

FIT2018 in reply to SlowDragon

Hi, and thanks for all that information. I'll try and answer all as accurately as possible:

I may have been mistaken in saying I was on B12 before my GP did the tests I posted. Since then, I have been taking B12 and Grey Goose suggested a spray, which I started 2 days ago (I think this is a 1000ug dose) and a Vit D spray 3000ug once a day. I take my (higher 175mcg) dose of levo at night now as well, as I was waking up with tinnitus and deafness and this also means I am not taking anything else with the levo. (this seems to have helped)

I have come off Propranolol with no noticeable effects - did this gradually..

I am no longer vegan, as you pointed out, this just became too difficult to manage - I am still dairy + gluten free and obviously the first thing to go was the soya after info received here.

So.. I have been called in to the GP due to the last test results, on the 22nd I believe I have a nasty feeling that he is rubbing his hands together as there is a nice get out of trouble result for him to grasp onto: Hyperglycaemia. I have read in many places that this is usually due to low T3 levels.conversion, so I'm going to have a medichecks test done before I see him and then see if he will either prescribe T3 if needed or refer me to an endo.

In fact my blood test results were almost precisely described in Dr Tofts report... which I have also printed out to use as a weapon!

I feel I have been reacting to advise given here and to my test results.. and then finding out other important info afterwards! Like not taking VitD within 4 hours of Levo... I am also not really sure how much B12 or D to take, so have been taking it to see if I feel any better.

To be honest, I have made some good improvements - my hearing has good and bad days now, which is both hopeful for the future and a blessed relief from constant deafness and noise. I truly believe that I can get this to a minimal manageable state once I get the full picture and can optimise everything.

So all in all I have made some drastic changes since coming on this forum, I expect these will take time to take effect, but I do feel very different.

No soya

No gluten

No beta blockers

Vitamin supps

Extra Levo

As a footnote, you mention neuropathy - I don't have this, but do get pins and needles/prickling in my arms, neck, head and legs at various times of the day which is new... keeping an eye on this.

Also have reduced my training regime to something more gentle and have increased my food/calorie intake with a balanced diet which now includes meat.Can;t wait to see the full T3 picture... feel like I'm on a mystery quest, juggling 20 balls and whistling a tune :)

SlowDragonAdministrator in reply to FIT2018

Sounds like you are making excellent progress

As well as B12 are you taking a good vitamin B complex? Helps keep all B vitamins in balance

Remember to stop taking Vitamin B complex 3-5 days before blood test

You are using vitamin D mouth spray? I don't think it as important to be 4 hours away, as we absorb it in mouth not gut. But if you're now taking Levo at bedtime that makes it easier anyway

Many of us find bedtime Levo works better

Have you looked at magnesium and vitamin K2 Mk7 supplements as well when on vitamin D. Propranolol apparently lowers magnesium (according to the book The Magnesium Miracle)

Yes Medichecks test at least 6-8 weeks after last Levo dose increase.

If your results show low FT3 then Thyroid UK has list of recommended thyroid specialists, some are T3 friendly

NHS GP is no longer allowed to prescribe T3, must be diagnosed as having clinical need by NHS endo

Obviously most NHS endocrinologists are being pressured into not prescribing. So it's important to see the right endo.

FIT2018 in reply to SlowDragon

Great info, I wasn't really holding out much hope for GP T3 etc... or endo for that matter... so I'm going to wait another couple of weeks before private bloods as you say, to allow for changes in Levo dose etc. Will then make use of the forum again for next steps. Will stop B vits before test as you suggest (and Levo 24 hours before, fasting etc)

In the meantime (as I am sure I have improved because of this) I will work on the supplements..

I wondered about the B complex- no I'm not taking any other vitamins (again because I am now so nervous about making mistakes!) - So off I trot to get a good B complex, magnesium and Vit MK7!

Many thanks for this great advice. Much appreciated.

SlowDragonAdministrator in reply to FIT2018

Igennus Super B complex is good quality (my favourite as it's two small pills per day. Can start with just one or remain on just one per day

Other recommended brands on here are Jarrow B right or Thorne. Both good quality, but large capsules

Natural origins is good vitamin K2 Mk7 - small soft gel

Calm vitality magnesium powder is cheap and easy to use. (Best early evening - four hours minimum away from Levo) Be warned start slowly on low dose, too much can cause diarrhoea

Lots of other magnesium options too

FIT2018 in reply to SlowDragon

Great stuff, thanks so much👍

FIT2018 in reply to SlowDragon

Hiya, bit of an update.. I received my medichecks T3/T4 results, with the comment from the doctor that everything seems normal.

Given the changes I have made, I'm pleased that I'm converting, if they results are being read correctly.

I have put myself on thyroid_s now since the day after the tests, to try and see if levothyroxine as a medication is causing the hearing /tinnitus /vertigo issues I have had to live with for so long.

With these results, if they are correct, I will know if Levo is to blame, as T3 is not the likely cause it seems.

Am I going in the right direction do you think?

I'm having b12 injections starting on Tuesday and doctors prescribed mega vitd weekly dosage...

I am my own science experiment!

I would really appreciate any insight you may have..

Thanks in advance 👍

FIT2018 in reply to FIT2018

0. 651.. 0.27 / 4.20. TSH

19. 300 12 / 22 free thyroxine

5.06. 3.10 / 6.80. free T3

SlowDragonAdministrator in reply to FIT2018

Your results look pretty good. Obviously all the vitamin improvements have made FT3 result pretty impressive. You appear to be a pretty good converter

Be interesting to see if you find NDT better.

Keep an eye on thyroid antibodies. Some people find antibodies rise on NDT, others find it better than T3

FIT2018 in reply to SlowDragon

Thanks again I will indeed keep testing. I want to give this new regime 6 weeks before doing the full spectrum test again... Whilst monitoring my hearing issues without levothyroxine.. I think I had a bit of a bad start as I was being cautious starting Ndt and went a bit hypo again, but should be OK.

If I don't get improvements to my hearing etc I might as well stay on levothyroxine seeing as I'm converting and at good levels.

I'll post my journey with this strategy as I progress.

Many thanks and best regards ☺️

Serum 25- hydroxy vitamin D3 level (XaEQa) 36.9 nmol/L

To work out your ideal dose of vitamin D3, use these two links :

1) Convert your result into ng/mL using this link :

It gives a result of approx 15 ng/mL

2) With a level of 15 ng/mL and assuming your weight is 140lbs (you can obviously put in the right weight for yourself), use this link :

Your ideal level of supplementation will be 4000 - 5000 iU per day.

Edit : 40 ng/mL is equivalent to 100 nmol/L.

FIT2018 in reply to humanbean

Hey, that is super helpful... many thanks :)

FIT2018 in reply to humanbean

Wow, that tells me I need 6000iu per day... so twice what I am taking. I am looking for a B12 calculator on this site now...

humanbean in reply to FIT2018

I've never come across a B12 calculator. :(

FIT2018 in reply to humanbean

Yep, I've been scooting about the net... nothing doing.. but thanks for the D calc though, another piece of the jigsaw done!

SlowDragonAdministrator in reply to FIT2018

Many of us need similar dose, even in summer

Ideally retest twice yearly via £29 NHS postal kit....if not doing Medichecks full test

You may also like...