I had private bloods done as my GP only tests my TSH. At my last NHS test my TSH was 1.0 and my GP wanted to reduce my thyroxine back down from 100mcg to 75mcg as TSH was below range. I fought to stay on 100mcg as i had felt the best at this dose, previously when i was on 75mcg my TSH was 6 (range being 0.27- 4.2). I therefore felt it best to get private bloods to check FT3 and 4 to see where i was in range before my next NHS bloods. As can be see my TSH has dropped lower to 0.7 but my FT3 and free thyroxine (which i presume is FT4?) are within range. I know one is meant to be higher in range than the other but I can't remember which way round, does it look OK though? In the Medichecks report it stated that prolonged reduced TSH can cause osteoporosis but if my FT 3 and 4 are within range then which value is the most important one i should be concentrate on? Also as can be seen my iron is low, i like spinach and brocolli but not enough to eat it daily so i was wondering about a supplement but is there one that won't make me constipated? Thank you for taking time to read this 😊
CRP 1.19 (0-5)
Ferretin 22.5 (13-150)
Folate 3.85 (>3.89)
Vit B12 65.6 (37.5-150)
Vit D 73
TSH 0.07 (0.27-4.2)
T3 4.96 (3.1-6.8)
Free thyroxine 18.7 (12-22)
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mle121
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Sorry I can't read those results on my laptop because the numbers are so small. Physicians never factor in that the bioavailability of Levothyroxine in pill form is only 80% so if you're taking 100mcg it means that you're not actually getting 100mcg. You should remind the physician of that. It states it on the dosing guidelines and in the pamphlet for the Levothyroxine. It is aroud 1.6 mcg per KG of body weight. You could print it out to show them. It says on the dosing guidelines that a 70kg person would need about 112-125. I was on 88mcg and my physician was always trying to lower to 75mcg which would make me non functional to the point I couldn't get out of bed. Even as a very petite woman I cannot survive on 75mcg which isn't being fully absorbed in the first place. To lower a patient from 100mcg to 75mcg is ignorance. I've learned from my own experience recently that Iron is super important. My ferritin, iron serum and saturation were all bottom of range because my low thyroid levels caused an iron deficiency. I take Thorne iron 100mg (4 capsules) every other day and it causes me no problems. The brand is well known for being gentle and the pills are small.
Thank you so much for your reply, sorry my results came out blurry. My weight is about 62kg so my dosing guideline would be 99 therefore 100mcg seems perfect. Thank you for the advice re supplement brand, i will look into it. I will try and repost my results enlarged to see if it is clearer.
Some need less and some more. I'm at 59 kg and alternate 100mcg and 112mcg. If I were to only take 100mcg it would place my Ft4 levels closer to the low end of the range and I can't function like that but I don't have any functioning thyroid. Just six months ago I was only 47 kg and took 88mcg daily and had high T4 levels. Take care
Impossible to read I'm afraid, small and blurry. Can you repost without the white space, just shown the results/ranges.
Don't supplement iron unless you do a full iron panel - Serum iron, transferrin saturation percentage, TIBC and Ferritin - which will show if you have iron deficiency, plus a full blood count to see if you have anaemia (you can have iron deficiency with or without anaemia). If serum iron and saturation are good then supplementing with iron will take them too high and too much iron is as bad as too little.
Hi, thank you, i have just reposted it enlarged but it still goes blurry once i post it. I can barely keep my eyes open at mo so i will type the results out in the morning for you to see.
◦Serum folate of less than 7 nanomol/L (3 micrograms/L) is used as a guide to indicate folate deficiency.
◦However, there is an indeterminate zone with folate levels of 7–10 nanomol/L (3–4.5 micrograms/L), so low folate should be interpreted as suggestive of deficiency and not diagnostic.
You should speak to GP and may be prescribed folic acid.
Vit B12 65.6 (37.5-150)
Active B12 below 70 suggests testing for B12 deficiency according to Viapath at St Thomas' Hospital:
If you do then list them to discuss with your GP and ask for testing for B12 deficiency and Pernicious Anaemia. Do not take any B12 supplements or folic acid/folate/B Complex supplements before further testing of B12 as this will mask signs of B12 deficiency and skew results and if you have B12 deficiency is not detected and treated then this could affect your nervous system. B12 deficiency should be treated before starting folic acid because folic acid can sometimes improve your symptoms so much that is masks B12 deficiency.
If you don't you could supplement with B12 sublingual.
Vit D 73
You might want to check out a recent post that I wrote about Vit D and supplementing:
The Vit D Council, the Vit D Society and Grassroots Health all recommend a level of 100-150nmol/L (40-60ng/ml), with a recent blog post on Grassroots Health mentioning a study which recommends over 125nmol/L (50ng/ml).
So now you look at how much is needed to reach 50ng/ml and you'll see that they suggest 3,700iu per day. You could take 3,000iu or 4,000iu.
Retest after 3 months.
Once you've reached the recommended level then a maintenance dose will be needed 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. This can be done 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. You will have to buy these yourself.
D3 aids absorption of calcium from food and Vit 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. 90-100mcg K2-MK7 is enough for up to 10,000iu D3.
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 D3 as tablets/capsules/softgels, no necessity if using an oral spray.
For D3 I like Doctor's Best D3 softgels, they are an oil based very small softgel which contains just two ingredients - D3 and extra virgin olive oil, a good quality, nice clean supplement which is budget friendly. Some people like BetterYou oral spray but this contains a lot of excipients and works out more expensive.
For Vit K2-MK7 my suggestions are Vitabay, Vegavero or Vitamaze brands which all contain the correct form of K2-MK7 - the "All Trans" form rather than the "Cis" form. The All Trans form is the bioactive form, a bit like methylfolate is the bioactive form of folic acid.
Vitabay and Vegavero are either tablets or capsules.
Vitabay does do an oil based liquid.
Vitamaze is an oil based liquid.
With the oil based liquids the are xx amount of K2-MK7 per drop so you just take the appropriate amount of drops.
They are all imported German brands, you can find them on Amazon although they do go out of stock from time to time. I get what I can when I need to restock. If the tablet or capsule form is only in 200mcg dose at the time I take those on alternate days.
If looking for a combined D3/K2 supplement, this one has 3,000iu D3 and 50mcg K2-MK7. The K2-MK7 is the All-Trans form
Magnesium should be taken 4 hours away from thyroid meds and as it tends to be calming it's best taken in the evening. Vit D should also be taken 4 hours away from thyroid meds. Vit K2-MK7 should be taken 2 hours away from thyroid meds. Don't take D3 and K2 at the same time unless both are oil based supplements, they both are fat soluble vitamins which require their own fat to be absorbed otherwise they will compete for the fat.
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.
Thank you so much SeasideSusie for all that information and for breaking it all down for me per result. I will start with asking my GP for FBC and iron panel then based on those results I can start supplementing as required. Is free thryroxine same as T4?
Join an iron group your ferritin is below 30, also i see your folate is low. You could have absorption issues. My advice is to join groups for everything you test for as NHS lets us get depleted before helping.
I've enlarged as best I can - it might make sense to type in the results if these are way off :
TSH : 0.07
T3: 4.56 - should read 4.96 - need a new magnify glass !!!
T4: 18.70
CRP: 1.19
Ferritin: 22.50
Folate: 3.85
B12: 65.60
D : 73.00
The TSH once on any form of thyroid hormone replacement is not an accurate measure of anything and we must be dosed and monitored on our T3 and T4 results.
Though fully understand that in primary care we tend to be dosed and monitored on just a TSH reading and why many of us are forced into arranging private blood tests and getting help from forums as we know where we feel best, and it is not where the TSH sits.
We generally feel at our best with a T4 up in the top quadrant of the range at around 80% as this should convert to a decent level of T3 of at least over 50 %.
Your T4 is coming in at around 67% and your T3 at around 38% so there is room to increase your dose of T4 - Levothyroxine but I very much doubt your doctor will agree.
The risks of osteoarthritis having anything to do with a low suppressed TSH have been discounted and are unfounded and one is equally at risk having too low a T3 and the body unable to function well.
Your vitamins and minerals do need attention are you taking any supplements ?
A ferritin below 30 needs further medical investigation by your doctor running a full iron panel to check for anemia and it would also be wise to check for celiac disease if this hasn't already been done and ruled out.
Your folate needs to be up at around 20 : B12 at around 75 ++ and vitamin D at around 100:
Are you aware you have Hashimoto's auto immune thyroid disease ? thyroidpharmacist.com
Many people with this condition appear to have stomach absorption issues and need to first heal their gut and check for celiac disease, followed by food intolerances to such things as gluten, dairy and wheat - to name but a few suspects !
Obviously with hypothyroidism and whole digestion system slows down and it becomes more difficult to extract essential key nutrients from your food no matter how well and clean you eat and why many of us have to supplement where necessary to keep ourselves well.
No thyroid hormone works well until your ferritin, folate, B2 and vitamin D are up and maintained at optimal levels.
When I found my ferritin down at 22 and started my own research everywhere I read said that ferritin needed to be over 70 for any thyroid hormone replacement to work well and ow 6 years later I still need to supplement all my vitamins and minerals on a daily/weekly basis in order to stay well and to optimize my thyroid hormone replacement.
P,S. Please note I have the wrong result for T3 - so ignore % through range ;
Hi Pennyannie, thank you so much for your great explanation. I know my GP won't increase my thyroxine higher so i will need to work on my nutients to improve my T4 levels. I do know i have Hashimotos and my gut slowed down so much prior to my diagnosis that i am now on Magrogol daily to move my gut along. I also take Lansoprazole daily so i know that impacts on digestion but essential I remain on it. My diet is probably considered awful, the only animal product i eat is cheese and most days i have a pepper and some cucumber at lunch then veggie pizza for dinner and i eat this most days and have done so for years as it is my favourite food. I will eat other food but i just don't have the energy to cook most days. I am reluctant to test for coeliac incase i am positive then i won't be able to eat pizza again 😒 You say folate needs to be above 20, that would be a massive difference from the bottom range, is that correct?
my Gp is v happy with 0.2 tsh at the moment, t4 varying between 19/20. It’s not budged even when I was taking 75 extra each week. I’d say you’re ok at that level.
You could wait a few months and request a Gp blood test to double check. You need to raise ferritin and vit d would be better over 100-120. B12 and folate too.
Re iron, I get extremely good results with spatone x2 a day with vit c. You must read the instructions and follow them though. I would wait for an hour after lunch and take then, sometimes with extra dissolved vit c (I use the sachet with vit c in as can carry in pocket). And then wait an hour afterwards.
In tbe past I’ve raised by 20-30 points over a month even with fairly heavy periods. Those are reducing and I’ve gone even higher more recently, to a point where I think I’ll just take one and when I remember as it was 117. I’m on hrt and apparently oestrogen improves how you absorb iron.
Hi Haggisplant, thank you so much for your reply. Like you i am also on HRT and i noticed a massive improvement in my overall wellbeing when i started that so I'm pleased that will be helping my iron absorption. I will look into the spatone, thank you for the recommendation.
iron affects thyroxine absorption and caffeine and calcium (eg in milk etc) affect absorption of iron so that’s why I ended up with that regime.
Ideally it’s best to take iron first thing on empty stomach with vit c and then wait an hour as the hormone that aid’s absorption (I think leptin? Something like that!) is higher in the morning. But my regimen has always been thyroxine first thing, then a cuppa, so I Al have always done it like this!
Hi slowdragon, sorry for not replying last time it wasn't deliberate, i am currently on brand Accord but it does vary with each prescription. I will discuss my results with my GP and see if she will agree to more blood tests. Thank you.
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.
Thyroid disease is as much about optimising vitamins as thyroid hormones
Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing. It’s possible to have low ferritin but high iron
I will update my profile, but i am female, aged 46, vegetarian but also don't eat eggs or milk so cheese is only animal product i still eat. I eat the same food every day as i like it so i think starting supplements could be the way to go for me. Thank you for all the information 😊
There are other things you could eat to obtain iron in your diet. You might not know, although it is very old news, a German scientist put the decimal point in the wrong place when doing spinach analysis and so it is not loaded with iron as we were originally led to believe. It is is high in oxalates and is known to increase kidney stone formation and urinary oxalate content. So not good for inflammation if you suffer with that.
Thorne Basic B recommended vitamin B complex that contains folate, but they are large capsules. (You can tip powder out if can’t swallow capsule)
IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results
With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a B12 supplement as well as a B Complex (to balance all the B vitamins) initially for first 2-4 months.
once your serum B12 is over 500 (or Active B12 level has reached 70), stop the B12 and just carry on with the B Complex.
Oh gosh this paragraph made me laugh so much : 'Considering how dreadful your vitamin levels are you have remarkably good conversion levels of Ft4 to Ft3'. There is so much information it is going to take a while for me to get my head around it all, thank you so much 😀
Thank you, i know i am going to have to start working on my diet and nutrition now. I have had numerous gastric bleeds and without PPI i have acid constantly coming into my mouth, my tooth enamel is all eroded from it and i now have a hiatus hernia from the constant reflux so i definately need to remain on PPI's.
The present review of the literature regarding B12 status among vegetarians shows that the rates of B12 depletion and deficiency are high. It is, therefore, recommended that health professionals alert vegetarians about the risk of developing subnormal B12 status. Vegetarians should also take preventive measures to ensure adequate intake of this vitamin, including the regular intake of B12 supplements to prevent deficiency. Considering the low absorption rate of B12 from supplements, a dose of at least 250 μg should be ingested for the best results.3
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Advice on below range FT3 please
Please can you look at my results and advise?
Help interpreting medicheck results 
Results advice please 
Medicheck results are in advice please 😊
