Still don’t know much about ranges for Underactive thyroid. But finally got to see Endo last week. My god she was arrogant. Looked more through my medical notes , not a lot of questions. I got a welll we can either take you off Levothyroxine or as your stable we will leave you on them. No blood test 🤔. Day after get a letter to go and get Bloods done. Got my results today. Please can someone tell me if ok ?? Thanks 🙏
TSH- 1.4 mU/L 0.30-6.00
Free T4 -11.2 pmol/L 10.4-24.5
FreeT3 - 4.9. Pmol/L. 3.0-7.1
Much appreciated for any feedback. 😀
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19mags66
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Only you can say, really. Do you feel OK? Are you symptomatic?
The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it needs to be for FT4 and FT3 to be in the upper part of their respective reference ranges when on Levo if that is where you feel well, for patients on Levo only.
So your TSH is pretty good at 1.4 mU/L (0.30-6.00) but your FT4 is very low in range at 11.2 pmol/L (10.4-24.5). Your FT3 is quite low in range.
What thyroid meds are you on? By the look of your results, it suggests that you take either NDT or T3, they don't really correspond with someone taking Levo only.
When did you take your last dose of thyroid meds before the blood draw?
What are your vitamins and minerals like, are they optimal:
I usually have my levothyroxine 50mg at 4am get up for work @5am. So I missed my dose and had a blood test at 3pm. That day.
B12 am due for injection again on 23rd Nov.
Doctor will not check full bloods for 12 months as they only go on T4 and said it was normal.
I do not feel ok. Aching all over, hair dry and like omg gummage. Legs heavy. Tired all the time . Forgetful with in seconds. Go shopping , walk in and stand there looking dumb... don’t know what I want or why I’m there 😯.
If I've worked this out right, you took your Levo at 4am the day before your blood test, missed the 4am dose on the day of the blood test (24 hours) then had blood drawn at 3pm (total 35 hours). If that's correct, then you have got a false low FT4 result and a test done under the advised conditions - ie leave off Levo for 24 hours - would give a higher FT4.
Your TSH will be lower at 3pm that it would if you'd had an early morning blood draw, so a test done under the advised condition would give you a higher TSH than this result.
So really, this test isn't telling you much at all.
If I were you, if I couldn't get a test at my GP surgery at the recommended time of 8-30-9.00am then I would do a private home test to get accurate results. Do it no later than 9am, adjust the timing of your Levo if necessary to leave no more than 24 hours (it can be a bit less but not too close to the blood draw), and fast from evening meal/supper until after the test (you can have water).
As you don't have current vitamins and minerals results, then I'd get those done too.
So really I should have took my dose at 4am. Hard with work just cannot get bloods done in a morning. What’s the do them myself ?? Even on the blood results I have. What does it mean if they are low ?? Why can my endo not see that if they are so experienced. ?
Why can my endo not see that if they are so experienced. ?
Most endos aren't experienced with thyroid disease. Most are diabetes specialists with little knowledge of how to treat thyroid conditions.
It's very unusual for a doctor to go by FT4 result, they tend to go by TSH normally. But with your FT4 so low in range, that should tell your GP that you are undermedicated anyway. As mentioned above, the aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it needs to be for FT4 and FT3 to be in the upper part of their respective reference ranges when on Levo if that is where you feel well, for patients on Levo only.
Free T4 -11.2 pmol/L 10.4-24.5
Your FT4 is 5.6% through it's range, that is extremely low. Most people need it in the upper third/upper quarter of the range.
Thanks Suzie, I know I’m not right or feel well. Will wait for endo to get back like she said so should hear something next week. Will post the outcome. Must admit really felt so deflated after my app . Felt more like I will tell you how you feel and how well you are. Like I had no say. Won’t repeat what I was really thinking . 🤔😮😀
I saw an endo, about 20 years or so ago. He was an absolute pig and very rude, even though my husand was there too. I saw him 3 times and cried on the way home each time (I'm tougher now, I wouldn't let anyone speak to me like that any more).
I asked my GP if she knew him. She said that she didn't know him personally but "knew of him". I told her I was refusing to go back to see him again. She said "I don't blame you" !! She also said she didn't agree with him reducing my dose of Levo and promptly increased it again. I wouldn't go and see another endo now if I was paid.
Seems I saw his sister then. Think the care profession gone on that score . Well paid job to deflate sufferers that they have not got a clue on nor experience in the field. Should be a vaccine to give them to experience the trauma we go though on a daily basis. Might think quite differently and show some compassion .
Exactly what I think. Every endo should be made hypothyroid for 6 months. Just to know what it feels like and be told the blood results are ''optimal''. Those guidelines for treating hypo would change very fast.
The more I read on this site, the more I realise how lucky I am to have an NHS endocrinologist who is a thyroid specialist and believes in treating patients as individuals.
Hi Dot , wish I had seen one that was so understanding. I saw mine on 25th Oct. sure she had a broom in corner. Must admit the only laugh I had was in the waiting room when the nurse came out. Holding up a cardigan and saying she had acquired a black cardigan ... any owners. I just replied yes it’s mine but I’m glad I didn’t leave my knickers in there. Cheered up the waiting room 😂
HiDot, great to hear you have a good NHS Endo. Have you given Dionne ( secretary of Thyroid UK) the name of your Endo? so she can share with all of us. As you say very rare indeed. Thanks B.
Hi I would recommend Dr Hisham Maksoud! He is based in Nottingham but I think he has clinics in the East Midlands. He’s very understanding & has told me how I can get T3! Given me links to chemists in Europe etc! He charges £250 for 1st appointment & £175 for subsequent appointments! He has written 2or3 books on thyroid problems . I feel so much better now he’s sorted me out!
How do these consultants remain in post when they are so offensive? It defies all logic. We really shouldn't be treated like this, but it seems that the system of hierarchy makes it inevitable, in most cases. Anyway, agree with you...we need to be quietly assertive.
How do these consultants remain in post when they are so offensive?
I think because the majority of us don't say anything, or if we do we don't take it higher. I would have been about 50 when I saw one, and both my late husband are/were the sort who afford respect to people, not the confrontational type, and I think we were like most people, thinking that doctors were something special. I'm older and wiser now, and wont take that sort of disrespect from anyone - after all respect goes both ways. If it happened now I wouldn't put up with it, I'd tell him what I thought about his attitude, leave the consultation and make an official complaint.
Having symptoms of hypothyroidism would make you symptomatic. The problems you describe mean yes, you are symptomatic and, therefore, probably under-medicated.
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, take last dose 24 hours prior to test, and take next dose straight after test. 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 .
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
Just a thought, but are you getting frequent enough B12 injections? I assume you were previously diagnosed deficient? Many people need more regular injections. I am not medically trained but as well as having thyroid problems , I need injections every other day of B12. Unfortunately serum B12 tests won’t help you once you’ve started injections but it’s something to be aware of. Also, your folate needs to be towards the top of the range as it is needed to activate B12. I found It difficult juggling thyroid and B12 levels/symptoms but it’s worth persevering. The books, Could it be B12? And those written by Martyn Hooper of the P.A. society would be worth reading, if you haven’t already. Do as much research as you can on B12 and thyroid is my advice. You could always post on the B12 site here too. Good luck with it all.
I am on B12 injections. I had a course at the beginning and now have to go back every 3 month. Oh boy!! I can really tell about 2 weeks before that am due for next dose as my legs are not my own till I get my fix. 😀
I know the feeling. By the way, I believe new BNF guidelines have just come out reducing the time between injections for people without neurological symptoms, from every 3 months to every 2-3 months. May be worth looking in to. Best of luck .
In the US, we have our share of incompetents, dolts and morons in the medical profession. Our advantage is that there isn't a centralized medical system, so we can take our business down the street until we find a doctor who treats a patient like a human and doesn't see lab results as the end all, be all. I've yet to find a primary care physician who knows more than I know, LOL. Seeing a new one in a few weeks; an osteopath. On his website, he sounds good. We'll see.
Follow up from Endo. Had 2 missed calls from Doctors . Been told that they received a letter from Endo and she has upt my dose to 75mg saying I was under medicated. Pick up meds tomorrow . Hey ho !! Some result there. 😀 Thanks Guys will see how I go .
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