Hello
I wonder if anyone can help with recent blood test results.
I have apparently got very high cholesterol but have a very healthy vegetarian diet with little fat intake,
I am 4 years post thyroidectomy and take 75mg of thyroxine daily.
I was hoping it might be low T3 causing it so ordered a private blood test but they have come back today in range.
Any ideas?
These results are from this week.
Your FT3 may be in-range, but only just! It's much too low, so not surprising you have high cholesterol.
Cholesterol levels have nothing to do with consuming fat. Fat and cholesterol are two different substances and do not magically turn into each other when you eat them - despite what your doctor may think! lol Cholesterol is made in the liver (because your body needs it) and the liver maintains a steady level by adjusting to how much you do or don't eat. But, when T3 is low, the body cannot process cholesterol correctly, and it tends to build up in the blood. Raise the FT3, and the cholesterol should drop. 
Here is a youtube video by Dr Paul Mason that provides a clear explanation of cholesterol levels and why the ratio between Triglycerides/HDL is the key matrix rather than LDL. Historical people with high LDL tend to live longer, healthier lives. You have to ignore the marketing from the pharma companies. well worth watching
What time was your blood taken for this test? The reference range which applies for the cortisol test depends on the time of day.
Your conversion from T4 to T3 isn't very good.
Your Free T4 is 75% of the way through the range.
Your Free T3 is only approx 21% through the range.
Low Free T3 is often found in cases of high cholesterol.
How high is high, by the way?
It does vary, but many patients feel best with a Free T4 roughly around 60% - 80% of the way through the range (so your Free T4 might be fine for you), and Free T3 roughly around 50% - 70% through the range.
Your Free T3 is dreadful, and I doubt that anyone with thyroid disease would feel well with your result.
You could probably do with some T3 added to your Levo. Don't reduce your Levo dose though - there is nothing wrong with your Free T4 as it is.
One common cause of poor conversion is low levels or non-optimal levels of vitamin B12, vitamin D, Folate, and Ferritin (a measure of your iron stores). If you have recent results for any of these it would be helpful to anyone commenting on your results.
see later reply from Beckxbrown
She took test at 1pm and last dose levothyroxine only 7 hours before test
So false high Ft4 result
Levo can spike 2-4 hours after taking it, so a gap of 7 hours which was left here will not have caused the FT4 result to be too high. Leaving a very long gap as recommended by some on this forum could well show FT4 as too low, creating issues with dosage. Most recommendations from medical professionals and various research studies suggest that a few hours between levo and testing is sufficient, as long as it is more than 4. A false low is equally as bad as a false high.
hindawi.com/journals/cmmm/2...
General Error Analysis in the Relationship between Free Thyroxine and Thyrotropin and Its Clinical Relevance Simon L. Goede and Melvin Khee-Shing Leow
Therefore it is important to probe a person already using L-T4 on a fixed time of the day before the intake of the daily L-T4 dose. For practical reasons, this can be done shortly upon awakening (i.e., prior to the ingestion of daily dose of L-T4) in the early morning between 07.00 h and 10.00 h.
Leading endocrinologists also recommend testing at 24 hours after last dose levothyroxine
As do NHS guidelines on testing here
sps.nhs.uk/wp-content/uploa...
See page 13
Primary care monitoring
Monitoring is by TSH levels measured from blood tests taken prior to the morning medication.
Hello humanbean, so to know whether ft3 is low, we compare it to the range provided in the test result, or to a specific recommended range? my ft3 is 3.6pg/ml (range 2.3-5.3), ft4 2 ng/dl (range 0.78-1.94).
You always compare test results to the range supplied with the test results.
You can't just pick any range that you like from other labs.
Assuming test was early morning and last dose levothyroxine was 24 hours before test ……Conversion rate of Ft4 to Ft3 is currently terrible
For good conversion we need optimal vitamin levels
When were B12, folate, ferritin and vitamin D last tested
What vitamin supplements are you currently taking
As a vegetarian it’s likely Ferritin is low
You may need Full iron panel test for anaemia
Which brand of levothyroxine are you currently taking?
I gave you details on tests that included vitamins on previous post a year ago
healthunlocked.com/thyroidu...
Did you get vitamin levels tested?
Optimal vitamin levels
Vitamin D at least over 80nmol
Serum B12 over 500
Folate and ferritin at least half way through range
When I was hyperactive with Graves’ disease my cholesterol was the lowest I have ever known it. Now that I am in remission my TSH has crept up and my cholesterol has crept up with it. I pointed that out to my GP and she just smiled - alas the NHS doesn’t go for fine tuning.
thank you so much for quick responses, I have included my serum lipids results and have not had ferritin done since last year but apparently fine then.
They put me on statins straight away but within 3 days my heart went bananas and they stopped them.
How do I go about getting t3?
Wow, the total cholesterol in the first lot of results really is high. Did you do the test having fasted? People used to be told they should fast for 9 - 12 hours before the test (apart from water which can be drunk freely). But recent research suggests this is not necessary.
medicalnewstoday.com/articl...
health.harvard.edu/heart-he...
Having said that, I've always fasted before blood tests for anything, including cholesterol, so I will continue to do so just so I'm making a fair comparison between current and old results.
The only way I've ever managed to reduce my own cholesterol, LDL, and Triglycerides is by cutting down on sugar. Fats make little or no difference to my results. Unfortunately, my attempts to keep off the sugar tend to fluctuate wildly. 
Sugar can appear in many foods under many names - and sometimes you'll find it hidden under several names in the same product..
UK :
bhf.org.uk/informationsuppo...
caloriestar.com/list-of-dif...
USA : sugarscience.ucsf.edu/hidde...
That’s really useful advice, I will cut out the sugar and see if that helps as an terrified to take the statins again.
have not had ferritin done since last year but apparently fine then.
What were the actual results
GP would say anything within range is fine…but on levothyroxine we need GOOD vitamin levels
Ferritin at least over half way through range minimum
These are most recent, I will have to get a batch of tests done when I can afford it.
So ferritin is far too low
cks.nice.org.uk/topics/anae...
Serum ferritin level is the biochemical test, which most reliably correlates with relative total body iron stores. In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency.
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...
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
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...
Effective supplement
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...
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...
Great research article discussing similar…..ferritin over 100 often necessary
ncbi.nlm.nih.gov/pmc/articl...
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. ‘
I take a vitamin D supplement and a B12 one also and my currently taking 25mcg mercury pharma and 50mcg almus.
SlowDragon humanbean greygoose FYI
75 mcg levo is only a small dose. But, you appear to be a very poor converter. So, increasing the levo probably isn't going to help raise your FT3 very much. This could be due to low nutrients, but there's no guarantee that raising nutrient levels will improve your conversion. You probably need to obtain T3 to take along with your levo.
That said, you do need to optimise nutrients for over-all health. How much vit D and B12 are you taking?
Are you also taking vit K2-MK7 and magnesium with your vit D? Vit D and magnesium work together so you can't take one without the other. Also, taking vit D increases the absorption of calcium from food, and vit K2-MK7 makes sure the extra calcium gets into the teeth and bones, and doesn't build up in the soft tissues and arteries.
And, are you taking a good B complex with your B12? The B vits all work together and need to be kept balanced.
I am using the better you spray vitamin D and B12 atm.
Are there any you would recommend?
Also I did test about 1pm and I had taken my thyroxine at 6am that same morning.
It looks like the cortisol ranges have been cut off at the edge of your picture so I'm not 100% sure what they are.
From what I can see the ranges are quite different to the ones usually seen from the NHS, but (I'm guessing) your cortisol may be high.
Cortisol production has a circadian rhythm which hits a peak at roughly 8am - 9am for many people, although severe insomnia and night shifts can alter when that peak occurs.
The normal purpose of testing for cortisol in blood is to identify the peak and determine whether it is at the right level for healthy people. If the peak is very high it could indicate a problem with Cushing's. If it is very low it could indicate a problem with Addison's Disease.
Deranged cortisol output is quite common on the forum and it can show up as high OR low.
Thanks humanbean the bit cut off was range description so I have attached the cut off bit.
Okay, thanks. I was getting muddled before when I couldn't see the whole range. I think your result is probably okay, but can't be sure since the sample time falls in the gap between the two ranges given.
If you ever do a 4-part saliva test for cortisol and DHEA the optimal results for cortisol are (see example one):
rt3-adrenals.org/cortisol_t...
This doesn't help with your current blood test result though.
Cortisol levels from saliva are not measuring the same thing as cortisol levels from blood, so they can't be directly compared.
This is the best saliva cortisol test I know of :
regeneruslabs.com/products/...
Note that the sample report given for that test above shows what looks to me like the patient probably has Addison's Disease! It isn't typical of the results most people on this forum get.
So TSH falsely low as tested at lowest point in day
Ft4 falsely high as you took levothyroxine before test
Recommend getting thyroid and vitamin levels tested correctly
ALWAYS test early morning, ideally just before 9am and last dose levothyroxine 24 hours before test
How much vitamin D are you taking
List of private testing options and money off codes
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...
If you can get GP to test vitamins then cheapest option for just TSH, FT4 and FT3
£32 (via NHS private service ) and 10% off if go on thyroid uk for code
thyroiduk.org/getting-a-dia...
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...
NHS easy postal kit vitamin D test £31 via
Only do private testing early Monday or Tuesday morning.
Watching this post as I'm also having issues. Hopefully relevant to poster - I Have ordered the Blue Horizon Thyroid Gold finger prick test. I know to take it first thing, 24 hours after last levo dose but how long should we stop all of the vitamins and other supplements before a test? I take Vit D, magnesium, ashwagandha, floradix and recently stopped B Vits anyway. As advised by others on here I had the wrong one.
Ahhh..... in that case you will have a false high of ft4. Suggest you retest aim for much earlier in the day... around 9ish. You should take levkthhroxine for 24hrs pre test. So if you usually take it in the morning first thing, fasting then you don't take it on the morning of your test.75mcg is very low dose for a full replacement. I think you are highly likely under treated.
Cholesterol is commonly high in underrated hypothyroidism.... Should normalise once you are an optimum dose.
If you manage to raise you HDL i.e. good cholesterol that will lower your bad LDL a little.
I have a high HDL and eat nuts everyday. 2 Brazils, 2 walnuts and 6 Almonds. My good cholesterol is always high Your FT3 is much to low.
My HDL is pretty high and has had no baring with lowing my LDL.
Good for you then
Good for me to have high LDL … interesting
Mistake, sorry.
I don’t know how true it is but the dr said after a certain point it doesn’t really benefit to have higher HDL and mine was already quite high.
Having just seen my endocrinologist regarding my thyroid levels, I mentioned my high cholesterol reading. He didn't think my cholesterol was due to my thyroid levels, however he did say to not worry and that as I am fit and well otherwise, there was no reason to consider statins. I told him I was being pressured to take statins - but his comment was for me to direct the doctors to the information regarding Number Needed to Treat (NNT).
The NNT website : thennt.com/
Statins in Persons at Low Risk of Cardiovascular Disease :
thennt.com/nnt/statins-pers...
Statin Drugs Given for 5 Years for Heart Disease Prevention (Without Known Heart Disease)
thennt.com/nnt/statins-for-...
Statins Given for 5 Years for Heart Disease Prevention (With Known Heart Disease)
thennt.com/nnt/statins-for-...
Other links that are worth reading :
drmalcolmkendrick.org/2012/...
spacedoc.com/articles/50-fa...
The following two links are from a diabetes forum and they contain lots of links to cholesterol and statin info elsewhere :
You have no thyroid and your only taking 75mcg levo …. That can’t possibly be enough meds for a person with no thyroid.
I also developed super high cholesterol after thyroidectomy but try to get the Endo to see the connection… agh
I really don’t get how I can only need that much but when they put it up I went over ranges.
What went over range? Your TSH? Your Free T4? Your Free T3?
If you haven't had all the above three tested then you don't have enough information to say that you were taking too much of anything.
The fact that your test(s) was/were done with blood taken at 1pm and you had taken your Levo just a few hours before means that your results aren't as informative as they could be.
It is important to do the tests having fasted overnight too.
Take a look at the graphs on this link :
healthunlocked.com/thyroidu...
Edit : Just remembered that you did get all three TSH/Free T4/Free T3 tested, sorry. Your TSH will vary according to time of day, and your Free T4 and Free T3 will be affected by the recent ingestion of your Levo.
Looking at your T3, it seems to be very similar to what mine used to be; within range but very low. I am now on just 5mcg of liothyronine and my LDL values have plummeted. With this small dose of lio my FT3 has shot up from one end of the interval to the other and brought my LDL down significantly. I am also on a plant based diet and my HDL is always pretty high, so we are in a very similar situation that way. An additional bonus of taking the lio was that my GFR, which was below range is now back in range. So I assume that my kidneys are also functioning better.
That’s good to know, how did you get T3 prescribed?
Can my gp do that or would I have to go through endocrinology (if I can get an appointment!!)
Are they likely to say no?
I'm in Canada. So there are probably some differences in healthcare procedures. But no doctor would give me T3 even though my FT3 (which I tested through a company that no longer operates in Canada, because no doctor would test FT3. Sigh!) was sometimes below interval. Then a member here, who lives where I live, private messaged me and informed me about a nurse practioner near me who could potentially help. And she did. Good luck. I think there is a list of U.K doctors you can get from administration. Maybe that would help you find a physician to help you out. I wish you all the best.
Your LDL lowered with 5mcg T3? Im on 10mcg T3 and it hasn’t touched my LDL but I wonder if my medication Im on for Psoriatic Arthritis has a much larger roll in my cholesterol levels I even went as far as a total diet cleanup and hasn’t really made a difference until I added ground flaxseed to my morning smoothie and in one month after the diet cleanup and then adding flaxseed I dropped my LDL by 12 points… not a lot and my doctor wasn’t impressed I thought it was a good thing.
I think a 12 point drop is not bad. But sorry that you went through all that effort without seeing more of a drop. It just shows, though, that one fits all does definitely not work. If only that not-so-new-news would get through to the majority of physicians.
High cholesterol and triglycerides can be a symptom of growth hormone deficiency (see NICE TA 64), This serious pituitary hormonal deficiency often lurks in the background while doctors focus on thyroid and cortisol . . . it is expensive to treat and doctors don't want to find it. But you should look it up and see whether your other symptoms fit.
hi guys
Quick update on post, I had a cholesterol test done by gp yesterday and it has come down a bit so thanks for advice, I have basically cut out sugar, eaten more oats than anyone should have to and had 4 Brazil nuts a day with a benecol for good measure. Also raised my activity levels.Not sure if it will continue to drop or if this is a decent drop for 6 weeks?
Still not in financial position to have full private testing done sadly.
GP still wants me to try another statin as obviously still too high but I am terrified it will have same effect.
No contact from endocrinology yet and when I mentioned T3 to gp she didn’t really know what I was talking about?
Cholesterol and thyroid blood test results
Cholesterol
hypothyroidism and cholesterol 
