Advice on test results please and heart palpita... - Thyroid UK

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Advice on test results please and heart palpitations


I’ve had some private blood test done and here are the results could you please help me understand them and what I need to do approaching my GP about them

I currently take 100 mg daily and have had an underactive thyroid for around six years now

Recently been prescribed anti anxiety meds as I’m suffering with bad heart palpitations which doc thinks is anxiety?

Does my medication address these problems?

thank you

32 Replies


Can you tell us what dose of Levo you are currently on, your profile shows previous posts which say that you have B12 injections, are anaemic and are diagnosed with hypothyroidism and that you were taking 75m g Levo at the time.

This report says it was done on the pre-op assessment ward/department, so are you scheduled for an operation?

It was a small procedure nothing to do with thyroid but they test for everything anyway this was some of the results

I’m currently on 100 mg per day

No more b12 as my levels where high so doctors stopped the injections

I don’t understand the difference between t3 and t4?

Lora7again in reply to Sanshia

Someone I know has a B12 injection every 3 months and she is on it for life.

The GP stopped your B12 injections!!! Oh my goodness they are for life and its pointless testing b12 once you are on them. Your body excretes out any excess through your urine. I would ask them to be reinstated.

And you are under medicated for your hypothyroidism and need probably more than one dose increase. So you GP should put your meds up to 125mcg Levothyroxine. Do a blood test in 6-8weeks to review and then increase by a further 25mcg as needed & so on until you are optimal

Both low b12 & undertreatment of hypothyroidism causes not surprised you have them.

Your GP should be aiming to get your TSH under 1 and your thyroid hormones in the top third of the ranges -some need them near the top of the range.

Most GP's sadly are ignorant about hypothyroidism so often patients are not treated optimally when they should be.

Ft4 - is to measure T4 which is the storage form of thyroid horome. Your body has to convert T4 into T3 which is the useable form of thyroid hormone. Ft3 is the measue of T3 in the blood. Have a read of Peatfield s book called Living with your thyroid. Knowledge is power.

waveylines I have same thing Low b12 although on 2000 mg and on 45 mcg armour thyroid I was on 60 mcg but I couldn’t take the heart palpitations and increase bpm So the dr reduced my meds so are you saying I was having palpitations due to low dose of Amour at 60 mcg? At 45 mcg palpitations decrease but I started to feel tired again. I am now getting my vitamins checked on the 9th what is normal b12? And normal D3 ? My hair is still falling off my head, and not growing in certain areas, and the drs says my thyroid levels are normal when I know they are on the low range and I don’t feel like I am well but she won’t listen. This is the problem these drs lack knowledge and undermine us. It’s as you say knowledge is power so I am going to have all my vitamins levels checked because I am only covered by insurance for blood work every 3 or 6 months depending on my A1C as I am also prediabetic. I have heart disease in my family so I was referred to a cardiologist and wore a heart monitor for a month and will have an echocardiogram on the 21st so if there’s nothing wrong with my heart then that means that my dosage is too low? Your input is greatly appreciated.

Sanshia - Im not a doctor but your thyroid blood tests show you are undermedicated. Being undermedicated can cause palpitations as you describe. Also stopping your B12 injections presuming you were prescribed them because you werent absorbing the b12 from your food(?) will also add to your problems because we need B12 for the uptake & conversion of t4 (storage form of thyroid hormone) to T3( useable form of thyroid hormones).

Do have a look on Thyroid uk website they have a lot of useful infomation on there which you might find helpful in increasing your own understanding of how the thyroid works, plus treatment. Seems to me you may have a doctor who doesnt know a lot about thyroid

Milagroscrs615 -You might be best to start a new post.

Cant comment on whether you are undermedicated as I dont know your blood test results.

However b12 ranges are wide. In the uk they are 185-900 but vary slightly lab to lab. Many people get symptoms around 300 & below. The PA Society recommends over 500. If you are already taking supplements this may skew the blood test results unless you want to check if you are absorbing any. Any excess of B12 is excreted out in your urine.

Re vitamin D The Vitamin D Council & Grassroots recommends your blood test should be over 100 up to 150. Make sure you take vit K with vit D -best in oil capsules or taken with a fatty meal. Vitamin k helps to ensure that any calcium you absorb ( vitamin d helps with uptake if calcium) is stored in your bones & not in your organs or arteries.

I have to look at my blood work for the range on the vitamin D here I was 30 but GP increased to 5k in February and hadn’t been tested since, going on the 9th for new blood work. Yes I take vitamin K-2 100 mcg MK7 I found out about that by greygoose about two months ago. I am also on b12 2k but I have stop taking as I am doing the blood test on the 9th I will take again after test. I am Also going for folate, and ferritin bloodwork too. When I get my knew numbers for my thyroid I will repost. I have Hashimotos disease my TPO went from 9 - to 7 so that was good. Thank for answering me back last I check my B12 was 400 but I was taking only 1000 mcg so this new test will tell me where I am at. I wish you and everyone here a Happy And Healthier New Year

Sanshia in reply to waveylines

Thank you I’m going to get that book as I feel more confused now than ever!

Your TSH should be 1 or lower for example mine is 0.70 at the moment and I am on no medication at the moment and I feel well. Have you asked for an increase of Levothyroxine? My Dad who is 78 is on 100mcg because he is classed as elderly I think you definitely need an increase.

You are under medicated if you are on only 75mg I know because I was on 50mg for 1 1/2 years and 75 mg for 4 months and I felt really ill and horrible fast heart rate palpitations and anxiety beyond belief. I am now on 100 mg and feel a little better but not quite right yet. Because of under medication for the hypothyroidism I now have hypertension high blood pressure and nerve damage and carpal tunnel syndrome and Raynauds poor circulation and all this at 32 years old.

I am so sorry you have been treated so poorly. It adds depression to the already debilitating issues of low thyroid. ... I often think: "Why, why, why can't hypothyroid people get first class medical care?"

Have you been diagnosed with Pernicious Anemia? If so your b12 injections are for life, also have they tested for thyroid antibodies?

Low iron can also cause racing heart along with b12 and low thyroid


Your TSH is high indicating you need dose increase in Levothyroxine

FT4 is only 50% through range

FT3 is BELOW range

Last dose Levothyroxine should be 24 hours prior to blood test

Often poor conversion is due to low vitamin levels

Ask Gp to test vitamin D, folate, ferritin and B12 levels

As others have said, usually B12 injections are for life.

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies

Have you had thyroid antibodies tested?

Ask GP to test vitamin levels and thyroid antibodies if these haven't been tested

You may need to get full Thyroid testing privately as NHS refuses to test TG antibodies if TPO antibodies are negative

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .

Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

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

For thyroid including antibodies and vitamins

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 special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random

Hi SD, the OP's FT4 is 18.7 (11-26) so is not above range as shown on the result above so I would think she definitely needs an increase in Levo

SlowDragonAdministrator in reply to Gingernut44

Whoops I misread top of range as 22

Yes I have now corrected original reply


Sorry misread the range on FT4 result

Your FT4 is only 50% through range

FT3 well below bottom of range

Helpful calculator for working out percentage through range

So definitely ask for 25mcg dose increase in Levothyroxine

Hidden in reply to SlowDragon

" "

Is there an English version?

SeasideSusieAdministrator in reply to Hidden

On my tablet it gives a link to an English translation of it, on my PC it doesn't - strange!

However, you don't really need an English translation, it's pretty obvious to work it out.

Result goes in the box next to FT4 or FT3, lower end of range goes in the next box next to "norma od" (English is "from") and top end of range goes in the other box next to "do" (English is "to").

Hidden in reply to SeasideSusie

"it's pretty obvious to work it out"

Not for me it wasn't! :-O :-O

I thought one box (probably the first if norma means "Normal") must mean the reference range and the other the units of measurement LOL

Thank you.

Sorry to jump on your post. But I thought palpitations was due to a too much levo. Not low dose.

SeasideSusieAdministrator in reply to Foxy23

Can be either, check signs/symtoms of hypothyroidism and hyperthyroidism on ThyroidUK's main website:



Foxy23 in reply to SeasideSusie

I have both symptoms on both of the above. Although we're to g more but am menopausal.

I was on 75. Dr said tests came through high. I was on menopace. Two trips to A&E.

Got new script.

I stopped menopace. I got mercury pharma 50 and wockhart 25. Just finished 2 months felt loads better but heart rate slowed down a lot to around 60.

Now got new script of mercury Pharma of both. Feels like they are stronger so have reduced to 50 one day and 75 another to see how I go. Don't want fast heart rate and palps again. Scary time. I kept saying I thought it was my medication. But no one listens.

I am struggling to take things in. I read this stuff up but find it too complex to take in. I get symptoms for both so it just makes no sense to me.

Wish I had money just to find an expert to sort it all out for me 😞

SeasideSusieAdministrator in reply to Foxy23

If you get symptoms of both hypothyroidism and hyperthyroidism, maybe you have autoimmune thyroid disease, aka Hashimoto's. Have you had thyroid antibodies tested, as suggested in a reply to your post here:

Foxy23 in reply to SeasideSusie

No, but think I will have to go down that route. Do GPs have to accept results from a private company?

SeasideSusieAdministrator in reply to Foxy23

No, they are not obliged to accept them but if they are reluctant there are a couple of things you can do:

1) Point out that the tests have been done with an accredited lab, same as the NHS uses, so why aren't they acceptable?

2) Invite the GP to do their own test at the surgery's expense (you were saving them money by doing the tests yourself). Be aware that in primary care only Thyroid Peroxidase (TPO) antibodies can be tested and sometimes those can be negative and Thyroglobulin (TG) antibodies positive which can suggest Hashi's, but TG antibodies will only be done by an endo.

Also, even if you do have Hashi's, the treatment is no different as it's the hypothyroidism that is treated, there is no actual treatment for Hashi's, but some members find that when Hashi's is present then a strict gluten free diet can help, as can supplementing with selenium. But if you know you have Hashi's then you are aware that symptoms and test results can fluctuate and that sometimes you may need to alter your dose of Levo (just the dose temporarily, not the prescription) when these fluctuations take place.

Foxy23 in reply to SeasideSusie

Ok. Thanks for your help and speedy response 😊

humanbean in reply to Foxy23

There are all sorts of reasons for having palpitations. It isn't just people with thyroid problems who get them. The wrong levels of thyroid hormones for the patient, low vitamin and mineral levels, anaemia, high blood sugar levels can all lead to palpitations, but I'm sure there are lots of other things that can cause issues like this too, that I know nothing about.

jgelliss in reply to Foxy23

Sometimes dosing with Levo only and not being a good converter from T4 to T3 can cause low T3 in the heart . The heart has receptor sights for T3 . Many with palpitations and are on T4 only are missing out on the T3 and manually must be added . Low Iron levels can cause palpitations too .

TSH is too high (though don't use its value as a basis for treatment). Your FT4 level is reasonable, hiking it higher might not have a benefit; there is no way of telling in advance whether you are T4-intolerant (as I am). The obvious problem here is that your T4->T3 conversion is insufficient because FT3 is below range, and you should add in enough T3 to bring FT3 up to about mid-range. Are you on a comprehensive supplementation program? Esp. important for thyroid function are trace minerals, all B vitamins, iron, D3. Supplementation is esp. important if you have any reason to believe that your digestive function is not good. Having struggled thru gluten enteropathy, I use an assortment of ~20 supplements most days, including free amino acids.

Thank you to everybody that has replied to this thread it means so much to have some information

Thank you to everybody that has replied to this thread it means so much to have some information

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