Test Results: Just wondering if anyone could help... - Thyroid UK

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Test Results

Crazy_Diamond profile image
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Just wondering if anyone could help me understand my blood test results below.

One of the symptoms I have with Hashies is extreme sweating when stressed or in a warm environment. It is extremely uncomfortable and is really getting me down. I've read that this could be associated with Hypothyroidism but my GP has no interest in this theory and told me that it is related hyperhidrosis and not thyroid.

Has anyone else with Hashimoto's experienced this?

Serum free T4 level - 13.6 pmol/L 11.2 - 20.2 pmol/L

Serum TSH level - 4.29 mIU/L 0.27 - 4.2 mIU/L

Thank you!

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Crazy_Diamond
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Jaydee1507 profile image
Jaydee1507Administrator

Do you have a formal diagnosis and are you on treatment yet? It would help us to know these things to know whats best to advise.

Your TSH is above the reference range and FT4 too low.

When hypo we get low stomach acid which means we cannot absorb vitamins well from our food, regardless of a great diet. For thyroid hormone to work well we need OPTIMAL levels of vitamins. Have you recently or could you ask your GP to test levels of ferritin, folate, B12 & D3? 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...

There is also a new company offering walk in & mail order blood tests in London, Kent, Sussex & Surrey areas. Check to see if there is a blood test company near you. onedaytests.com/products/ul...

Only do private tests on a Monday or Tuesday to avoid postal delays.

Many with autoimmune thyroid disease aka Hashimoto's benefit from a gluten free diet. A smaller percentage of those also need to remove dairy from their diet to feel well. These are intolerances and will not show up on any blood test.

Recommended blood test protocol: Test at 9am (or as close as possible), fasting, last levo dose 24hrs before the blood draw, last T3 dose 8-12 hours before blood draw & no biotin containing supplements for 3-7 days (Biotin can interfere with thyroid blood results as it is used in the testing process)? Testing like this gives consistency in your results and will show stable blood levels of hormone and highest TSH which varies throughout the day. Taking Levo/T3 just prior to blood draw can show a falsly elevated result and your GP/Endo might change your dose incorrectly as a result.

Crazy_Diamond profile image
Crazy_Diamond in reply to Jaydee1507

I was diagnosed with borderline Hyperthyroidism back in 2007 and put on Levothyroxine. It was a lower dose at the beginning but I am now on 100mg daily. My ferritin has always been high and I was encouraged to have blood removed by a private doctor that I saw several years ago. Even now it continues to be high and out of range in all my blood tests done by my GP but this is not something they are ever concerned about. My GP refuses to do a D3 test. However I did have one done that included vitamin D testing via a private lab in 2022.

I never take Levo on day of blood test.

I take 2000IU of Vit D3 daily along with K2, B Complex, iodine, selenium, magnesium, Vit C and as of today Vit A. I never feel any better.

This was the test results from one I had done privately in jan 2022. Apologies for the bad formatting.

Inflammation

CRP HS 1.23 mg/L (Range: 0 - 5)

Iron Status

Ferritin X 427.00 ug/L (Range: 13 - 150)

Vitamins

Folate - Serum 8.05 ug/L (Range: > 3.89)

Vitamin B12 - Active >150 pmol/L (Range: 37.5 - 188)

Vitamin D X >250 nmol/L

<25 Deficient

25 - <50 Insufficient

50 - 75 Adequate

>75 - 200 Optimal

(Range: 50 - 200)

Thyroid Hormones

TSH 1.89 mU/L (Range: 0.27 - 4.2)

Free T3 3.68 pmol/L (Range: 3.1 - 6.8)

Free Thyroxine 16.900 pmol/L (Range: 12 - 22)

Autoimmunity

Thyroglobulin Antibodies X 291.000 IU/mL (Range: < 115)

Thyroid Peroxidase Antibodies X 66.90 IU/mL (Range: < 34)

Thank you for your help and advice.

Jaydee1507 profile image
Jaydee1507Administrator in reply to Crazy_Diamond

Hashimoto's often starts with a period of hyperthyroidism so you have that and positive antibodies to back the diagnosis up.

You need a 25mcg dose increase. Your FT4 is only 27% of its range and I would expect it to be up towards the very top. You may need to be a little pushy in a nice way with your GP. Try and find one that is more helpful and open minded.

I'd recommend retesting your vitamin levels, should be tested annually.

Your folate is too low. Should be around 20 in that range. What B complex are you taking? The ones recommended here contain 400mcgs methylfolate. This B complex has all the right vitamins at a not unreasonable cost for 90 days supply. amazon.co.uk/Liposomal-Soft...

Your vit D is a little on the high side. Optmal level is 100-150. Need to retest that to see where it is now. NHS easy postal kit vitamin D test £31 via

vitamindtest.org.uk

AS you have Hashi's have you tried a strictly gluten free diet that many find helpful? Some Hashi members also need to remove gluten from their diet.

Crazy_Diamond profile image
Crazy_Diamond in reply to Jaydee1507

Ive been on prescribed Folic Acid for the last 4 months, but my surgery didn't bother checking the levels in the last blood test so I'm not sure where that is now. That said I did receive a text the other day to speak to a GP in late August about my results for the test which was carried out in early July!

I'll look into further tests done privately.

Could my low FT4 cause a rapid heart rate? I have had trouble sleeping lately because of that.

Jaydee1507 profile image
Jaydee1507Administrator in reply to Crazy_Diamond

It's more that your low FT3 will cause you symptoms as thats the active hormone. You probably need several dose increases before you will feel much better and you will need to take the lead and drive the increases as your GP likely won't without that.

Get the private tests done and upgrade your B complex.

Crazy_Diamond profile image
Crazy_Diamond in reply to Jaydee1507

B Complex is the Costco brand

Jaydee1507 profile image
Jaydee1507Administrator in reply to Crazy_Diamond

That doesnt contain the active methyl vitamins. Many people cannot convert those to be sued by the body. Recommend switching to the one I listed above.

FancyPants54 profile image
FancyPants54

Hi

I don't have raised antibodies for Hashimoto's, but who knows? However I am hypo, have never yet got meds to a sensible level to cure my symptoms, which are numerous. I have suffered from excessive sweating for many years. Walk into a warm room from a cool environment and I instantly steam my glasses up and sweat beads up and runs down my face very quickly.

I have suffered excessive sweating for quite a long time before I was diagnosed Hypo, I think I was back then, but that my body was compensating and keeping things going with my adrenal glands. I would do an exercise class and be literally pouring with sweat. Running off in rivulets. My hair soaked and dripping. The funny thing was I would be hot when doing the exercise, it was when I stopped that the hideous sweating began.

Now I sweat at the drop of a hat. I need a fan on my face most of the time to stop it. I am on HRT, these aren't hot flushes, they are just horrible sweats. I've not been able to wear make-up for a couple of decades because of it.

Crazy_Diamond profile image
Crazy_Diamond in reply to FancyPants54

I think I could cope with most of these horrible symptoms that come with this condition if I could just lose the sweating as it so uncomfortable and so embarrassing.

Staffsgirl profile image
Staffsgirl in reply to Crazy_Diamond

I agree. I have Hashimoto’s and sweat profusely, so much so that after a short walk, I need to shower and change my clothes. All through the summer. I have a fan on my face overnight. I carry a handheld old fashioned fan in my bag all the time!

Crazy_Diamond profile image
Crazy_Diamond in reply to Staffsgirl

Same here. I barely do any exercise as once the sweating starts I start to feel completely drained. No energy to do anything anyway! The slightest bit of stress or anxiety will also exacerbate the sweating. And as for hair styling - forget it.

FancyPants54 profile image
FancyPants54 in reply to Crazy_Diamond

I've been doing a bit of gentle housework this afternoon. I've got wet rats tails for hair right now.

Crazy_Diamond profile image
Crazy_Diamond in reply to FancyPants54

I dread doing housework. It’s the worse trigger for me. Especially in this heat. Just curious, does yours occur when just sitting doing nothing?

FancyPants54 profile image
FancyPants54 in reply to Crazy_Diamond

No. Unless I’ve come from a cold environment into a hot and humid one. That will kick it off. But not just sitting relaxed or working on the computer etc.

Crazy_Diamond profile image
Crazy_Diamond in reply to FancyPants54

Mine act and feel like menopause. Starting at the back/neck rising into my face. This can happen when I am just sitting quietly and watching TV.

FancyPants54 profile image
FancyPants54 in reply to Crazy_Diamond

Having to shower and dry mu mum is a killer. Hot, humid, cramped and awkward. That leaves me soaking wet.

Regenallotment profile image
Regenallotment in reply to Crazy_Diamond

Yep I’m a Hashi hypothroid sweater too, was better for a spell but became over medicated and it’s back. Had it since a teen. Now 49 and trying to unpick whether it’s thyroid/peri menopause/climate/ ferritin/high cortisol weirdly it’s moved over the years, suddenly more head and face related and I agree, housework really brings it in. Argh. 🥵🥵🥵 I was clearly designed to sit and look decorative and not scrub 🤣

Crazy_Diamond profile image
Crazy_Diamond in reply to Regenallotment

Looking back M y thyroid issue started at around the same time as menopause and I do wonder if there was a connection of some kind. By rights I should be well out of menopause now at 64 years of age, but the sweating only gets worse. I too have often wondered if it is high ferritin related as HRT treatment does not stop it. I think I notice the sweating more in my face head and neck which drives me insane as it’s so noticeable. I just feel like I’m stuck with this for the rest of my life now.

SlowDragon profile image
SlowDragonAdministrator

if on levothyroxine you need dose increase

If not on levothyroxine you need starting on levothyroxine

List of thyroid specialists and endocrinologists

healthunlocked.com/thyroidu...

You also need vitamin D, folate, B12 and full iron panel test including ferritin BEFORE booking any consultation

Note your high ferritin in previous post

How old are you …..pre or post menopause

Are you on strictly gluten free diet and/or dairy free diet

Crazy_Diamond profile image
Crazy_Diamond in reply to SlowDragon

I am on Levo and have been for many years. I am taking Vit D and B12 (I inadvertently left that off of the previous post). I have also been on Folic Acid for the last 4 months as my GP told me that I was deficient in it.

I am post meno and 64 years of age. Not on a gluten free or dairy free diet.

SlowDragon profile image
SlowDragonAdministrator in reply to Crazy_Diamond

Serum free T4 level - 13.6 pmol/L 11.2 - 20.2 pmol/L

Serum TSH level - 4.29 mIU/L 0.27 - 4.2 mIU/L

Shows you are under medicated

Contact GP practice and request 25mcg increase in levothyroxine

You may initially find it better to increase slowly by only adding 12.5mcg daily for 6-8 weeks before increasing to 125mcg daily

Do you always get same brand levothyroxine at each prescription

Which brand

Do NOT supplement iodine.

Levothyroxine contains all the iodine we need.

Extra Iodine can make symptoms much worse and likely exacerbating issues

Crazy_Diamond profile image
Crazy_Diamond in reply to SlowDragon

I have a telephone appointment with a GP on the 30th August regarding my blood test from early July so I am assuming this may be addressed then.

I try to stay on the same brand of Levothyroxine, but end up with a different one if the pharmacy doesn't have it it, or in a recent case, stopped stocking it. So now I am on Accord and always request this when picking the prescription up.

I am surprised to read about the iodine as I was led to believe that this was supposed to be good for the thyroid. ..? Lots of groups appear to advocate this and use it a part of a protocol. I've always felt that it improved my sleep.

SlowDragon profile image
SlowDragonAdministrator in reply to Crazy_Diamond

Your levothyroxine contains all the iodine you need

Excess iodine is anti thyroid. Iodine use to be used to treat hyperthyroid patients

drknews.com/iodine-and-hash...

thyroidpharmacist.com/artic...

SlowDragon profile image
SlowDragonAdministrator in reply to Crazy_Diamond

I have also been on Folic Acid for the last 4 months as my GP told me that I was deficient in it.

Once you finished folic acid prescription

rather than taking just B12

If serum B12 result below 500, (Or active B12 below 70) recommended to be taking a separate B12 supplement and add a separate daily vitamin B Complex 

Then once your serum B12 is over 500 (or Active B12 level has reached 70), you may be able to reduce then stop the B12 and just carry on with the B Complex.

If Vegetarian or vegan likely to need ongoing separate B12 few times a week

supplementing a good quality daily vitamin B complex, one with folate in (not folic acid)

This can help keep all B vitamins in balance and will help maintain B12 levels too

Difference between folate and folic acid

healthline.com/nutrition/fo...

Many Hashimoto’s patients have MTHFR gene variation and can have trouble processing folic acid.

thyroidpharmacist.com/artic...

B vitamins best taken after breakfast

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)

Thorne currently difficult to find at reasonable price, should be around £20-£25. iherb.com often have in stock. Or try ebay

Other options

healthunlocked.com/thyroidu....

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

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg)

Post discussing how biotin can affect test results

healthunlocked.com/thyroidu...

Retest vitamin D, folate, ferritin and B12 annually

Crazy_Diamond profile image
Crazy_Diamond in reply to SlowDragon

In this part of your message above ......'Once you finished folic acid prescription rather than taking just B12'........

What are you recommending I take after the Folic Acid please? I have finished the course, but was told by GP to take multivitamins thereafter. As most multivitamins contain iron I thought this to be ridiculous advice for someone with high ferritin levels.

SlowDragon profile image
SlowDragonAdministrator in reply to Crazy_Diamond

Never take multivitamins

Once you finish folic acid start a good quality vitamin B complex

SlowDragon profile image
SlowDragonAdministrator

Gluten and Hashimoto’s

Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels

Low vitamin levels affect Thyroid hormone working

Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten. Dairy is second most common.

A trial of strictly gluten free diet is always worth doing

Only 5% of Hashimoto’s patients test positive for coeliac but a further 81% of Hashimoto’s patients who try gluten free diet find noticeable or significant improvement or find it’s essential

A strictly gluten free diet helps or is essential due to gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and may slowly lower TPO antibodies

While still eating high gluten diet ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first

NICE guidelines that GP should test for coeliac at diagnosis of autoimmune thyroid disease

nice.org.uk/guidance/ng20/c...

Assuming test is negative you can immediately go on strictly gluten free diet 

(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially) 

Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

thyroidpharmacist.com/artic...

drknews.com/changing-your-d...

Non Coeliac Gluten sensitivity (NCGS) and autoimmune disease

pubmed.ncbi.nlm.nih.gov/296...

The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported

nuclmed.gr/wp/wp-content/up...

In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned

restartmed.com/hashimotos-g...

Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.

Similarly few months later consider trying dairy free too. Approx 50-60% find dairy free beneficial

Hashimoto’s and leaky gut often occur together

Post discussing gluten

healthunlocked.com/thyroidu...

Crazy_Diamond profile image
Crazy_Diamond in reply to SlowDragon

Thank you for the above advice and recommendations. I will definitely look into it.

Justine_Case profile image
Justine_Case

As Slow Dragon advises above, extra supplemented iodine can cause issues.

I have Hashimotos, and too much iodine makes me feel considerably worse - fast pulse, racing heart etc.

Crazy_Diamond profile image
Crazy_Diamond in reply to Justine_Case

Oddly enough it appears to have the opposite affect on me. It calms me and helps me sleep.

Stourie profile image
Stourie in reply to Crazy_Diamond

You’re maybe low on iodine and not getting quite enough with your levo. Just a thought. Jo xx

Crazy_Diamond profile image
Crazy_Diamond in reply to Stourie

Maybe. Too be honest I didn’t know that Levo contained iodine. One thing for sure, it definitely helps me sleep when I take 3 drops in water along with Selenium. I don’t take it every day because of the selenium. Apparently that can be dangerous if it builds up in your body.

Stourie profile image
Stourie in reply to Crazy_Diamond

It might be an idea to get your iodine tested and see where you are with it. Jo xx

Crazy_Diamond profile image
Crazy_Diamond in reply to Stourie

Yes I probably do need to get that done as well. Also Selenium levels.

SlowDragon profile image
SlowDragonAdministrator

My ferritin has always been high and I was encouraged to have blood removed by a private doctor that I saw several years ago. Even now it continues to be high and out of range in all my blood tests done by my GP but this is not something they are ever concerned about.

Do a full iron panel test to check if it’s only ferritin that’s high

Medichecks iron panel test

Test fasting and don’t eat iron rich meal night before test

medichecks.com/products/iro...

Ferritin up to 650 is considered “normal “ once past menopause

Ferritin range on Medichecks

healthunlocked.com/thyroidu...

Inflammation affecting ferritin

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. ‘

you could donate a pint of blood now and then

Crazy_Diamond profile image
Crazy_Diamond in reply to SlowDragon

I need to do the iron test and had planned to do so following the doctors advice from Medichecks. Excerpt from his summary for the test in Jan 2022....

.....'Your ferritin, a marker of iron stores, is high. This is often due to a high dietary intake of iron, or taking iron supplements. If you are not taking supplements I recommend an iron home blood test which looks at other markers of iron storage in further detail.,........

I don't take iron supplements and try to avoid anything with iron in at all times. I was not aware that levels up to 650 were normal after menopause. That's interesting as a private doctor I saw several years ago and the Medichecks doctor above says its too high. If that is the case then I am within the range.

SlowDragon profile image
SlowDragonAdministrator in reply to Crazy_Diamond

I have Hashimoto’s, (so inflammation) ….post menopause and high ferritin (around 300)

GP does an iron panel every 2-3 years to check my iron is ok …it’s fine

radd profile image
radd

Crazy_Diamond,

Jaycee and SlowDragon have given advice regarding nutrients, thyroid hormone meds and iodine.

Looking at previous posts your ferritin levels have been elevated for over 5 years. As CRP is low in range, this is not ok. Ask your GP to investigate by means of a full iron panel and if both ferritin and transferrin saturation are elevated you would need a referral to a hematologist for assessment of haemochromatosis or another iron disorder. In the case of haemochromatosis this would give you access to ongoing NHS venesection treatment to control ferritin levels.

Hyperhidrosis is only the diagnose. Conventional medicine is useless in identifying the cause and will only suggest applying aluminum chloride antiperspirants, anti fungal creams or receiving private botox injections. If the sweating starting since the Hashi swings there’s a fair chance of it being related. Also adrenal issues (common in hypothyroidism) and/or with periods/becoming (peri) menopausal can induce sweating.

Imbalanced thyroid, adrenal and sex hormones are known to cause nervous system dysregulation of our temps by encouraging overactivity to the nerve signalling to our eccrine sweat glands. Hormonal insufficiencies can be just as negatively influential as elevated.

Therefore you have several areas to consider regarding the reasons for your sweating - autoimmunity (reducing high levels through g/f diet, etc), optimising thyroid hormones (levothyroxine replacement meds), supporting the adrenal glands (healthy life style and possibly supplements), assessing menstrual cycle (function, stage, possible replacement HRT). All hormones require optimal levels of nutrients to function effectively.

I have an iron overload disorder and elevated iron levels makes me hot, more sweaty and very tired!

Crazy_Diamond profile image
Crazy_Diamond in reply to radd

The sweating started back around 2008 around the time I was diagnosed with an under active thyroid At the time it was assumed it was menopause related. Roll forward 15 years or so and it is still here and just as bad as it was back then. HRT did not control it, in fact I think it made it worse.

I have tried to get more help on the high ferritin but my GP just tells me that it is within normal range. They are more interested in pushing Statins on me for high cholesterol, which is also likely to be caused by Hashies.

radd profile image
radd in reply to Crazy_Diamond

Crazy_Diamond,

'Ferritin X 427.00 ug/L (Range: 13 - 150)’.

The ‘range’ is the (numbers in brackets) that your measured level should fall between. Yours is above range and elevated by nearly 300 %.

Five years ago you posted on this forum that ferritin was '528 (13 - 150)' and again CRP (inflammation) was low at 1.7 (0.00 - 5.00).

If this were me and my own GP wouldn’t investigate, I would ask for a second opinion because consistantly elevated ferritin with no other elevated inflammatory markers deserves further investigation. Ask for a full iron panel.

Crazy_Diamond profile image
Crazy_Diamond in reply to radd

I have a telephone appointment with a GP (never get to see or speak to the same one) at the end of August and I will ask again. Most are not interested and just tell me that it’s within range.

Crazy_Diamond profile image
Crazy_Diamond

I am following on from this thread from a couple of months go as I now have my blood test results. it's taken a while, but got there in the end! I would really appreciate if someone could take a a moment to look at these and tell me what they think Many, many thanks!

Serum TSH level 0.5 mIU/L 0.35 - 4.94 mIU/L

Serum vitamin B12 438 ng/L 200 - 900 ng/L

Full blood count - FBC

Total white cell count 6.7 10*9/L 4 - 11 10*9/L

Haemoglobin estimation 146 g/L 115 - 165 g/L

Platelet count 257 10*9/L 150 - 450 10*9/L

Red blood cell (RBC) count 4.8 10*12/L 3.8 - 5.8 10*12/L

Haematocrit 0.435 1/1 0.37 - 0.47 1/1

Mean corpuscular volume (MCV) 90.6 fL 76 - 98 fL

Mean corpusc. haemoglobin(MCH) 30.4 pg 27 - 32 pg

Mean corpusc. Hb. conc. (MCHC) 336 g/L 300 - 360 g/L

Red blood cell distribut width 12 % 11 - 15 %

Mean platelet volume 10.3 fL 8.5 - 10.0 fL

Neutrophil count 3.7 10*9/L 2 - 7 10*9/L

Lymphocyte count 2.4 10*9/L 1 - 4 10*9/L

Monocyte count 0.4 10*9/L 0.2 - 0.8 10*9/L

Eosinophil count 0.2 10*9/L 0 - 0.4 10*9/L

Basophil count 0.1 10*9/L 0 - 0.2 10*9/L

Serum folate 14.9 ug/L 3.0 - 20.5 ug/L

IRON STUDIES

Serum iron level 20 umol/L 9 - 30 umol/L

Serum transferrin 2.3 g/L 1.80 - 3.82 g/L

Transferrin saturation index 33 % 15 - 50 %

Serum ferritin 365 ug/L 30 - 250 ug/L

FULL LIPID PROFILE

Serum cholesterol 6.7 mmol/L - mmol/L

Serum HDL cholesterol level 1.09 mmol/L 1.20 - 5.00 mmol/L

Serum triglycerides 2.8 mmol/L 0 - 1.7 mmol/L

Serum cholesterol/HDL ratio 6.1 -

Serum LDL cholesterol level 4.3 mmol/L - mmol/L

Se non HDL cholesterol level 5.6 mmol/L - mmol/L

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