Can I please ask your thoughts on my last test results?
TSH: 2.77 mU/l (Range 0.35 - 5.5) 46.99%
FT4: 9 pmol/l (Range 9 - 23) 0.00%
FT3: 4.7 pmol/l (Range 3.5 - 6.5) 40.00%
Vitamin D is still at 87 nmol/L (50nmol/L - sufficiency)
, while on a dose of 5000 iU every other day (2500 iU per day). My plan is to up dose to 5000 iU every day.
The problem with the test is that it was done around 11am and I had eaten breakfast (granola with yoghurt). I was at the nurse for a different blood test and she caught me off guard by saying she could thyroid tests now too as they were due in a few months anyway.
Lately, I haven't felt well: less energy, easily overwhelmed and low mental health. But work has been very busy, I have moved house, it has been christmas, I'm a mam.. so I've put it down to that. But maybe my thyroid can be improved?
Thanks a lot for your advice!
Last year, I have felt soooo much better and I couldn't have had that without your help. We all know how much feeling well is worth! And I'm super grateful. As well as for the support to know that it's not just all in my head. 🙏
Further info:
It's only been last year I have started learning about my thyroid.
I have started supplementing Vit D, B12, B complex and Vit K.
I don't take any thyroid meds.
This is only the second full thyroid test I have had and the first one since starting vitamin supplements.
B12, folate and iron not tested this time. (previous results B12: 'treat as lifelong PA')
All info is in my profile.
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Dandelions
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Your thyroid is definitely showing signs of struggling Dandelions, as TSH should always be under 2 and TS4 barely in range. I would look to test before 9am next time, as this will ensure the highest TSH and your GP may then offer a trial of Levothyroxine.
Thanks, Buddy! Does TSH always need to be below 2? I didn't know this.
Yes, that would be ideal, but I don't know how to convince my GP to do another blood test. In his mind he has fulfilled the annual test requirement and everything is within range and hunkydory.
I would look to test privately; Medichecks have 20% off this month so maybe worth investing their advanced thyroid (as this covers key vitamins too).
Yes TSH in healthy adults is under 2, although it’s important to remember that many members here only feel well when this falls significantly under 1. Unfortunately many GPs will not prescribe Levo until TSH is much higher than 2, so an early morning test would benefit you as TSH higher on waking.
I don't understand since you have a diagnosis of Hashimoto's why T4 - Levothyroxine hasn't already been prescribed ?
Your T4 is too low and not even the accepted ' normal ' range - and your results show a struggling thyroid and the T3 and T4 the wrong way round and invented.
A normal healthy thyroid would be showing a TSH of around 1.5/1.7 and a T4 at around mid range - so around 50% through it's range with a T3 tracking at a slightly lower percentage.
The body converts T4 into T3 as and when needed as T3 is the active hormone that runs the body and it is too low a T3 for you that is responsible for the symptoms being tolerated.
There is now not enough T4 circulating in your blood stream to easily convert to T3 - and your body under pressure to make more T3 while your reserves of T4 are too low to support your body.
Almost. I don't understand: " and it is too low a T3 for you that is responsible for the symptoms being tolerated" What do you mean by that?
If T3 is the active hormone, how can I have a reasonable amount of this, if there's not enough T4 to convert? Also, does it even matter if T4 is low when T3 is the active hormone?
The endo I saw at the time, just said it's subclinical hypo and nothing should be done until my thyroid is more broken🤷♀️ That I was feeling rubbish was just a coincidence.
Symptoms of an overactive and underactive thyroid are the pole opposite ends of the T3 yardstick :
If your T3 is too low in the range for you - you experience symptoms of hypothyroidism -
just as if your T3 is too high for you - you 'll experience symptoms of hypothyroidism -
It's not that clear cut however as some symptoms can sit in both ' camps ' - there is a detailed lists of symptoms on the Thyroid uk website thyroiduk.org -which may help you determine where you are in all this.
I understand that with Hashimoto's you can also experience erratic thyroid hormone production after an immune system attack which can cause ' swings in symptoms ' and over to under range blood test results after attacks from your immune system.
A fully functioning working thyroid would be supporting you on a daily basis with trace elements of T1 , T2 and calcitonin + a measure of T3 at around 10 mcg + a measure of T4 at around 100 mcg.
If you look at the T3 and T4 ranges they are on a sliding scale and you need a good level of T4 to make sufficient T3 to support your body -
I need my T3 up at around 5.70 to feel well which means my T4 is at the very top or slightly over the T4 range - we are all different :
You have an auto immune thyroid disease and your thyroid already damaged and all but broken - and need a prescription for thyroid hormone replacement - T4 - Levothyroxine to give you more T4 and then more T3 as and when needed as currently you look to be running on with an almost empty tank of T4 and struggling.
A prescription of T4 is the obvious first option in order to bring your T4 up into the range and take the pressure of your damaged thyroid trying to support you.
Your thyroid is already damaged by this AI thyroid disease - when were your antibodies run and showed positive for Hashimoto's as I would have thought a prescription for T4 should have been forth coming then ?
20 odd years ago you would have been acknowledged as hypothyroid when your TSH was at 3 - or if you had symptoms - and this still applies in other countries in the world -
but in the UK the current guidelines recommend waiting until the poor patient has 2 x TSH tests, months apart, both showing a TSH reading over 10 -
I believe there is leeway to prescribe if there are positive antibodies and the patient is struggling with symptoms and I find this totally cruel or just plain ignorance on the part of the doctor - who does not respond with a prescription.
T4 costs pennies to produce but as hypothyroidism is classed as a long term chronic health issue we are currently entitled to free prescriptions on everything prescribed for life - just a thought !
Hashimotos was diagnosed in 2019. And I naively believed what the endo was telling me, so when I wasn't feeling well, I just thought I was weak. It seems that I'm unlucky being in the North East of England, as the endos all seem to think thyroid patients are not to be trusted.
Well you are not weak - and simply trusted the medical profession as we all start off doing - and when things don't go well - and we are not listened to - we then find support and advice elsewhere and start to become our own best advocates.
You have made a good decision - and this forum helps very many people - looking at the top of this screen we now have over 135K members -
when I fell in here researching low ferritin ( mine was at 22 ) some 8 years ago - we were just over 15 thousand members on Thyroid UK.
So - it's not just you, nor being in the North East - the lack of knowledge is endemic throughout the country and the exception to the rule is having a doctor with some understanding of hypothyroidism and thyroid AI health issues.
There are no endos on the list of thyroidUk in my area: Highest up is North Yorkshire. I’ve heard the guy who’s written the damaging guidelines - which we are all suffering from- works in the north east. So I haven’t found an alternative yet. I either may have to travel out of my area or find a better GP. I’ve booked in with a different GP. Fingers crossed!!
Thanks Pennyannie! It’s amazing what difference it makes reading your words.
Maybe start a post asking for recommendations of endo/thyroid specialist n your area ?
Your post will get turned off as we aren't allowed to openly discuss any medical professional - but replies will come through to you on the ( PM ) - Private Message system and the paper plane icon lights up if anyone contacts you privately.
I read that many endos are still offering video consults - ?
so - as it costs money either way - best make sure you know you are seeing someone who you know will help you and a video consult to someone recommended has to be better than seeing someone in person who hasn't a helpful track record with patients.
You are right to say that T4 costs pennies (so does T3 in most countries, but that's a whole other story!) and yet doctors seem reluctant to prescribe it. As you suggest, this may well be connected with the fact that patients on levothyroxine are entitled to free prescriptions for life.
Personally, I have never understood why this is so. When I wes first prescribed levothyroxine 16 years ago, I was astounded to learn that prescriptions for any other medication I was prescribed would be free. Why?! Surely this is costing the cash strapped NHS millions of pounds which could be better spent elsewhere. We could have the levothyroxine free, but not everything else as well.
Further to this, I was shocked to hear about a friend of my daughter, in her early 30's, who's been diagnosed with Rheumatoid Arthritis and will need to take methotrexate for life, but will have to pay for her prescription!
The whole system is in need of a radical overhaul, which might then mean fairer distribution of medication according to need.
Ironically, there seems to be no restriction of prescription of drugs such as antidepressants which are much more expensive, and many thyroid patients - myself included - have been prescribed these when in fact a correct dose of levothyroxine would have sufficed. It beggars belief!
Yes Kacey12 . I'm afraid I agree with Charlie-Farley that healthcare seems to fail by design.
Funny that you mention arthritis, I was actually also thinking about that today and the different treatment my husband has had with auto-immune arthritis and myself with auto-immune thyroid. It's almost like they want to help him!
But before his diagnosis, when he presented with more psychological symptoms, he got treated very poorly as well. So perhaps that's the main issue: many of thyroid disease symptoms are (seemingly) psychological and very often there's this divide in medical thinking between true health issues and malingering/'it's all in your head nonsense' (as it's seen; not by me obviously!).
When I presented to the doctor with the possibility of having an under active thyroid having been essentially diagnosed by a fellow sufferer she agreed to get tests done - probably with a view to saying "there you silly thing you see it's all in your head". On that day she entered a diagnosis of Depression Anxiety Disorder. Of course she could NOT ignore the lab work when it came back AND the 10 years of symptoms I had been presenting with that could all be associated with Hypothyroidism. Taken All together (which they don't until made to) PLUS my father having had an underactive thyroid it was actually a very clear case, despite not having reached the magic 10 for TSH. Then stuffed up by keeping me on 25ug of levo for 6 months because they don't know enough (well only enough to be dangerous). 🙄
I to some extent agree, indeed if doctors knew how to diagnose and manage hypothyroidism it would save millions in the NHS and have a positive impact on productivity at a national scale. Sadly they have yet to join the dots.....but when they stuff up and don't manage us properly some people with hypothyroidism have the potential to develop other serious comorbidities.
Also ability to work can be affected. I read regularly on here people who are tearing their hair out (that's if it's not falling out) because they have been made so unwell by doctors ignoring symptoms and as you rightly point out - using antidepressants rather than optimising thyroid hormone replacement. These folk often can no longer hold down a job or run their businesses. They have to make drastic lifestyle changes, living a poorer existence and they are gaslighted to within an inch of their lives by the doctors. I see free prescriptions as a very necessary safety net.
Those of us who are lucky enough to regain a level of wellness will not draw down much from the system anyway. When I was severely under medicated I literally experienced a physical and cognitive crash. My brain wouldn't work, I couldn't trust myself to drive so stopped, 20 minutes to make a cup of tea, 2 hours to get washed and dressed. I feared if I didn't get well we would lose our business. I have always been physical and quite cognitively sharp, juggling things, always taking on too much and delivering. During this scary phase my husband ended up caring for me The only thing he didn't do was wipe my 'you know what' and wash and dress me. I have to say that has left an indelible print on mind. It has definitely made me grateful for that safety net, though I hope I never need it.
Extremely low ferritin, B12, folate and vitamin D before supplementing
When were folate, B12 and ferritin levels last tested
Test at least annually
Strongly recommend getting FULL thyroid and vitamin retest …..
In week before blood test, when you stop vitamin B complex, you definitely consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg) and continue separate B12
all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test
Testing options and includes money off codes for private testing
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
Test early morning, only water to drink between waking and test. Avoid high iron rich dinner night before test
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I don't understand: " and it is too low a T3 for you that is responsible for the symptoms being tolerated" What do you mean by that?
Blood test results please advise 2.7
Test results- advise please.
Iron test results advise please!
