Thyroid labs : Hopefully someone can help me... - Thyroid UK

Thyroid UK

118,695 members137,687 posts

Thyroid labs

Jazziestar profile image

Hopefully someone can help me understand.. I seem to have severe end symptoms of both hypo and hyper so I'm confused.


FREE THYROXINE 14.6 pmol/L 12.00 - 22.00

FREE T3 5.27 ( 3.10-6.8)

Thyroid peroxidase antibody 280. normal is less than 60

Advice. I'm totally fatigued. Palpitations.. Weight gain then weight loss. Feel cold but severe night sweats?

Help 😁 is it hashimotos or thyrotoxicosis?

36 Replies

Hi Jazziestar

You can’t always go just by symptoms - perversely, people who are hypo sometimes experience symptoms more commonly experienced by those who are hyper and vice versa.

Assuming you aren’t on any thyroid medication:

With those numbers, you don’t appear to be hyper. Your FT4 is within range, but quite low, while TSH is above range. You don’t give the range for either FT3 or TPO, your TPO result coupled with FT4 being quite low suggests you may have Hashi’s.

Do you know the range for FT3?

Jazziestar profile image
Jazziestar in reply to Valarian

Hiya and thanks for replying.

Ft3 range is 3.10 to 6.8 pmol

Antibody range was up to 60.

Hope that helps.

Valarian profile image
Valarian in reply to Jazziestar

So FT3 is also within range.

I don’t have Hashi’s, so can’t comment on the likelihood of your being offered treatment for being hypo at this stage, but would have thought it unlikely as your thyroid levels are within range.

Hashi’s also has hyper phases - have the symptoms you feel are ‘hyper’ (all or any of them) reduced recently ? Possibly by the time you were tested, your thyroid levels were on the way down (or even up). If you don’t feel any better, or if your symptoms change over the next few weeks, it might be worth a retest, although you may need to organise this privately.

As Aurealis suggests, this could be something else. Most of the symptoms we experience with thyroid disease aren’t unique to thyroid problems. If your GP insists there is nothing wrong with your thyroid, you might find that asking ‘so what is causing me to feel so awful?’ puts the ball back in their court, rather than giving them the opportunity to simply keep insisting there is nothing wrong with your thyroid.

Your results and ranges are inconsistent with hyperthyroidism but could be consistent with hypothyroidism. Unfortunately the symptoms you have could occur with either... or you could have something else?

Jazziestar profile image
Jazziestar in reply to Aurealis


I'm having some malabsorption issues despite and excellent whole food diet.. Some low minerals. Calcium and selenium both just under range. My d was low but is in range past few months on supplements. Selenium I am eating Brazil nuts and calcium, I am taking d plus k2-mk7 and it was low in serum and high in hair to push it back into the bones.

There is some suspicion of macrophagic myofasciitis but only a suspicion based on ASIA syndrome.. I see neurology and gastro mid january..

I've been very unwell and incredibly fatigued past 5 years. I started gaining weight even though very sick then in 2016 and had been diagnosed with fibromyalgia and interstitial cystitis in 2014. Then in January this year I kind of went into a semi conscious state for 3 weeks and just slept and then as that stopped, I suddenly lost 23kg in 7 weeks for no reason and now struggle to gain but my bmi is just hanging in there at the bottom end but there is muscle wastage and lower limb weakness.. I've been through so so many tests its unreal this year but I just don't feel they are any closer..

We know there are thyroid antibodies and we know there are small gut absorption issues. That's about it.. Gp suspected mitochondrial damage but I've to wait to see the neurologist as its only then that can refer to mitochondrial team in Oxford.

I just feel its thyroid I don't know why.

I'm pretty housebound now as of crippling fatigue. Hair loss started this year, loads brushes out when I wash it so I don't as often. I get body jerks like spasms, cold hands and feet all the time.. Severe night sweats.. I've had the weight gain now weight loss. I have palpitations and sometimes mild trembling type feeling.

Its a mish mash of hypo and hyper symptoms.

Given the huge amount of testing I've done ( even seen the Porphyria team) then by exclusion there's not much I do have!! Just very very unwell and confused and worried honestly.

We are not allowed to name sources sorry. Could you possibly edit your post or admin will remove the info you gave later. Go to the word 'more' at the bottom of post, click, and you can edit your post.

SlowDragon profile image

High TPO antibodies confirms Hashimoto's

Low vitamin levels are extremely common with Hashimoto's

Essential to test vitamin D, folate, ferritin and B12. Always get actual results and ranges. Post results when you have them, members can advise

Night sweats can be low B12

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, sometimes 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

Thank you.

I've had all these tested and posted a bit above about the gut issues im having.

I am mostly milk sugar and gluten free the past 2 months.

I'll pop the results up with the ranges when I get home.

I have got my serum calcium and selenium up a bit already.. D was rock bottom but ok for now.. midrange so continuing supplements.

Folate was low, I supplemented.. It came up but has dropped again. I eat leafy greens daily for folate and calcium. I eat all meats re B12. B12 has always been normal but I've not yet tested for Mtfhr mutations, nor have I done an active b12 or methylmalonic acid test.. Are these important to do?

Thank you


SlowDragon profile image
SlowDragonAdministrator in reply to Jazziestar

Yes all vitamins need to be OPTIMAL, not just in range

Vitamin D around 100nmol

Vitamin D mouth spray by Better You is good as avoids poor gut function. It's trial and error what dose each person needs. Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Retesting twice yearly via

Local CCG guidelines

Government recommends everyone supplement October to April

Also read up on importance of magnesium and vitamin K2 Mk7 supplements when taking vitamin D

Do NOT supplement any vitamin K if you take any blood thinning medication including aspirin

Vitamin C and bones

B12 and folate, Supplementing a good quality daily vitamin B complex, one with folate in not folic acid may be beneficial. B vitamins best taken in the morning after breakfast

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

Ferritin level is important too

Perhaps test Zinc too

Gluten free diet needs to be absolutely strictly gluten free. Each time you eat a speck of gluten it takes months to recover

I would recommend that you look at Thyroid DNA testing too

Thanks.. I'm back in an hour so ill post results of minerals and vitamins I've had done. I've both serum and hair.. Do you want both? Or just serum?

Thanks again.


Serum sodium 140(133-146)

Serum potassium 3.9(3.5-5.3)

Serum total protein 65(60-80)

Serum calcium 2.23(2.25-2.55)

Serum albumin 41(35-50)

Serum Alkaline Phosphatase 45(30-130)

Serum Parathyroid 3.2(1.6-6.9)

Serum D 25ho 70.1(50-150).

Serum magnesium level 0.84 mmol/L [0.7 - 1.0]

Serum vitamin A level 1.46 umol/L [1.28 - 1.91]

Serum vitamin E level 19.78 umol/L [9.9 - 30.6]

Serum copper level 16.8 umol/L [12.5 - 31.8]

Serum selenium level 0.82 umol/L [1.0 - 1.78]

Outside reference range

Serum zinc level 12.6 umol/L [8.4 - 14.2]

Serum vitamin B12 level 426 ng/L [180.0 - 914.0]

Serum folate level 2.5 ug/L [3.0 - 20.0]

Outside reference range

Consider folic acid treatment if clinically indicated.

Serum ferritin level 149 ug/L [10.0 - 307.0]

I tested negative for celiac bloods.

I am using Invita D liquid 25000iu/ month past 5 months.

I'll read into your links while you look through these or any of you.

Many thanks.

I'm doing a medicheck for t3 and t4 on Tuesday. What do I need to stop and do I need to fast at all prior. It will be TSH, FT3 AND FT4 again.. Mine seen to jump around alot.. Tsh varies from 3.1 to over just over 5.



SlowDragon profile image
SlowDragonAdministrator in reply to Jazziestar

Your folate is BELOW range

B12 low at under 500

Supplementing a good quality daily vitamin B complex, one with folate in, not folic acid may be beneficial.

B vitamins best taken in the morning after breakfast

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

Vitamin D remains too low.

25,000iu a month is only 800iu a day. Dose needs increasing. Aiming to improve to at least 80nmol and around 100nmol may be better . Vitamin D mouth spray by Better You is good as avoids poor gut function. Suggest you supplement 2000iu for 2-3 months and retest.

Retesting twice yearly via

Selenium is BELOW range. Look at adding a yeast free selenium supplement

Much appreciated.. I'm not using biotin but may I ask of I should. I'll add and up the others and get the mouth spray and increase.


Go Slowdragon

I have ordered the extra supplements you advised and will go totally gluten free.

I've just had my microbiome report back for bacteria and fungi / yeast.. Is this the correct forum for gut healing as well and should I post a new thread with those results and my gut issues?



SlowDragon profile image
SlowDragonAdministrator in reply to Jazziestar

Yes suggest you put a new post up

Members know thyroid and gut are connected

Most medics still don’t seem to understand it

I had a range of tests done privately because docs gave me omeprazole which reduces acid and seems to be the blanket treatment given. Not good if acid is already low. The in-depth tests and scans eventually showed I had bile mal-absorption. He gave me medication but said fatty food can make symptoms worse which I’ve noticed is true.

I've had proton pump inhibitors, steroids and opioids for a couple of years but stopped the Omeprazole last year. I'm taking hcl betaine now and proteolytic enzymes.

I tested positive for intestinal fungi so I'm on my 3rd week of antifungals and my stomach after 2 weeks of vomititing and diarrhoea ( assumed herxheimer reaction) my gut is starting to feel a bit better. I've gastro starting mid January so hoping that will explain more.

If you don't mind me asking, do you know what test was done for bile malabsorbtion?

Did you get tested for fungi and SIBO as well and what scans / biopsies did they do? I put mine down to most of the medication I've been on as I've also had hundreds of antibiotics in my life due to interstitial cystitis. Really has not done me any good. Hope you're feeling better.


A 9 am cortisol test cannot 'come back negative', the cortisol will either be high, low, or in the right place, but there will be cortisol. Do not trust this doctor. :)

My symptoms go from one to the other too. It seems my whole body goes into overdrive for a few days then swings the other way where I can’t think straight and don’t want to do anything. Luckily this is not too regular an occurrence.

Yes that's how it feels I'm 75 percent totally in bed or I'm up and get a lot done in a day.

Symptoms too.. I've hypo and hyper and they haven't yet found another explanation for any of my symptoms. Really sorry you feel crap too. Its not nice and so little support out there from the medical world.


I replied above to some of your questions. In aware of NDT and a friend has reccomended LDN as well.. Would it be worth a low Dose of t4 to bring it up and suppress the tsh down to around 1 to see how I feel or does it not sound like a thyroid issue? Thanks alot for your reply.. J

And yes constipation is severe. Gp has me on 4 laxidos a day and a prokinetic.. My diet is excellent and I drink kefir daily etc. I'm mostly sugar gluten and dairy free last 2 months.

Skin is very dry despite using coconut oil daily and drinking 3 + litres of water a day. I despair.

Lol at the ' vampires'. I have days where I'm completely out cold and sleeping or can't get out of bed and then a day or 3 a week where I can get up, get to shops and cook and freeze food. There is no obvious pattern for me except ladies time where I tend to completely crash mid cycle and during menstruation.. My hormones are all in range normal ovulating 44 year Old female.



Yes its awful. I have a throw to chuck on and a spare duvet. Your skin gets wet and hits the cold air then we are freezing. Is it common with hypo?


Hidden profile image

Sounds like careless wording from the doctor. "Negative" probably meant if the level is normal

SlowDragon profile image

TSH is above range and FT4 low in range, you need to see an endocrinologist and trial 50mcg Levothyroxine

Thank you. This is ideally what id like to do but my gp totally said no. Given my symptoms I think a trial at least would do no harm.

I did the 4 point saliva cortisol which was low normal normal high.. Nor sure what that all means yet either.., Thoughts? Best of luck. We don't seem to get it from our doctors.

Is this normal with Hashis to swing high and low?

I'm going to post my vitamin and minerals in a bit, there are some low so it could he affecting I guess.


Aurealis profile image
Aurealis in reply to Jazziestar

One way of stopping the swinging high and low is to take thyroid hormone at a dose which suppresses tsh ...

Ooh that sounds awful.. Have you all got it? No one else in my family has symptoms or any history of it.

But already im seeing my gp not even want to consider it. How do you all manage?

Ok then yes there is diabetes, glaucoma and dyslexia in the family. My nana had some kind of illness which affected her both mentally and I know she struggled to get up in the mornings. Also had 3 late miscarriages. Possible thyroid connection?

I think so too. The not being able to get up and mental health issues combined with frequent miscarriages.. She was treated as a psychiatric patient and given electric shock therapy. Oh how I wish I could have been there for her.. I'm certain it was an illness and not a mental health issue. Tragically sad.

Can’t recall all the names of the procedures but I had colonoscopy, endoscopy, blood tests, fecal tests and then something that tested bile absorption which was done in two separate tests. The initial test was to eliminate bowel cancer as irregular bowel movements was the start.

Thanks for that. My gp has ran the cancer one and faecal elastase for pancreatic enzymes and a couple of others. H pylori was negative. Done loads of bloods abd had 3 twin sets of cameras in 3 times. I fascinatingly watched the last one wide awake in the big screen!! Nothing was found but last one was over a year ago. Definately not had the bile test. What symptoms were you getting? Did you have weight loss? Vomiting at any point?

Thanks for replying.


Dreadful diarrhoea. I already had digestive problems and was put on omeprazole. I have since stopped because I have low acid which was coming up in a fine spray affecting my throat and sinuses.

Omeprazole certainly seems the go to choice for Doctors. They also had me on olanzaprole.. I've had months of diarrhoea and vomiting which was so bad I ended up in agony and acute kidney function loss abd low potassium that led to temporary heart issues. All seem to have resolved. I'm now severe constipation with bouts of diarrhoea.

Its just awful. Hopefully a more in depth study may show something. Still currently on anti fungal D although I requested Diflucan, gp gave me Lamisil.. I can't find any info on why lamisil would be used over Diflucan for oral, eosophigal and intestinal yeast? It does not seem like a cheap drug.. Anyone any thoughts? Should I order Diflucan?


You may also like...