My friend has just had these results .
Can anyone give advice
Note FT4 top of range. Ft3 just above bottom of range
24 hrs left between dose and test
Vit D 224
ferritin 326
Advice for these results : My friend has just had... - Thyroid UK
Advice for these results
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Digger031145
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Jaydee1507Administrator
It's lovely that you are helping your friend but it would be much better if they could make an account and post in person.
Clearly they are a poor converter and would likely benefit from adding some T3 to their Levo.
You haven't given ranges for vitamins but vit D look on the high side.
No result for B12 or folate.
no results for B12 or folate .she can’t create an account for herself as she doesn’t have a computer that’s why I’m doing it for her.
No idea what range I for Vit D
I'd recommend your friend getting full thyroid plus vitamin testing. Private tests are available, see link for companies offering private blood tests & discount codes, some offer a blood draw service at an extra cost. thyroiduk.org/help-and-supp...
They should ensure that all vitamins are optimal so need further bloods for folate and B12.
Make sure not taking too much D3. Also should be taking D3 with K2 to help it go to the bones.
She/he could ask for a referal to an Endo via the NHS which would be slow and no guarantees of being prescribed T3. They could also email info@thyroiduk.org for a list of T3 friendly Endo's and see one privately which would be much faster but again no absolute guarantee of being prescribed T3. Recommend making a post once they decide which Endo they want to see and getting feedback via personal message only on the one they wish to see.
her full thyroid results are there though
True, still need the other vitamin levels and to know range for Vit D & ferritin.
I put the range for ferritin in my reply to SeasideSusie.
It’s 13-150
Hello 130396 :
I find it difficult advising people for their friends as the information isn't immediately there - for instance - what is your friends diagnosis, how much thyroid hormone replacement are they taking, what are they taking, and did they follow the rules as advised before having the blood test ?
On first look - It's obvious there is a conversion issue :-
with a T4 at 20.90 and a T3 at 3.20 the conversion ratio if on T4 only is coming in at 6.53 -
which is very wide of accepted ratio which is said to be 3.50 - 4.50 T3/T4 :
SeasideSusieRemembering
130396
Your friend needs to answer the following questions.
1) Does she supplement Vit D? If so how much and does she also take Vit K2-Mk7 and magnesium - two very important cofactors when taking D3. Ask her to confirm that the unit of measurement for Vit D is nmol/L.
2) What is the reference range for ferritin? Does she supplement with iron?
3) Does she take biotin or B Complex or any supplement containing biotin? If so did she leave this off for 3-7 days before the test?
4) Does she take any other supplements?
Her conversion of T4 to T3 looks poor but good conversion needs optimal key nutrients, so testing B12 and folate are also important.
SeasideSusie
No range given for Vit D.
She doesn’t take Biotin. Her dose is 100mcg fairy taken first thing in the morning . Tests was done 25 hrs after last dose.
Range for ferritin 13-150
Recently had UTI and ear infection
No other supplements
Had celiac disease.
Used to be a very good converter when she started on Levo. Keeps to same brand.
She was supplementing with vitamin D stopped a couple of weeks ago was nutri liquid 1000iu
Take vitamin C but not for a week 1000mg a day
No biotin or b complex as her B12 still high
She is taking probiotics because shed been on 3 lots of antibiotics
130396
I know there's no range for Vit D as that had already been mentioned 
but I asked for confirmation of the unit of measurement. If it's nmol/L then the recommended level is 100-150nmol/L according to the Vit D Council, Vit D Society and Grassroots Health. Nmol/L is the usual unit of measurement in the UK but occasionally it is ng/ml and if that's the case the recommended range is 40-60, so you can see why it's important to know.
Her Vit D level is over range whichever unit of measurement it is, but if it's ng/ml she has probably reached toxicity level and if it's nmol/L then she's well on her way to toxicity.
She was supplementing with vitamin D stopped a couple of weeks ago was nutri liquid 1000iu
She has an extremely high Vit D level for someone only taking 1,000iu D3. What made her start taking it? Did she test first, if so what was the result? If she didn't test why did she start taking it?
Has she been taking Vit K2-MK7 and magnesium?
She should not resume taking her D3 and it would be a good idea to test at the end of October, that will tell her if she needs to supplement over the winter. You can post the result on here for guidance at the time.
*
Her dose is 100mcg fairy taken first thing in the morning . Tests was done 25 hrs after last dose.
And did she do her test no later than 9am, did she have nothing to eat or drink except water before the test?
*
Ferritin is well over range, does she take iron tablets or recently had an iron infusion?
*
How recent was her UTI and ear infection. Thyroid tests shouldm't be done until a few weeks after an acute infection.
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Take vitamin C but not for a week 1000mg a day
That's not going to make a difference to anything, nor will the probiotics.
*
No biotin or b complex as her B12 still high
What was her B12 when tested - result and unit of measurement?
Was she supplementing or was that her natural level without supplements?
*
Although I appreciate that your friend doesn't have a computer, from all the questions that continually crop up as we find out more information, I think you can understand why we say it's best to deal direct with the person rather than through a third party who has to keep going back and asking the questions and we get the information in dribs and drabs but as long as we get all the facts we can hopefully help.
Hi seaside susie and everyone else that’s commented thank you so much .. I haven’t got a PC and was at work .. I work at a GP surgery as a phlebotomist so can’t access my phone 
I always follow protocol .. fasting bloods first thing in the morning no Levo ..
My vitamin D was at 79 optimal on the lab reference range a year ago but I took nutri 1000iu a day as thought it would help my thyroid as the T3 has be consistently going down ..
My B12 has always been high ever since I had B12 injections 6 or more years ago no explanation for that from my GP ?
I probably should have waited for my blood tests as my friend advised me too but wanted to get them sorted .. as worried about my T3
I’ve had 3 lots of antibiotics as I had a UTI then a bacterial and fungal ear infection ,. Not taking any iron or infusion.. I do eat a lot of red meat and chocolate 😳 I know infection can raise ferritin 😞 and doubt chocolate and red meat helps ..
My GP is on annual leave till next week so I will ask him about T3 then as also my cholesterol is at 7 and my HDL is low at 0.99 .. I’ve given up chocolate and trying to keep to fish white meats salad not having carbs I’m a coeliac so GF .. but not having bread either at the moment .. Thank you for your help and thanks to my dear friend for trying to help .. I understand it’s difficult if it’s someone posting for me xxxxxx
Hi darling
Glad you’ve managed to access the group now . Hope you get the help you need xxx
Thank you SO much for trying to help I can see it’s difficult for the members to give accurate help if I wasn’t adding posts myself .. it’s just a no way at work and not having a PC now it’s a bit harder on my phone xxxxxx
I would get on and ask for a referral to an Endo 🤗
Perfect example of a bad converter, you'll need some T3 as your GP will just reduce your T4 to 'bring your TSH up a bit' 🙄
Thank you .. my GP is on annual leave till next week .. I have private health insurance but AXA say I need a referral from my GP 🤬 .. I will as on here for recommendations who I can contact for T3 if he refuses to prescribe 😞 nightmare with these doctors .. why on earth thry take an oath first do no harm ?? Xxxx
Frustrating wait but perhaps ask admin for the list of Endos which might give you a name in your area to aim for? Don't know how it works with AXA do you get a choice of who you see?
Edit... just looked up AXA
Axa options
hi thank you .. how do I request a list in my area ? My friend has found a endo in my area Ipswich Suffolk
>>name removed<< he seems good but I would check out others I need to know I will definitely get prescribed T3 🙏
I have gone private before and the endocrinologists I saw were useless they were more qualified and interested in diabetes 😞
Thank you so much xxxx
hi Lynn
I’ve looked at the list of recommended endos but the only one I can find is the one I’ve already told you about.
There is another one but he’s a functional dr and requires lots of blood tests x
How about the one in Bury St Edmunds ( we aren't supposed to mention names on here) Look in the C's 😉 if Digger031145 pings you the list
Would be easier if the list were in Counties rather than alphabetical wouldn't it
Glad you could make it lynnwin
My vitamin D was at 79 optimal on the lab reference range a year ago but I took nutri 1000iu a day as thought it would help my thyroid as the T3 has be consistently going down ..
That's a phenominal increase in your Vit D level from just 1,000iu D3 daily, that's usually just a maintenance dose. Like I say, I wouldn't take any now, summer is here and you should make some naturally from the sun but you have a good store anyway. Retest end of October, if only testing Vit D then this NHS lab that offers dried blood spot tests to the general public is easiest to do:
My B12 has always been high ever since I had B12 injections 6 or more years ago no explanation for that from my GP ?
What was the reason for B12 injections? I imagine not Pernicious Anaemia. How long did you have them for? Our B12 store is supposed to be good for about 4 years I think. If you can get B12 and folate tested these are the recommended levels:
B12 - top of range for Total B12, if Active B12 is tested then 100 plus.
According to an extract from the book, "Could it be B12?" by Sally M. Pacholok:
"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".
"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."
If unit of measurement is pmol/L then the figures would be at least 332pmol/L as deficiencies can appear below 406. For brain/nervous system health and older adults near or above 738pmol/L.
Folate is recommended to be at least half way through range, if no range and just shows as, eg >3.89 then aim for double figures.
Not taking any iron or infusion.. I do eat a lot of red meat and chocolate 😳 I know infection can raise ferritin 😞 and doubt chocolate and red meat helps
Liver has the highest iron content and if you don't regularly eat that I'd be surprised if a meat rich diet would cause such a high ferritin level. It could be raised due to your recent infection so it might be worth retesting everything in a couple of months time just in case these figures have been skewed by your recent infection.
Do come back with new results, it certainly looks like poor conversion of T4 to T3.
Thank you seaside susie my vitamin D always goes high on the liquid it’s happened before and the same with my niece .. I’ve stopped it now .. once the GP gave me strong vitamin D tablets they just upset my tummy and my vitamin D didn't move .. I was given B12 as I had peripheral neuropathy and bring a coeliac they tested and a Harley street endocrinologist advised my GP to do them the last time it was tested it was over 2000 😳
I’ve also recently increased my propranolol from 20mg a day to 40mg I take it a hour and half after my Levo .. I have private health insurance madness when I work NHS but don’t get any privileges so I’m going to call the Nuffield tomorrow to see if I can see >>name removed<< without a referral ?
I also read that beta blockers can raise ferritin .. the two infections haven’t helped and my leukocytes are a little raised so still fighting some infection ..My liver funtion test was ok .. Thank you for your time I will update xxxxxx
Ah you are on Propranolol. I'm afraid this beta blocker is known for lowering the conversion rate of thyroid hormones. Although 40mg isn't a high dose it would still affect. Most beta blockers work like this but Propranolol is one of the worst. It really will be lowering your T3.And in addition because it slows conversion your ft4, would rise.
I would definately wean off it. Is there something else that your GP can prescribe instead.
Everyone is different with their vit D dose. However 1000iu is definately a low dose. I take it to maintain my levels with a short further boost in winter. Are you sure that's what it says.... Not 10,000iu? Just a thought.
I meant to add that once in b12 injections testing should not be done. It will always give a high reading. What's important is that your symptoms improve and that's the basis of the frequency of jabs.I still need daily b12 jabs to keep my neurological symptoms at bay. I also take a B complex to balance my bs. They work together. So your GP should not be basing the frequency of your B12 jab on blood tests..
only other thing different is I run out of progesterone cream 3 weeks ago .. xx
your progesterone level was really low even though you used the cream anyway so don’t think it’s relevant xxx
Sorry can't comment on progesterone cream. Female hormones, adrenal & thyroid are all interlinked Each area is influenced by the other. So getting your thyroid hormones sorted out would be a good start and may help with your female hormone levels. T3 is the useable form of thyroid hormones. Low levels means your body runs slow, every cell needs T3. So low levels can cause a myriad of problems. Hypothyroidism is called the great mimicker for good reason. For me my starting point would be weaning off the beta blocker once you've consulted with your doctor. Reinstating b12 jabs as they were recommended by your specialist. Then see how the land lies and retest in a few weeks time. A B complex added in would be a good idea and then make sure you stop the B complex a week before retesting. Beta blockers of all types made me very ill... & affected my thyroid conversion levels everytime. Propranolol at high dose is used to help manage HypERthyroidism. Say no more.... Lol.
I'm not medically trained. I have hypothyroidism, b12 deficiency and formally diagnosed with gluten intolerance. The above is my experience.
hi thank you ❤️ yes expect the propranolol as was originally given to me when I went hyper years ago and need carbomenazole to bring it down as I had Hashimotos thyroiditis .. I stayed on it as my migraines returned when I stopped it as recommended by my GP
My GP won’t give anymore B12 injections as my last blood test for B12 was 2000 🤦♀️ it doesn’t go down .. I am a coeliac been gluten free for 30 years now after being diagnosed at aged 33 .. that’s how the b12 deficiency was discovered and I had a PN probably caused by the years of not being diagnosed Coeliac and B12 deficient
My progesterone cream has arrived this morning so I’m back using that ,,
I have found another endocrinologist at a different private hospital who will see me without a referral .. I’m waiting for a call back from his secretary as my friend found out he uses armour so not sure if I will go to him .. Just for a laugh one of the GP’s just phoned me and said my thyroid is NORMAL what the hell ? She said it’s just my TSH which is low 🤦♀️ and she said that’s what they go by .. I said I know that and it’s wrong and asked for a referral to Damian Morris at the Nuffield in Ipswich .. She is going to do it but bloody hell how can she think my results are NORMAL 😳
Thank you xxx
Cos they know nothing about treatment for hypothyroidism and are advised to go by TSH only!! Be very careful which specialist you see. Many of the endocrinologists are experts on diabetes and no little more than the GPs re hypothyroidism. This is why people advise on here checking very carefully before asking for a referral from GP. I had my thyroid levels tested very recently. First when I didn't know they were doing them so had taken my thyroid meds that morning and hadn't stopped my B complex that contain biotin the week before. My results came back sky high with a ft3 Of 18 & ft4 of 28. Both way over the ranges. Did the GP think that's weird she's never had results like that before? No of course not. Instead I got a text! Yes a text.... Telling me to drastically cut my thyroid medication with some huge variation of dose alternate days. I'm on Armour. I was furious that I hadnt been consulted and the adjusted dose advice was plain ridiculous. Complained. GP rang me and when I'd explained what had happened he agreed with me.... I said of course if I'd been consulted I would've been able to explain this. No apology. I didn't go into his dose advice regime... not worth the hassle tbh.
It's plain dangerous.
OMG that’s bad .. not telling you they were testing your thyroid .. I ask my dr what bloods I want I’m a phlebotomist.. but no expert on thyroid etc my friend helps me she is very knowledgeable and I come on here when I can ..
yes I have asked for a referral to >name removed< just in case this other endo doesn’t prescribe T3 ?? and he is self referral which is good xxxxxx
RThat's great. You will need to remove his name from the posts as we are not allowed to name. & discuss clinicians by name on post only in chat!You can put a post up naming a clinician & asking for feedback via a post though.
You know your later appointment might be rather good as it would give time to start slowly weaning off orpsnolol. It should be done gradually. Not just stopped. Worth a try...
Yes it was poor. I did ask the nurse if they were doing thyroid as had taken my meds and take biotin. Nurse didn't know. I asked can you let labs know. Clearly didn't happen or they didn't get the message. It's such a waste.
oh sorry I will try and remove it and add a post asking for feedback ..
oh that’s rubbish she would have known if you were having a thyroid test we have to look at the tests to see which bottle and how many tests for chemistry as one 7.4 ml bottle does 14 tests so if more than that for chemistry we have to add another bottle .. if it was taken at your surgery she can add to your notes when adding blood test taken that you took your meds ! If done at the hospital she wouldn’t have been able too .. but would have known what tests you’re having ? And it’s the protocol from WHO if a patient asks what bloods are being done we have to tell them .. It’s appalling 🤬 yes I agree I will slowly cut down my propranolol I’m only taking 30 mg today that’s one 10mg less .., as I’ve been only taking 40 mg for 6 months I hope I don’t get any withdrawal ? It’s definitely worth a try .. Thank you for your help xxxx
The nurse, was at the hospital. He said he didn't know which tests. It's electronic so doesn't show. However I thought they would do a thyroid test because it was a pre op test. The hospital just said it was appointment with consultant no mention of pre op tests.... Turns out there was a battery of them. Didn't mind but would've like to have known before hand!! Too much pressure on NHS.... Bless them.
If you look at the bottom of ure reply to a post you will see a button that says more. If you click on it brings menu up, select edit than you can alter your reply.
No need to apologise. 😊
I made a new post asking for recommendations but I think I did something wrong as it has been closed for comments can only receive comments privately 🤦♀️ I’m not good on this site xxxx
Yes that's what happens. People will feed back through the chat to you.
Hashimoto's should not be treated with Carbimazole - this will have down regulated your conversion and totally unnecessary as your T3 and T4 would have naturally fallen down back into rages themselves.
Carbimazole is an Anti Thyroid drug and should only be prescribed to people with Graves as their T3 and T4 do not fall down but keep rising higher and higher and seen as life threatening if not medicated.
thyroidpharmacist - for all things Hashimoto's :
hi that was 17 years ago I was really hyperactive GP sent me to endocrinology at the hospital I had a goitre which was FNA ‘ed .. I lost loads of weight and had all the hyper symptoms.. they wanted to give me radioactive iodine but I refused I was on carbimazole for 6 months then went euthyroid for years then about 8 years ago went Hypo as the TPO antibodies killed my thyroid .. xxxxxxxx
Ah - ok - lucky you were treated with fine FNA :
I had RAI thyroid ablation for Graves back in 2005 :
We now have this research and simply do not understand why it is still an option, and in some cases the only treatment ( as in my case ) offered in a health care setting :
The Propanolol is likely part responsible for your very poor conversion of T4 :
Please get this changed to a different beta blocker that does not effect T4 to T3 conversion.
Once T4 medication is up in the top quadrant of its range yhe accepted conversion ratio when taking T4 only medication is said to be 1 / 3.50 - 4.50 T3/T4 with most people feeling at their best when they come in this ratio at 4 or under.
So your T4 is at 20.90 and a T3 at 3.20 and if we divide the T4 by the T3 your conversion is coming in at 6.53.
We generally feel at our best when you T3 and T4 thyroid hormones are balanced t around a 1/4 ratio T3/T4 once the T4 - levothyroxine is up in the top quadrant of it's range.
Your T4 is running at around 89% with a T3 is just 1 marker in a range of 37 so at around 2.70 % :
Thank you so much I will have to read that over again as I can’t compute it lol 😆 just had a call from one of the GP’s who says my Thyroid was fine 😳 and it was just me tsh which was too low .. I’ve asked for a referral so at least she is doing that .. but what the hell how can she say it’s normal ? When my T3 is so low will they wait till my T3 is under the lowest range ??? I work NHS and I’m shocked at the way things have gone 😞 xxxxxxx
I'm afraid the current guidelines all centre around having a TSH in the range :
The yearly thyroid function tests for those already on T4 - are generally just a TSH reading and doses adjusted on this very unreliable measure of anything once on any form of thyroid hormone replacement.
It's endemic and why forums such as this exist - when I joined around 7 years ago researching low ferritin, we had around 15 K members - just looked up to the top of this screen - and we are tipping over 131 K.
We are mostly women and tend to put others first before we worry about ourselves and I'm afraid the computer dogma seems to over rule thought, reason, and health and wellbeing of a vast sector of the population.
I have Graves and had RAI thyroid ablation in 2005 and refused any treatment option other than T4 - I fought my CCG/Hospital/doctor all to no avail, and this stress simply exacerbated my symptoms so now I stay away and buy my own thyroid hormone replacement, supplement vitamins and minerals and run a yearly blood test.
I did write to my surgery in 2018 advising them of the medication I was taking and to cancel T4 off my prescription and offered to furnish them with copies of my private blood test results. I never even received an acknowledgement of my registered letter and T4 disappeared from my prescription 18 months later.
The brain needs an awful lot of T3 and of course you can't compute as your level of T3 much too low !!
yes and it doesn’t help me at work either .. poor patients I’m taking their blood 😳🤦♀️ xxxx
All beta blockers affect conversion rates.... Just that some are worse than others. Personally I wouldn't go near them. Have had three bad experiences with different beta blockers.... Even when told this one won't affect your thyroid. They do!!
sorry I put that post asking for recommendations I thought it was allowed ? 🤦♀️ I removed a endos name from one of my posts but I must have misunderstood one of the members who said put a post on for feedback on endos in my area .. sorry xxx
It is allowed to ask for recommendations but as explained when I replied to that post we have to close the post to replies to avoid any names being mentioned on the forum, hence I asked for any replies to be sent to you by private message. The post is still visible and if anyone has any recommendations they will send you a private message.
Thank you so much xx
Thank you darling xxxx
if you decide to go down the private endo route be careful which one you choose. I had very similar test results and paid to see a endo on the thyroid U.K. list, he reduced my dose and now I’m in a very bad place, far worse than I was before I consulted him.
• in reply toDizzy444
can you pm me the name of who you saw? I saw an awful one from the thyroid UK list too x
Dizzy444 Hidden If you haven't already done so, do send feedback to Thyroid UK. They will want to know about your bad experiences.
• in reply toRedApple
I did write an email but it bounced back actually, do you mind sharing the email address? 🙏
Email it to Lyn Mynott on enquiries@thyroiduk.org
Out of interest, what email address was it that bounced back?
• in reply toRedApple
admin@thyroiduk.org
• in reply toRedApple
I sent this:
Hello Lynn, I hope this finds you well. We get so much benefit from the forum, thank you so much for the role you play in it I just wanted to message you because a few friends of mine (that I met through the forum) have used the Thyroid UK recommended practitioner list but sadly found that they do not use the treatments / specialise in the conditions that list states they do. I realise this list is probably created based upon patient feedback about seeing them, so I thought it might be valuable to hear some potentially up to date information about these practitioners and their services. Personally, I saw XXXXXX. As side from the service he provided being very very slapdash, he has also just diagnosed me with primary adrenal insufficiency. However, he says he has no experience with this condition and suggests I find someone else to help me with this. (Even tho even his website says he is an adrenal specialist 🤦♀️) in any case, I saw him because I knew I had an adrenal problem and I thought he’d be the man for the job as he’s on the list and adrenals are cited as something he helps with. I wouldn’t have gone to him had I realised he didn’t understand adrenals, indeed many are even questioning his diagnosis of me at all! Additionally, my friend saw XXXXXXXX who says she used Adrenal Cortex Extract when in fact she didn’t even recommend adrenal testing and when asked if she’d recommend Adrenal Cortex Extract, she said no as it’s not regulated (but she prescribed NDT?) Similarly, my other friend from the forum saw XXXXXX states she treats adrenals but hadn’t even heard of adrenal saliva testing, left it to my friend to search her own adrenal protocol. None of this is so say the list is to blame - it’s so kind and helpful that it even exists! but just to hopefully give you some useful updates for the list so future people can make more informed decisions about their practitioners. Many thanks, and thank you again for all your dedication
lynnwin• in reply to
please could you DM me the one you used as hopefully not who I’m booked in for ? Xx
let me know who it is Lynn when you find out darling xx
can you PM me too the one you used who had made you worse - many thanks
UPDATE ON SPEAKING TO MY GP
He said he can’t prescribe T3 as he isn’t allowed too .. he said my T3 is still in range at 3.2 range 3.1-6.8 he said your body only uses T3 when it needs it 🤷♀️ I will have to wait till my first endocrinologist appointment on the 19th June .. I’ve cut my propranolol down which he agreed .. xxxx
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