1.5.4 Consider a 6-month trial of levothyroxine for adults under 65 with subclinical hypothyroidism who have:
* a TSH above the reference range but lower than 10 mlU/litre on 2 separate occasions 3 months apart, and
* symptoms of hypothyroidism.
If symptoms do not improve after starting levothyroxine, re-measure TSH and if the level remains raised, adjust the dose. If symptoms persist when serum TSH is within the reference range, consider stopping levothyroxine and follow the recommendations on monitoring untreated subclinical hypothyroidism and monitoring after stopping treatment.
In some countries you would be diagnosed with hypothyroidism when TSH goes over 3, the NHS sadistically generally makes us wait until it goes over 10. Use the guideline above to request a trial of Levo, you met the criteria previously despite you latest test being within range so there was no reason not to offer you a trial back then.
If your RDW is too high, it could be an indication of a nutrient deficiency, such as a deficiency of iron, folate, or vitamin B-12.
These results could also indicate macrocytic anemia, when your body doesn’t produce enough normal red blood cells, and the cells it does produce are larger than normal. This can be due to a deficiency of folate or vitamin B-12.
Additionally, you may have microcytic anemia, which is deficiency of normal red blood cells, and your red blood cells will be smaller than normal. Iron deficiency anemia is a common cause of microcytic anemia.
When hypothyroid we frequently have low vitamin levels due to low stomach acid leading to poor nutrient absorption and low vitamin levels as direct result
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 with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)
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 .
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
See GP and request B12, folate, ferritin and vitamin D are tested along with thyroid antibodies
Prolactin is high (just within range.) high prolactin common with autoimmune thyroid disease
Request ultrasound scan of thyroid too
Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins
If TPO or TG thyroid antibodies are high this is usually due to Hashimoto’s (commonly known in UK as autoimmune thyroid disease).
About 90% of all primary hypothyroidism in Uk is due to Hashimoto’s. Low vitamin levels are particularly common with Hashimoto’s. Gluten intolerance is often a hidden issue to.
Hi, just to update, managed to see Gp this morning. Was able to persuade him to put me on lethyroxine, only 25mg for a month, but its a start at least 🤷♀️ He said that he was reluctant as its a live time commitment, but as my t4 levels have been declining over the past three blood test he would. He wants to see me in a month's time. Also said he would refer me to a endocrinologist, tho what should I expect? Hoping I can finally be on the mend after years of misery.
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Understanding blood test results
I don't understand my thyroid test results as my doctor seems reluctant to discuss them he looks at me like I should know what they mean
I Realized I don't understand something - T3 before blood tests
Trying to understand test results, please can anyone advise how to read them? 
