Blood tests ok but feel rubbish : Basically that... - Thyroid UK

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Blood tests ok but feel rubbish

Rachael3000 profile image

Basically that, I had been feeling rubbish for a few months now - tired, joint pain, no energy - the classic hypothyroid symptoms. I had blood tests but doctors said this came back as normal. I have also been put on the mini pill desogestrel - could this interfere with hypothyroidism?

I’ve added my recent blood tests. Would be very grateful if someone could help?

Thank you

21 Replies
SeasideSusie profile image


Where are your thyroid test results?

Anything else that we can't see - Serum iron is 21, which is fine, but was anything else tested, eg Ferritin? B12? Folate? Vit D?

Oh sorry, thank you for replying.

Iron 21umol

B12 355ng/l

Folate 11.3 ug/l

TSH 2.13

Treepie profile image
Treepie in reply to Rachael3000

FT4 ,FT3 and antibodies and ranges for all thyroid results are needd.

Rachael3000 profile image
Rachael3000 in reply to Treepie

So do I need to go back then?

shaws profile image
shawsAdministrator in reply to Rachael3000

A blood test for thyroid hormones, should be at the very earliest, fasting (you can drink water). If you were taking thyroid hormone replacements you'd allow 24 hours gap between last dose and test and take afterwards.

You should request:

TSH, T4, T3, Free T4, Free T3 and thyroid antibodies.

Get a print-out with the ranges. Ranges are most important for members to comment upon them.

Treepie profile image
Treepie in reply to Rachael3000

For good advice from the expert sufferers on this site you must always give the ranges shown in brackets as lab ranges differ and it is important to know where you are in the range. So Seaside Susie who is very knowledgeable on vits can give good advce.

The GP should have tested FT4 but they rarely test FT3 which is stupid as it is the active hormone all cells need .It is why so nany use private testing.

Are you takng Levothyroxine ,if so how much?

Rachael3000 profile image
Rachael3000 in reply to Treepie

Oh I do have ranges

Iron 21 (7-32)

B12 355 (211-911)

Folate 11.3 (2.0-11.5)

TSH 2.13 (0.35-5.50)

SlowDragon profile image
SlowDragonAdministrator in reply to Rachael3000

For full Thyroid evaluation you need TSH, FT4, TT4, FT3 plus TPO and TG thyroid antibodies.

Plus very important to test vitamin D, as well as folate, ferritin and B12

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies

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. When 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)

If 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. Low vitamins are especially common with Hashimoto's. Food intolerances are very common too, especially gluten. So it's important to get TPO and TG thyroid antibodies tested at least once .

A TSH over 2 very likely means you are under medicated and need dose increase. See GP and request 25mcg dose increase and bloods should be retested in 6-8 weeks time.

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

(Many of us need TSH nearer 0.2 than 2.0 to feel well)

See box

Thyroxine replacement in primary hypothyroidism

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

Thank you for your response, I will go back to the doctor to see if they will do the other blood tests. I don’t have a slight concern with being increased as I was on 125mg about 16 months ago but the dose was too high and I was brought back down to 100 however I don’t know what my levels we’re at that point and if they have changed since that.

SeasideSusie profile image
SeasideSusieAdministrator in reply to Rachael3000


Iron is fine, as mentioned. But you really need ferritin as well and that needs to be half way through it's range.

B12 is on the low side. Check to see if you have any signs of B12 deficiency here and if you do have any you will need your GP to test for B12 deficiency/pernicious anaemia.

An extract from the book, "Could it be B12?" by Sally M. Pacholok says:

"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".

"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."

Folate is good.

You need Vit D testing.

TSH 2.13 (0.35-5.50) - this alone is not enough. You also need FT4, FT3 and Thyroid antibodies. If your GP wont do them you can do a private test with one of our recommended labs which covers everything you need.

Thank you for your reply. In terms of B12 the only symptoms I feel is Weakness/fatigue, and constipation. I did have bit D levels checked in September which came back as being slightly too high and was told to stop taking any supplements but I don’t take any however no direction was then given. So really I need to get the doctor to do further blood tests?

SeasideSusie profile image
SeasideSusieAdministrator in reply to Rachael3000


What was your "sightly high" Vit D result back in September?

If you don't have any symptoms of B12 deficiency you will be fine to take sublingual methylcobalamin lozenges to raise your level. I would think that you could buy some 5000mcg dose, use one bottle then change to 1000mcg dose. When taking B12 we need a B Complex to balance all the B vitamins. As your folate is at a good level, you might want to look at Igennus Super B, contains the active form of the ingredients, and 1 x tablet daily should be enough.

I can’t remember what the results we’re now. So if I purchased the B12 supplement and I genius super B should I still get the recommended blood tests done? Any particular brand for the B12? If I get blood tests done privately which package shall I go for, there’s so many?

SeasideSusie profile image
SeasideSusieAdministrator in reply to Rachael3000


The only nutrient test missing from the main ones always recommended here is Ferritin. You could ask your GP to test that, if he wont then Medichecks do an "Iron Deficiency Check" which is a fingerprick test and includes the full iron panel, normal cost is £39 but sometimes on offer at £29.

As your vitamins and minerals have been tested (mostly) then you need a full thyroid panel and this one covers everything Thyroid Check Plus

But there is currently an offer on Thyroid Check UltraVit which includes the vitamins and minerals - Ferritin included - and it's £79 at the moment so cheaper than doing the iron deficiency check plus the thyroid panel

It wont hurt to repeat the vitamins and minerals. and you get Active B12 rather than serum B12 which is useful.

Jarrows is a popular 5000mcg sublingual methylcobalamin supplement, I don't use it but I only need 1000mcg dose.

Thank you so much for your help, is B12 natural? I won’t feel any side effects if I don’t need B12 or too 5000 much etc? I have found this one? Any good?

Sorry I don’t know much about the condition(other than the basics) doctors aren’t supportive and always say blood tests are normal. I’m very grateful for your help xx

SeasideSusie profile image
SeasideSusieAdministrator in reply to Rachael3000


Yes, that's the one. If you're a bit nervous about the 5000mcg dose, why not buy some 1000mcg dose. B12 is water soluble, so any excess is excreted. You certainly wont be taking too much if you take the 1000mcg dose. Jarrows do one, or the one I use is this one which is on 3 for 2 this month.

I accidentally brought the b12 as methylcobalamin and adenosylcobalamin is this okay still or not as effective?

Thank you

SeasideSusie profile image
SeasideSusieAdministrator in reply to Rachael3000


Are you talking about the Cytoplan one? If so that is fine, it's the one I use.

Yes it was that one, there was one with just B12 which was the one I intended to buy but accidentmy purchased this one. Oh good at least it should do the trick. How long until it should make a difference, I’m going drs later this week to get the extra bloods done and my thyroxine increased (hopefully!)

SeasideSusie profile image
SeasideSusieAdministrator in reply to Rachael3000


With a B12 level of 355 and taking only 1000mcg supplement, it will take quite some time. It would rise more quickly if you took 5000mcg daily as I originally suggested that you use 1 bottle then change to 1000mcg dose but you didn't seem too keen to do that. So it will rise with taking 1000mcg daily but I can't say how long it will take.

Ok I have ordered the 5000mg tablets, I panicked slightly with the high dose but I’m now happy to try anything I’ll make me feel better. Thank you

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