Hi Everyone, I wonder if you kind souls would run your eyes over my latest test results. I have had a fair bit going on this year ( hubby has been very unwell) and haven't been taking my normal vitamins (Vit D + K2/ B complex/Magnesium. I note that my Folate has fallen quite low even though I eat plenty vegetables and Brown rice?
CRP - HS 8.2 (0 - 5 )
FERRITIN 69.5 (13 - 150)
FOLATE 4.44 (3.89 - 19.45)
B12 - ACTIVE 72.8 (37.5 - 188)
VITAMIN D 66.2 (50 - 200)
TSH 0.15 (0.27 - 4.2) .
FT3 4.52 (3.1 - 6.8)
FT4 19.1 (12 - 22)
Thyroglobin Antibodies 12.1
Thyroid Peroxidase 10.8
Test taken at 9am. I take 100mcg Levothyroxine daily but none taken until after the test
My TSH is constantly under range much to the horror of the GP who is always trying to reduce my medication. CRP is usually over range but I do have arthritis so possibly that is the reason?
Any help and advice gratefully received.
Thank you.
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DoeStewart
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I note that my Folate has fallen quite low even though I eat plenty vegetables and Brown rice?
I eat broccoli plus a few sprouts 3 or 4 times a week, supposed to be folate rich but I don't find it helps my folate level. To keep that at a reasonable level I need 400mcg methylfolate daily in a B Complex.
Brown rice isn't particularly rich in folate, it is supposed to contain more vitamins and minerals than white rice, except for iron and folate, see the table of nutritional information here:
Hi SeasideSusie, thanks for your reply. I normally do take a B Complex tablet as recommended on the forum. I hold my hands up, this is my own fault but as I say I had more things going on and just took my Levo each day and no vitamins. I'm afraid I've knocked my own health backwards
Can I just add conversion of T4 into T3 can also be compromised by inflammation, any physiological stress ( emotional or physical ) depression, dieting and ageing.
Your vitamins and minerals all look like they need some building up and I now aim to maintain ferritin at around 100, folate at 20, active B12 at 75+ and vitamin D at 100:
Your T3 and T4 are in range so hopefully your doctor on seeing this private thyroid blood test will not adjust your dose down which will have a negetive effect of your wellness.
I'm sorry to read of your current situation which is likely compounded your conversion issues.
Hi pennyannie, hope you are well and thank you for replying my Ferritin has improved, I'm not a red meat eater but was advised by forum members to eat liver or blackpudding which I now do. I normally take Igennus vitamin B complex, 1 tablet per day so will go back to this as I have half a pot. Do you also take vitamin B12 as well as B Complex? The Vitamin D I use is Better You spray also contains K2. My T4 looks quite good, in the top third of the range but as you know I have constant arguments with the GP because of under range TSH. I looked back on past blood test results ( going back years) my TSH has always been low and mostly under range, no idea why. When a hospital Doctor dropped my Levo to 75 per day in December 2020, my TSH came just in range but T4 and T3 dropped too low and I started to feel unwell so upped Levo back to 100mcg. I have been under tremendous stress for a few months but after a barrage of tests my husbands ill health isnt what the hospital originally led us to believe it was which was life limiting, I'm surprised I have any hair left as it was falling out in handfuls blocking the plughole when washing it. I will get back to looking after myself starting with taking my vitamins. Thank you.
Yes, the worry of all this will not have helped matters and you have put your own health on the " back burner " which I totally " get " but you " can't do this " !!!
I now maintain my vitamins and minerals with :-
1 pot a week of Asda frozen chicken livers :
A daily Igennus Super B complex + 1 x D3 + MK7 + vitamin C :
I also take adrenal glandular support and NDT as you know, and self medicating.
NDT contains T3/T4 so will lower a TSH reading but the TSH is the least important of all the blood readings.
Considering you are without almost all of your thyroid gland it is essential that you are dosed and monitored on your T3 and T4 levels and to a high enough level to give you back your " you ".
Considering a fully functioning working thyroid would be supporting you daily with trace elements of T1. T2 and calcitonin, plus a measure of T3 at around 10mcg plus a measure of T4 at around 100 mcg - and with T3 being around 4 times more powerful than T4 - I think to drop your dose below 100 T4 is simply illogical and with no thought process and just reading and accepting of the computer dogma.
Does your doctor see these private results and understands the significance of T3 ?
Personally I would need my T3 higher than yours, and if everything else were optimal, I'd be inclined to increase my full spectrum thyroid hormone replacement and see how I go.
TSH stands for "Thyroid Stimulating Hormone." The job of TSH is to kick the thyroid gland in the butt to say, "get busy and make more thyroid hormones." Right? But if there isn't any thyroid gland there to kick, just what exactly do these doctors think the job of the TSH is? Why are they so freaking fixated on the TSH number?
Hi there, do you know what, that is something I have said to numerous GP's, their answer is to ignore me completely because as you know, they know best. It makes perfect sense to my, I have a tiny bit of thyroid to stimulate and to be honest after 30+ years since my operation it is highly likely that the bit I was left with has give up the ghost. I despair.
First, although the TSH isn't going to affect a non-existent thyroid gland, its level would be expected to be high if you were under-medicated, or low if over-medicated.
Second, there is the idea that TSH itself affects bone and, if too low, bone health might suffer.
However, it is questionable whether TSH response works exactly the same in someone on replacement thyroid hormone as it does in someone with no thyroid issues.
And, if the amount of TSH matters so much to bones, why doesn't it matter when it rises to 10?
The other day I was mulling this over and started writing about this issue. Pasting that below - still very imperfect:
If someone suggests a suppressed TSH is a problem, for atrial fibrillation and other heart issues and for bones, I tend to think through the argument like this.
(Let us assume that “below 0.10” is the threshold for being suppressed. I suggest that simply because it is easier to discuss using an actual number. And the reference interval is 0.40 to 4.00.)
TSH must be an extremely potent hormone if the amount needed to register 0.10 in your blood, rather than 0.00, is sufficient to prevent atrial fibrillation and other heart and bone issues.
If it is such a potent hormone, why do some guidelines suggest that there should be no treatment between 4.00 and 10.0?
That is a range of 6.0 (between 4.00 and 10.0)– or sixty times 0.10. Yet that is perfectly acceptable, and even advised not to treat.
Hi Helvella, thank you for your reply. certainly food for thought. It is a real headache isn't it, the Doctors are contradicting themselves ? I am afraid I don't have much faith in the GP's at my surgery but as they give me my script for Levo I am stuck with the battles every year.
It's just computer dogma and until the rules and guidelines are rewritten we are in this TSH boat and quick fix adjustments that likely work for 80% of the population,
I think it so ridiculous and if nothing else new guidelines should be written for those who have a thyroid auto immune thyroid disease
We also need additional guidelines for those who have had a medical intervention and the thyroid surgically removed, and for those of us who have had RAI thyroid ablation a further set of guidelines should be available.
We can't rely on there being any medical knowledge and independent thinking.
It seems that currently the computer dogma is blindly followed - all you can hope for is getting an appointment when there's a power cut and be able to actually have a conversation face to face with the person who is meant to care about your health.!!!
Hi - I understand I can't do this and thank you for reminding me. Can I ask what the adrenal gland support does, is this something that would be any use to me? My GP knows I do full private testing, always asks me why? I tell them that they don't test all thyroid hormones and their answer - only need TSH, I only get T4 done as TSH always below reference range . Not interested in T3 and when I try to tell them it's importance I get the look of "oh here is another one who reads too many articles" - not interested. They tested my vitamins 2 years ago and that was that. I have had these battles since 1987, new GP's come and go but the battle is always the same.
Yes, I think " having these battles " seem to be power for the course if you want back your independence and health.
Well, I had RAI in 2005 for Graves Disease and became very unwell around 8 years later.
I started my recovery after reading a few books as I was housebound and referred to as a conundrum by my doctor, and dosed on just T4 and dosed to have a TSH in range, which put put me in an ever decreasing circle of wellness.
Your Thyroid and How To Keep It Healthy written by a doctor, Barry Durrant-Peatfield who has hypothyroidism and takes NDT, made sense.
Though the title of his book was somewhat counterintuitive as I'd drank a toxic substance to burn out my thyroid in situ - but anyway - vital information on how to repair myself.
Then through reading Graves Disease - A Practical Guide written by Elaine Moore, I learnt that Graves is an AI disease and having RAI treatment can compound one's health further
Elaine never fully recovered after her RAI for Graves. and I read how RAI is taken up by other glands and organs within the body including the adrenals and thought I'd start there, as it didn't involve my having to see a doctor.
So this was my starting point and my so achey achey lower back was slightly relieved after a month on glandular adrenal and I 've carried on, once those symptoms reduced, at a lower maintenance dose, as some sort of insurance policy.
I then asked for a trial of NDT and then T3 in around 2016/17 through the NHS and denied because of my TSH being too low so I then jumped ship some 4 years ago and now look after myself.
I don't know if you need adrenal support, I think I remember your doing " zumba " classes ?
If this is now also on your " back burner " you obviously are not as well and active as last time we spoke.
Quite what symptoms you are currently dealing with I don't know but guessing with your arthritis it's important to keep moving and being as active as your body allows.
You have certainly been through the mill and I have no doubt that you would still be most unwell if you hadn't taken matters into your own hands.. My Zumba classes ceased during lockdown and have never started back up so I am joining a gym that has classes to keep me moving and active, maybe I don't need adrenal supplements. I do get so fed up with the constant battle with the Drs and wish this had never happened to me, like all of us. I just wish somebody would stop looking at TSH and treat me by T4/T3. When I added a small bit of NDT to my Levo I felt good, hair started growing again and I just felt more alive if that makes sense. All fine until I have to go for my blood tests to Drs surgery to keep getting my script for Levo - thats when the you know what hits the fan....
Well, if you have stopped taking the NDT I'd be inclined to add it back in possibly at a slightly higher dose and drop some Levothyroxine :
You're seen the benefit - so why not ?
Which ever round this goes if you want to feel better it 's likely at the expense of the TSH - either back up to a dose of T4 that worked for you or by your own slight of hand and a pill cutter for a small addition of NDT.
I presume, you too were dosed and monitored on your TSH reading and not your symptoms, and why, you ended up on here looking for answers, like all of us.
Nothing is cast in stone - I've been on 1+1/2 grains now 4 years and take a yearly private blood test more for my vitamins and minerals than my thyroid ( or lack of ) :
My TSH is always at 0.01 which it was when I was relatively well on T4 only, but I wasn't allowed to stay on the dose of Levothyroxine that worked best for me.
I fully anticipate I may need to adjust my medication as I age, but so far so good.
I am 74 and accepting that most days I dip onto the sofa in the PM, don't frequent disco's and am in bed by 10 .
However I have never been able to find the stamina for such things as Zumba but you could and likely can do again, if you help yourself back to better health despite your doctor's dogma.
Thanks for that, I literally added probably 1/4 grain NDT to my Levo last time, as I take 100mcg Levo would you be inclined to drop maybe 1/4 tablet Levo and replace with 1/4 grain NDT? I have a good pill cutter so will be ok. Always dosed by TSH so when I was taking my tiny bit NDT the Dr nearly had a fainting fit when he saw my TSH, I didnt tell him I was taking the NDT. I persuaded him it was probably a blip and maybe retest in 8 weeks which he agreed to reluctantly. I stopped NDT and did re-test, TSH still below range but not as low as previous test so he put up with it as I said I wouldn't drop my dose of Levo . I am told my cholesterol is higher than it should be and I refuse statins and suggested maybe I was under medicated, the Drs reply was that it has nothing to do with it 😡. I am 68 years old, live on the wirral and just been for a lovely long dog walk by the seaside - beautiful sun for a couple of hours. I walk every day, pick 2 of my grandchildren up from school and try to excercise to keep active. I have no problem helping myself but just don't need the hassle from the GP.
Well yes, my health issues were exacerbated by keep listening to the doctor - so I stopped going;
Once I was settled on NDT and knew I'd made the right decision for me I wrote to my doctor advising of my self medication and said i would be available fr the yearly thyroid function test providing both T3 and T4 were tested and I was dosed on monitored to keep these two essential hormones balanced within the ranges at around a 1/4 ratio :
Never heard a word, not even an acknowledgement but Levothyroxine was dropped off my prescription about 2 years later.
Now my prescription is just for some eye drops that I have to also buy for myself as the allocation of 1 drop in each eye daily, hardly touches the sides when I use it.
If you have NDT just play around - 1 grain is around 9mcg T3 and 38 mcg T4 and said to be " like " 100 mcg T4 :
It is what it is, as we are different in our ability to covert T4 so just go slow and see for yourself : NDT is the original and considered the best thyroid hormone replacement by many - other people can't tolerate NDT and take a synthetic T3/T4 combo.
Considering you have just about only an 1/8th of your thyroid left I think you need the addition of some T3 as you have all but lost your own T3 thyroid hormone production which is said to be at about 10 mcg daily, and for me, like a pilot light, and it kicks starts my metabolism.
Likewise by adding in some T3 it should resolve the " high " cholesterol so your doctor will be happy - so he can't have it both ways - and as you and I both know you don't need another prescription for statins but just an optimal level of thyroid hormone replacement.
Thank you for that, maybe I should do another post asking for T3 suppliers or do you think the bit of NDT will push it up? I am not "unwell" I just think I could be better than I am. I certainly do not want or have any intention of taking statins - nope, not for me. I have serious problems losing weight, all my excercise and no weight loss. Never dieted in my life until the loss of most of my thyroid gland and a diet doesn't do anything, starvation is the only way I lose weight, 1 meal a day and I may drop 2lb a week !!! Not doing that either. You do wonder where the Drs common sense is with your eye drops? All about money saving I'm afraid except when it comes to themselves but I won't go there, it makes me very angry.
Well dieting actually inhibits conversion of T4 into T3 :
You need calories for thyroid hormone medication to work well.
If you still have some NDT I'd go with that as you know it suited you.
I have always been tall and heavy and I believe undiagnosed hypothyroid from a very young age as I was " slow to walk " and " slow " to do anything according to my mother and again, undiagnosed dyslexic.
Now my T3 is up at a decent level my reading and understanding is much improved and after about a year on NDT I noticed my clothes were becoming loose something I've never experienced.
I don't diet - I cook from scratch, and don't have scales but am around 2 dress sizes down from where I was 4 years ago and now around a 16/18 :
Ok, if I add in some NDT would you drop some Levo? If so then how much would you suggest? If you remember I tried going up to more than half a grain of NDT but I got palpitations? Maybe I was on too much Levo? I am the same, never get on scales, just go by my clothes. I am a size 14 but was always a 10/12, its not the end of the world its just frustrating when I work so hard to keep myself fit. You have worked so hard to get to this point, all power to you.
Well my weight drop was just a by product as my health improved once my metabolism kicked in, which it did slowly and surely by switching to NDT.
I found NDT vert subtle and I continued to improve long after stabilising on my dose.
OK - so as you found you couldn't go higher than 1/2 grain with 100 mcg T4 :
Did you take a 1/4 grain before or did you start out on 1/2 grain ?
1/2 grain is around 4.50 T3 + 18mcg so maybe drop T4 by 25 mcg. first.
So suggest you drop down some T4 - wait a few weeks as it takes time to leave the body and then add the NDT - if it doesn't work, you've lost nothing but this probably means you need a little more NDT - I went up in 1/4 grain increments.
I started on 1/4 grain NDT plus 100mcg Levo then moved to 1/2 grain plus 100mcg levo, I am guessing too much Levo then? I am guessing the NDT will lower my TSH even more?
Any thyroid hormone replacement containing T3 will likely lower your TSH :
As would, being on an optimum dose of T4 - Levothyroxine for you - as you found out years ago when your dose started being reduced down because of your lowering TSH.
The TSH was originally introduced as a diagnostic tool to help diagnose a case of hypothyroidism - and it was never intended to be used once the patient was taking any form of thyroid hormone replacement.
The TSH blood test seen in isolation is pretty much a waste a time, especially when you haven't a fully functioning working thyroid.
The Hypothalamus-Pituitary - Thyroid feedback loop - that doctors and the TSH relies upon isn't there as you have all but " lost " your T - thyroid - because of the surgery you underwent.
Drop 25 mcg T4 and take 1/4 grain and after a couple of weeks increase up to a 1/2 grain which is where I think you felt well previously but then felt the palpitations.
The T4 takes around 6 weeks to fully leave the body so just go low and slow building up the NDT, once you have dropped some T4 - Levothyroxine.
Thank you, will give that a go. Back on my vitamins today so will re-test after Christmas, see where my results are then. Great to speak to you, take care of yourself.
Hi, that sounds like a good idea but no chance of getting extra 25mcg from GP surgery. I take it if I purchased extra Levo and took that as you advise then this would lower my TSH even further?
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