Hypothyroidism : My recent blood test resultsTSH... - Thyroid UK

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Hypothyroidism

Poppycat999 profile image
25 Replies

My recent blood test resultsTSH 4.46

T4 16.1

FT3 THEY NEVER TEST THIS SHOULD I ASK?

Vitamin D 85

Folate 7.7

Ferritin 44

B12 644

Plasma viscosity 1.77

Serum calamine aminotransferase level 34

Cholesterol 5.7

I have headaches most of the night every night.

I'm tired alot of the time. Especially evening

I have to pull myself upstairs with banister due to aching hips and legs. My shoulders ache.

I'm on levothyroxine 100 daily

I am 61 female

I had late menopause at 58

I have a goiter with 3 nodules 3

I have felt I'll since 2020

Tried HRT November after 3 weeks ended up on bathroom floor so tired l couldn't do anything. Came off it immediately as it raised my TSH levels l think.

Any suggestions on what is wrong or what would help would be greatly appreciated

Poppycat999

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SeasideSusie profile image
SeasideSusieRemembering

You need to post the reference ranges as well as the results please as ranges differ from lab to lab. It's not possible to interpret results without ranges .

Did you do test as we advise:

* No later than 9am

* Nothing to eat or drink except water before the test

* Last dose of Levo 24 hours before the test

* No biotin or B Complex or any supplement containing Biotin for 3-7 days before the test .

Poppycat999 profile image
Poppycat999 in reply to SeasideSusie

Yes test done early morning with only water took levothyroxine straight after test

SeasideSusie profile image
SeasideSusieRemembering in reply to Poppycat999

Still need all the reference ranges.

Buddy195 profile image
Buddy195Administrator

Hi Poppycat999, please can you edit your post to add the ranges (in brackets after results) as these vary between laboratories. Have you ever had any antibody tests (to confirm if your thy condition is auto immune)?

TSH levels need to be under 2, with most members reporting they feeL best with levels significantly under 1…. So highly likely you will need a dose increase.

As most GPS do not routinely test FT3, many members (myself included) look to do this privately to have a better picture of our thyroid health.

SlowDragon profile image
SlowDragonAdministrator

Ferritin is low

Low ferritin levels (storage form of iron) very common when hypothyroid, especially if under medicated

What’s your diet like?

Vegetarian or vegan?

cks.nice.org.uk/topics/anae...

In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency

Also See page 7 on here 

rcn.org.uk/-/media/royal-co...

Look at increasing iron rich foods in diet 

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

List of iron rich foods

dailyiron.net

Links about iron and ferritin

irondisorders.org/too-littl...

davidg170.sg-host.com/wp-co...

Great in-depth article on low ferritin 

oatext.com/iron-deficiency-...

drhedberg.com/ferritin-hypo...

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.

healthunlocked.com/thyroidu...

Thyroid disease is as much about optimising vitamins as thyroid hormones

healthunlocked.com/thyroidu...

restartmed.com/hypothyroidi...

Post discussing just how long it can take to raise low ferritin 

healthunlocked.com/thyroidu...

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 

Medichecks iron panel test 

medichecks.com/products/iro...

Iron and thyroid link

healthunlocked.com/thyroidu...

Excellent article on iron and thyroid 

cambridge.org/core/journals...

Posts discussing why important to do full iron panel test

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Chicken livers if iron is good, but ferritin low

healthunlocked.com/thyroidu...

Shellfish and Mussels are excellent source of iron 

healthline.com/nutrition/he...

Heme iron v non heme

hsph.harvard.edu/nutritions...

Ferritin over 100 to alleviate symptoms 

healthunlocked.com/thyroidu...

Low Iron implicated in hypothyroidism 

healthunlocked.com/thyroidu...

Ferritin range on Medichecks 

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

We have received further information the lab about ferritin reference ranges. They confirm that they are sex dependent up to the age of 60, then beyond the age of 60 the reference range is the same for both sexes: 

Males 16-60: 30-400 ug/L

Female's: 16-60: 30-150

Both >60: 30-650 

The lower limit of 30 ug/L is in accordance with the updated NICE guidance and the upper limits are in accordance with guidance from the Association of Clinical Biochemists. ‘

Poppycat999 profile image
Poppycat999 in reply to SlowDragon

I have a good diet l think. I eat loads of salmon and chicken. I have eggs porridge bananas orange juice yogurt. Probably eat too much I'm 5ft 7 and 12 stone so could do with losing a bit.

SlowDragon profile image
SlowDragonAdministrator in reply to Poppycat999

when hypothyroid how good or band our diet is, is largely irrelevant

Being hypothyroid frequently causes low stomach acid levels and this leads to poor nutrient absorption and low vitamin levels

But adding red meat and liver etc to help improve ferritin

See what full iron panel test shows. You may need iron supplements

All four vitamins need to be at good levels

Poppycat999 profile image
Poppycat999 in reply to SlowDragon

I am having another blood test on January 18th. I will post results then with reference ranges didn't know they varied. Hopefully l will get to feel better eventually l cant put up with feeling so tired and headaches every night.It's a long journey

Poppycat999 profile image
Poppycat999 in reply to SlowDragon

Hi SlowDragon I have a blood test on 18th Jan my doctor will only test TSH levels l went to the surgery and asked receptionist if t3 TSH and t4 could be tested she rang me saying the doctor is only testing TSH she said t3 happens automatically and doctor knows best. I was so upset as on 100 levothyroxine and still feel bad aching shoulders and hips and cannot sleep at night because of terrible pulsing headache and bit dizzy. Still tired but not as bad as before. Doctor ringing me 24th Jan dont know what to say as my TSH was 4.46 on 50 dose l want to get it to about 1 but their range says 0.27 to 4.2 so she might say it's not my thyroid l want to see a specialist I'm sacred to say I'm not happy with her not testing more. I put my last results on this site alot was tested then but this time on 100 only TSH will be tested. Tell me what to say to try and see an endocrinologist my life is not as it was as all

SlowDragon profile image
SlowDragonAdministrator in reply to Poppycat999

What’s the TSH result on recent test

You are legally entitled to printed copies of your blood test results and ranges.

The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results

UK GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.

Link re access

healthunlocked.com/thyroidu...

In reality many GP surgeries do not have blood test results online yet

Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.

Obviously just testing TSH is completely inadequate but all NHS increasingly offers

You need to test TSH, Ft4 and Ft3 yourself

Only do private testing early Monday or Tuesday morning. Test just before 9am and last dose levothyroxine 24 hours before test  

Watch out for postal strikes, probably want to pay for guaranteed 24 hours delivery 

List of private testing options and money off codes

thyroiduk.org/getting-a-dia...

cheapest option for just TSH, FT4 and FT3 £29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/

Monitor My Health also now offer thyroid and vitamin testing, plus cholesterol and HBA1C for £65 

(Doesn’t include thyroid antibodies) 

monitormyhealth.org.uk/full...

10% off code here 

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Have you been working on improving low ferritin

Red meat 2-3 times week, liver or liver pate once a week etc etc

aiming for ferritin at least over 70

SlowDragon profile image
SlowDragonAdministrator

Looking at previous post a month ago

healthunlocked.com/thyroidu...

I think …….These are the results from when you were on just 50mcg levothyroxine ?

It takes a minimum of 6-8 weeks for each dose increase to have effect

Perhaps a bit longer as you were increased from 50mcg to 100mcg in one go

It’s usually recommended to ONLY increase by 25mcg …..wait 6-8 weeks…..retest ……and increase again if need be

Hormones can’t be rushed

You are likely finding it difficult to adjust to large increase in dose

You will need to retest thyroid levels in at least another month

Poppycat999 profile image
Poppycat999 in reply to SlowDragon

I will post my TSH results on 100 levothyroxine as soon as l get it back from doctor. I dont have a problem seeing my results as l always go to surgery and ask for a print out l also have my chart app which takes ages to show results as they dont put them up very quickly. I dont understand why my doctor is only going to check TSH levels if this us inadequate? I want to see an endocrinologist so want her to refer me. 4.46 TSH last test. Headaches are terrible every single night. I am very unhappy with the service from my doctor. She never tells me to have blood test early morning or not yo take my levothyroxine before the test. She booked my last blood test for the afternoon so l altered it and had it early morning without taking the levothyroxine before it. This l learnt from this site.

SlowDragon profile image
SlowDragonAdministrator in reply to Poppycat999

It’s all many/most NHS labs test these days

It’s why thousands of U.K. patients forced to test privately

If you use Monitor My Health the NHS private test service GP can’t dismiss the results

Examples of MMH results

healthunlocked.com/search/p...

Examples of Medichecks results

healthunlocked.com/search/p...

examples of Blue horizon results

healthunlocked.com/search/p...

shaws profile image
shawsAdministrator

If you need to alter anything within your post, press the down arrow - across from Reply - and select 'edit'

SlowDragon profile image
SlowDragonAdministrator

I'm on Almus 100 levothyroxine dose 

These are the results T4 22.9 (12.0 -22.0)

TSH 0.03 (0.27- 4.2)

I am totally shocked as last results in November 2022 were 

FT4 16.1

TSH4.46

I was on 50 Almus levothyroxine then.

Was test done early morning, ideally just before 9am, on empty stomach with only water before test and last dose levothyroxine 24 hours before test

As expected, that’s why it’s standard practice to only increase by 25mcg at a time

Suggest you request staying on 100mcg for now and retest in another 6-8 weeks

Approx how much do you weigh in kilo

Eventual dose levothyroxine is approx 1.6mcg per kilo of your weight per day

Just testing TSH and Ft4 is completely inadequate

Suggest you get TSH, Ft4 and ft3 tested together yourself privately

cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/

have you had BOTH TPO and TG thyroid antibodies tested for autoimmune thyroid disease (hashimoto’s)

If not get these tested too

medichecks.com/products/thy...

Presumably you have increased iron rich foods in your diet

Red meat every day and liver or liver pate once a week plus orange juice to increase absorption of iron

Request GP retest full iron panel including ferritin see how much ferritin levels have improved

Poppycat999 profile image
Poppycat999 in reply to SlowDragon

Hi SlowDragon Thankyou for your reply. Yes l had test at 9.am and didn't take my tablet till after the test. I usually have tablet at 7am with water. Food at about 8.30am or after. My weight is 12 stone. Dr would only test my TSH and t4. I asked receptionist to ask of l could have t3 tested as it's all to do with my thyroid problem she said doctor says it happens automatically l said well l suppose she knows best. Receptionist said he certainly does. I felt like l wasnt supposed to ask by her look. Dr rang with the results l gave you and told me to have a blood test friday to check my cortisol levels. She also said I'm now over medicated and need 75. She said she is going to refer me to an endocrinologist so I'm pleased about that. I think l might only take 75 tomorrow morning as not feeling great at all.

Poppycat999 profile image
Poppycat999 in reply to Poppycat999

She also said it might not be a thyroid problem if not what is it. I'm a bit scared as been suffering for 3 years now ever since my late menopause at 57 nearly 58.

SlowDragon profile image
SlowDragonAdministrator in reply to Poppycat999

I suggest you perhaps ONLY reduce levothyroxine to 75mcg and 100mcg alternate days

You will need to cut Almus tablet to get 75mcg

Use sharp craft scalpel to cut in half

Then cut one half to get 1/4 tablet

Store spare 1/4 tablet in pill dispenser

Get weekly pill dispenser for tablets so you know which one on which day

12st = 76kilo

76kg x 1.6mcg = 121mcg as likely eventual daily dose levothyroxine required

You have just had dose increased too quickly

After 6-8 weeks on reduced dose get FULL thyroid testing done privately

TSH, Ft4 and Ft3

Poppycat999 profile image
Poppycat999 in reply to SlowDragon

Thankyou for your information. I have some 50s levothyroxine so l can take one tablet and cut another in half. Hubby has a sharp stanley knife.

Poppycat999 profile image
Poppycat999 in reply to SlowDragon

Hello SlowDragon I am on 75 levothyroxine have been for a while was on 100 levothyroxine before that for a while.

My blood test on 18th January was T4 22.9. (12.0-22.0)

TSH 0.03 (0.27-4.2)

So then went on 75 levothyroxine (Almus cut one in half and whole one of 50s)

Today my blood test results are in

TSH 0.08 Below range(0.27-4.2)

T4 17.9 (12.0-22.0) so within range

The notes on my TSH says follow up No further action.

Why when I'm too low? I questioned receptionist and said l didnt feel well to tell doctor she said she'd message doctot and l might get a phone call later.

No call received. Should l lower my levothyroxine dose to 50 now as l dont feel well tired aches headaches dizzy and my eye surrounds are swollen? Would be grateful for advice please? I'm 61 and weight is 12 stone. Height 5.7ft

SlowDragon profile image
SlowDragonAdministrator in reply to Poppycat999

was test done early morning and last dose levothyroxine 24 hours before test

STRONGLY recommend that you get FULL thyroid and vitamin testing done

Request GP test vitamin D, folate, ferritin and B12

What vitamin supplements are you currently taking

Wait to get vitamin results from GP before testing

TSH, Ft4 and Ft3 privately yourself

If GP can’t/won’t test vitamin levels test these yourself too

Poppycat999 profile image
Poppycat999 in reply to SlowDragon

Yes test done 8.30am didn't take levothyroxine till after test. Learnt that from this siteI take magnesium 500mg vitamin D 1000i.u daily.

My doctor tested vitamins last time all ok. Doctor says it's not necessary to test anything else this time except TSH and T4

I dont like the finger prick tests. Last time in January my vitamins tests were all ok.

I started this morning on 50micrograms levothyroxine as 0.08 TSH l thought best as was on 75micrograms l hope 🙏l have done the right thing.

SlowDragon profile image
SlowDragonAdministrator in reply to Poppycat999

FT4: 17.9 pmol/l (Range 12 - 22)

Ft4 only 59.00% through range

Most people when adequately treated will have Ft4 at least 70% through range

So no I wouldn’t reduce dose levothyroxine

I would stay on 75mcg and retest again in another 2-3 months

GP is quite happy with results

Approximately how much do you weigh in kilo?

T4 therapy

ncbi.nlm.nih.gov/labs/pmc/a...

In a study evaluating tissue function tests before total thyroidectomy and at 1 year postoperatively when using LT4, it was found that peripheral tissue function tests indicated mild hyperthyroidism at TSH <0.03 mU/L and mild hypothyroidism at TSH 0.3 to 5.0 mU/L; the tissues were closest to euthyroidism at TSH 0.03 to 0.3 mU/L [48]. A normal serum TSH level consequently does not necessarily indicate a euthyroid state at the tissue level.

SlowDragon profile image
SlowDragonAdministrator in reply to Poppycat999

12st = 76kilo 

76kg x 1.6mcg = 121mcg as likely eventual daily dose levothyroxine required

So definitely do NOT reduce dose levothyroxine

SlowDragon profile image
SlowDragonAdministrator

Your Ferritin level was far too low

Low ferritin level will lower TSH

Are you working on increasing iron rich foods in your diet

Red meat every day and liver or liver pate once a week

Aiming for ferritin at least over 70 …..over 100 might be better

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