Tsh: Hello there. I’m hoping someone can help me... - Thyroid UK

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Hello there. I’m hoping someone can help me understand my recent blood test results. I had them done via medichecks.

I’m currently taking 135mcg of levothyroxine daily but have been feeling off so decided to have bloods done. It says Tsh is high but T3 and T4 are normal. Does this mean my current dose of levothyroxine is too low? I have attached the results.

35 Replies

Hello Fafafa

Do you have the antibody test results from the above blood test, and do you already have a diagnosis of your health condition ?

Yes it does. Ft3 is the important result and many need it to be 70% or there abouts through the range to be symptom free. Your Ft3 is 42% through range. You need an increase in levo.



It's unusual to have such a high TSH with those FT4/FT3 results.

I would suspect possibly some antibody activity maybe. Did you have antibodies tested or do you already know if you have autoimmune thyroid disease aka Hashimoto's?

As you're new to the forum and there's no information in your profile, it may help us to help you if you can tell us about your thyroid journey, maybe post some previous results, dose changes, etc.

Hello. Thank you for replying. I didn’t have the antibody test, no. I was diagnosed by GP sometime in 2011-12

in reply to Fafafa77

Do you have current vitamin and mineral blood test results ?

Your thyroid hormone conversion, either your own, or that supplemented can be compromised if ferritin, folate, B12 and vitamin D are not optimal in the ranges.

in reply to pennyannie

Yes, they are all slightly low. Im struggling to make sense of a lot of the results due to severe brain fog!

As far as I’m aware I’ve never been tested for antibodies. I had symptoms for about a year before diagnosis.

The symptoms were rather severe considering my tsh was always around 3-5. The skin on my face started peeling off, actually peeling off not just dry skin. My ankles and face were always swollen and periods completely stopped. Hair was also falling out in clumps.

I suspect if my symptoms hadn’t been that bad my Gp wouldn’t have put me on levothyroxine.

I started on 25mcg and gradually over the years the dose has increased to 135mcg.

I had bloods done last year at Gp surgery and Tsh was under 1. I don’t remember the exact number

in reply to Fafafa77


If you click on the blue "Reply" directly underneath the message you are responding to, that member then gets a notification of your reply.

I would suggest getting antibodies tested as there is a possibility that you could have autoimmune thyroid disease. Medichecks do a thyroid panel including antibodies, as does Blue Horizon. Whilst doing another test I'd suggest doing the thyroid/vitamin panel as we Hypos tend to have low nutrient levels. Medichecks does Thyroid Check ULTRAVIT and Blue Horixon do Thyroid Check PLUS ELEVEN.

Always do thyroid tests no later than 9am after an overnight fast (you can drink water), and last dose of Levo should be 24 hours before the blood draw.

Other than that there may be some problem with the assay and you have a false TSH result with that test. In this case it's best to get tested with a different lab. Seeing as your last test at your GP surgery was last year, I would ask your GP to test as they should do it annually anyway. Explain to your GP how you are feeling "off" and ask for a thyroid panel. It may only be TSH, it may include FT4, but it wont be a full panel or include antibodies.

The only other thing I can think of is do you take Biotin or a B Complex containing Biotin (B7). This is known to give false results with tests so should be left off for 7 days before any blood tests.

My vit d, iron & biotin were a tad low. I’m trying to attach a picture of the rest of my results but can’t seem to figure it out. I will ask gp to test again. Thank you.

in reply to Fafafa77

You can add a picture to the first post in a thread only. You can edit your first post to add your picture, make sure you don't include any personal details that can identify you.

Or you can type the results and reference ranges in.

How to edit a post:


then scroll down a bit to "Add a picture".

I don't know but I think I've read you can only do 1 photo a post ?? Could be wrong - don't stress, can you type them in ??

in reply to pennyannie

That's right pennyannie - only one picture and it has to be in the first post of a thread :)

Sorry it’s not very clear! I will try to type out the important ones


120 - 160 R

LYMPHOCYTES 4.47 x10^9/L

1.2 - 3.65 R

BASOPHILS 0.12 x10^9/L

0 - 0.1 R


19 - 35 R


0 - 5 R

TIBC 74.7 umol/L

45 - 72 R


20 - 50 R

VITAMIN B12 - ACTIVE 52.1 pmol/L

37.5 - 188 R

TSH 8.96 mIU/L

0.27 - 4.2 R

FREE T3 4.65 pmol/L

3.1 - 6.8 R


12 - 22 R

VITAMIN D 43 nmol/L

50 - 175 R

FOLATE - SERUM 4.53 ug/L

> 3.89 R

VITAMIN B12 - ACTIVE 52.1 pmol/L

37.5 - 188 R (this one is normal but as the range is so wide would a supplement help?)

These aren’t all of them, just the ones out of range or borderline. It was biotin that was low it was folate that’s borderline. I’m awful at this!

Thank you for all your help so far.

in reply to Fafafa77

I'm not well versed on all the above, but don't worry, as others are, so well done for typing all this out - I don't think I see a ferritin level there, do you have one ?

in reply to pennyannie

I do but it says it’s within normal range.


21.3 ug/L

13 - 150 R

in reply to Fafafa77

I've just enlarged your photo results.

Ok, for thyroid hormone to work effectively ferritin needs to be up and over 70 -

In range it may be, but not optimal, and where it needs to be if with a thyroid issue -

so, I think this may, along with the other vitamins and minerals need to be supplemented and I know someone will soon be back here to advise you accordingly.

My ferritin was in range at 22 - I was very unwell - but I was told I was ok, when I pressed for a better answer than ok, and why had it taken 3 years to realise this fact, despite my saying I felt so unwell, I was told I was in range and that I could supplement as it might make a difference.

It seems doctors are not taught about vitamins, minerals, and the knock on implications when the patient already has a health condition. I can't see easily any of these results but if you look at the ferritin range, you are very low within it, aren't you. If this applies to folate, B12 and vitamin D too, these are the major vitamins and minerals that will need to be addressed first and foremost.

Please ask your doctor's for the print out of when he diagnosed you, back in 2011-12. He would have diagnosed you from blood tests, telling him what to do, and your antibody test should be on there, though he may not have thought it worth discussing with you.

in reply to pennyannie

Thank you. I’m seeing Gp soon so will discuss it with him. Do I take an iron supplement to increase ferritin?

The range is 13-150 and mine is 21.3

in reply to Fafafa77

It's very likely that you will have to supplement yourself as if you fall into the NHS ranges you probably don't qualify for prescription vitamins and minerals.

You may need to be on them longer and on a higher level of dosage than the NHS recommend, so it might be better to DIY.

It's a sorry state of affairs, I know, but many of us have been in a similar situation.

If you buy your own, possibly from some on recommendations from here, you'll take back some control which is the first step back to better health.

Many of us have experienced the brain fog, don't worry, it does get better as your health improves.

in reply to Fafafa77


Your Ferritin is way too low and could be causing some problems. Ferritin should be half way through range and needs to be at a good level for thyroid hormone to work properly.

This article lists symptoms of low ferritin (ignore any reference to supplements):


Low ferritin can suggest iron deficiency anaemia. Please add all the results/ranges for the iron status and red blood cells, I can't make them out in the picture.

VITAMIN B12 - ACTIVE 52.1 pmol/L 37.5 - 188 R

This is too low. Actibve B12 below 70 can suggest B12 deficiency - see Viapath at St Thomas' Hospital:


Reference range: >70*; * between 25-70 referred for MMA

Check for signs of B12 deficiency here:


and if you have any then list them to discuss with your GP when asking for testing for B12 deficiency/pernicious anaemia.

Folate - although over the low limit is very low. This would need addressing but not before further testing of B12 has been carried out.

VITAMIN D 43 nmol/L 50 - 175 R = 17.2ng/ml

This is too low, it is in the Insufficiency category.

The Vit D Council recommends a level of 125nmol/L (50ng/ml) and the Vit D Society recommends a level of 100-150nmol/L (40-60ng/ml).

To reach the recommended level from your current level, based on the Vit D Council's suggestions you could supplement with 4,900iu D3 daily (nearest is 5,000iu)


Retest after 3 months.

We don't know whether you have Hashimoto's but I'd say it's a possibility considering your poor nutrient levels, Hashi's tends to cause gut/absorption problems whch lead to poor levels.

When Hashi's is present, for best absorption it's suggested to use an oral D3 spray, eg BetterYou. Some Hashi's patients also find that an oil based softgel, eg Doctor's Best, also gives good absorption. The softgel gives much better absorption than tablets or capsules so your choice should be the softgel or oral spray.

When you've reached the recommended level then you'll need a maintenance dose to keep it there, which may be 2000iu daily, maybe more or less, maybe less in summer than winter, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. You can do this with a private fingerprick blood spot test with an NHS lab which offers this test to the general public:


Doctors don't know, because they're not taught much about nutrients, but there are important cofactors needed when taking D3 as recommended by the Vit D Council


D3 aids absorption of calcium from food and K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems such as hardening of the arteries, kidney stones, etc.

D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds if taking tablets/capsules/softgels, no necessity if using an oral spray.

Magnesium helps D3 to work. We need Magnesium so that the body utilises D3, it's required to convert Vit D into it's active form. So it's important we ensure we take magnesium when supplementing with D3.

Magnesium comes in different forms, check to see which would suit you best and as it's calming it's best taken in the evening, four hours away from thyroid meds if taking tablets/capsules, no necessity if using topical forms of magnesium.




Check out the other cofactors too (some of which can be obtained from food).

Don't start all supplements at once. Start with one, give it a week or two and if no adverse reaction then add the next one. Again, wait a week or two and if no adverse reaction add the next one. Continue like this. If you do have any adverse reaction then you will know what caused it.

Do you take any supplements at the moment?

Thank you, that’s all very helpful. It certainly explains a lot.

I do currently take a daily multi vitamin and mineral and also high dose vit b complex. I stopped taking it for a week before my blood text and restarted yesterday

in reply to Fafafa77

Your multivitamin may not be much help, they're generally not a good idea. They tend to contain too little of anything to help low levels, often contain the cheapest and least absorbable of ingredients, and tend to contain things we should test for before supplement, eg calcium, iron, iodine.

If it does contain iron then that will affect the absorption of everything else.

I would ditch the multi and concentrate on the supplements that you do need.

I’ve just checked the dose of the vit b complex. The amount of B12 is 10,000 mcg which is a fairly high dose isn’t it? My appointment with Gp is on the 23rd so I have another week to worry!

in reply to Fafafa77

I've never heard of a B Complex containing that much B12. What's the brand, or can you link to it please?

in reply to Fafafa77


It doesn't contain 10,000mcg B12, it contains 250mcg which is 10,000% of the NRV (Nutrient Reference Value)

Sorry, I’ve just had a proper look! Having a dumb moment


120 - 160 R

117 g/L


0.35 - 0.47 R

0.353 L/L


3.8 - 5.8 R

4.22 x10^12/L


81 - 98 R

83.5 fl


27 - 33 R

27.8 pg


300 - 350 R

332 g/L


11.5 - 14.4 R

12.9 %


5.8 - 34.5 R

10.3 umol/L


45 - 72 R

74.7 umol/L


24.2 - 70.1 R

64.4 umol/L


20 - 50 R

13.79 %


13 - 150 R

21.3 ug/L

Your B12, folate and vit D are all too low. Active B12 under 70 means that you should be investigated for pernicious anaemia. Ferritin also too low - needs to be at least 70.

It says Red cells and Platelets appear normal but I will ask Gp to repeat the tests. Thank you.



Iron is complicated and I don't totally understand it so I'm not diagnosing here. However, a diagnosis of iron deficiency can be made when someone has both low haemoglobin and haematocrit and low ferritin. You have below range haemoglobin, your haematocrit has just about scraped into range and your ferritin is low in range.

With an iron panel, the following are said to be optimal results:

Serum iron: 55 to 70% of the range, higher end for men - yours is 10.3 (5.8-34.5) which is 16% through range.

Saturation: optimal is 35 to 45%, higher end for men - yours is 13.79% (20-50)

TIBC: Low in range indicates lack of capacity for additional iron, High in range indicates body's need for supplemental iron - yours is 74.7 (45-72) so it's over range

All in all, with your haemoglobin/haematocrit/ferritin results, coupled with the results from your iron panel, I think you should be discussing all this with your GP because maybe this needs addressing.

I was advised by a member on another site to eat pate when my ferritin was low. Incidentley it is now high because of inflammation in my body caused my my inflamed thyroid.

in reply to Lora7again

I do eat a fair amount of chicken liver so I’ll just carry on with that and maybe add a supplement too.

Sorry, too small to read and too blurred when magnified.

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