Thank you for all the help to date & advice on ... - Thyroid UK

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Thank you for all the help to date & advice on latest results please



Firstly a huge thank you to all the people who post replies to help those in need of advice. You’ve been brilliant.

These are my latest results :

TSH 0.34 mU/L (0.27-4.2)

TPO 105 IU/ml. (0-34)

T4. 22.7 pmol/L (12-22)

T3. 5.3. pmol/L( 3.2-6.8)

Ferritin 135 ug/l (13-150)

Vit D. 127 nmol/l (50-200)

Serum Folate 9.3 ug/l (>2.9)

Red cell folate 648nmol/l (285-1474)

Other dietary changes I’ve made are egg, dairy & grain free & ive added selenium (thank you Jim111).

Dose of Levo is 75mcg twice per week and 100mcg 5 days per week.

Any thoughts on these? Is ferritin too high? It’s gone up & serum folate has come down since last test.

Thank you v much and all the very best for your health in 2019.


11 Replies


How do you feel?

Are you taking any supplements?

Vit D is good.

Ferritin - you don't want that to go any higher.

Folate seems OK.

What about B12?

Your FT4 and FT3 aren't balanced. Your FT4 is over range and your FT3 is 59% through range, it may be better if your FT4 was a bit lower and your FT3 higher.

Thank you SeasideSusie

I don’t feel as good as I did before my health took a nosedive 9 months ago but I’m better than I was a few months ago. I still don’t have the energy to exercise, my sleep is still a bit up & down & mood a bit subdued. Weight is still v low too but hair loss & dryness has lessened a bit which is good.

I’m taking these supplements

Vit C, B complex , D with K, magnesium selenium & zinc.

Sorry I forgot to add B12

> 256 pmol/l (45-165)

I thought that too about the respective levels of T3 & T4. Is the level supposed to be 4 if you divide T4/T3?

What causes high ferritin & why is it a problem ?

I forgot to say my cortisol on 24hr saliva was high.

Also I was prediabetic HbA1C 43 so that’s not great.

Any thoughts on what could be going on?

Thanks so much

Polly x

in reply to Polly91

What B Complex are you taking? I'm surprised your folate level isn't higher if you take it regularly. I take Thorne Basic B, 1 x daily (usually 5 days a week) and last test showed 35.2 (8.83-60.8) with Blue Horizon and 17.1>3.00 with GP test, those results are about what they normally are for me taking that dose.

Is there much B12 in your B Complex as your Active B12 is very high, or do you take a B12 supplement or have B12 injections?

Iron is a complicated subject and if ferritin it is continually high (as in very over range) it needs looking into. Yours is fine, I was just wondering if that is your normal level without supplementing, or if you did supplement I was going to suggest reducing the dose a touch. But inflammation and infection can cause raised ferritin and as you have Hashi's it's possibly linked to that.

Was your cortisol test the 24 hour saliva test? If so were the results high in range or over range. Are you doing anything to reduce the levels?

When on Levo only, good conversion takes place when the ratio of T4:T3 is between 3:1 and 4:1, yours is slightly over at 4.28 :1

I’m taking nutri advance B complex & I take 1 tab per day which has 25 micro gram of B12 & 200microgram of folate. I think my folate has come down over the last 9 months or so. I need to double check but this is the dose of Bcomplex I’ve always taken.

If TPO has come down would that suggest ferritin would also come down?

How can you reduce inflammation other than healthy diet?

My cortisol was over range & yes it was 24 hr. the only point that was within range was the afternoon cortisol. The other 3 points were high. No I’m not doing anything other than try (!) to reduce stress level.

So my T4 is too high but T3 is ok? Is that right?

Thanks again

P x

in reply to Polly91

You might want to consider increasing the B Complex to 2 a day to give 400mcg methylfolate, that's certainly the magic dose for me!

I don't think you have to worry about your ferritin level, it's within range, I have read that 100-130 is ideal for women, the time to worry is if it is continually way over range.

You might want to retest adrenals to see if your levels have improved. If they are still high then it might be worth looking into supplements that can help reduce it.

So my T4 is too high but T3 is ok? Is that right?

Your FT4 has gone slightly over range. Some of us need that to get a decent FT3 level.

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine (the magazine for doctors)

"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)."

He recently confirmed, during a public meeting, that this applies to Free T3 as well as Total T3.

You can obtain a copy of the article by emailing Dionne at

The office is closed until 3rd January.

However, FT4 going too high over range can mean that T4 converts to reverse T3 rather than free T3 so we have to be careful. With your ranges, most people on Levo would feel best with FT4 around 19.5ish and FT3 around 5.9ish but we have to bear in mind that we are all individual and need levels that are right for us.

Have you also had a serum B12 test done? Some of us have naturally high B12 levels, but if Active B12 is high and serum B12 isn't then that can be indicative of a problem. Take a look at Gambit's reply in this thread on the PA forum (8th reply down)

I don't know enough about B12 to offer any suggestions, you could ask on there about your high level of Active B12 considering the dose of b12 in your supplement is so small.

Thats interesting as I’ve been thinking about increasing to 2 tabs B complex per day so I will give that a go.

Is 100-130 ferritin the right level for post menopause? I’m post menopausal.

How often would you test adrenals? This is my first test. Also which supplements are good for over range cortisol?

What % T3 of range is optimal? My units for T3 are different to those in Dr Toft recommendation so a bit hard to work out? But it looks about 60%?

So ideal T4 & T3 for most people is 19.5 & 5.9. So I’m not quite there yet. Thanks haven’t changed my dose of Levo for about 6 months.

My serum B12 wasn’t tested but last time it was it was towards the upper end.

Thank you for sharing the message by Gambit. It was v helpful.

Thank you SeasideSusie

P x

in reply to Polly91


Is 100-130 ferritin the right level for post menopause? I’m post menopausal.

I really have no idea. I cannot find the definitive answer for what the correct reference interval is for post-menopausal and pre-menopausal females. When I have my ferritin tested, my GP surgery's range is 15-300, and Medichecks/Blue Horizon use 13-150 - both have my date of birth so I don't know why the difference. I just go by it needing to be above 70 for thyroid hormone to work and I've seen 100-130 is good for females, so if mine is around the 100 mark then I am happy (but it's usually lower when I test).

How often would you test adrenals? Also which supplements are good for over range cortisol?

There are adaptogens which are meant to be "balancing". However, personal experience, and that of other members of the forum, found that adaptogens tend to lower cortisol. So if using adaptogens it's a good idea to retest and personally I wouldn't go longer than 6 months. I was prescribed a supplement containing a mix of adaptogenic herbs by a practioner to lower my top of range (but still in range) cortisol. I stopped consulting with the practioner and continued with the supplement, not thinking to retest and went on using the supplement for 2 years. It reduced my cortisol to almost a flat line at the very bottom of the range so now I'm having to work at raising it again.

What % T3 of range is optimal?

That's very individual, we all have to find our own personal best level.

My units for T3 are different to those in Dr Toft recommendation so a bit hard to work out? But it looks about 60%?

Dr Toft's talking about Total T3 in his article, your result is Free T3 but as mentioned he did say that his comments about T3 staying within range relate to FT3 as well. I wouldn't bother about the percentage, "normal" doesn't mean anything other than in range, we need it where we need it.

So ideal T4 & T3 for most people is 19.5 & 5.9. So I’m not quite there yet.

For most people, remember we're individual and that might not be appropriate for everyone.

Thanks. What was in your adaptive herbal protocol ? My bp is v low & weight still low so I might try reducing cortisol.

in reply to Polly91

My practioner had me on Nutri Advanced Adreset.

Thank you. Are you in US?

in reply to Polly91

No, I'm in the UK.

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