T4 is only 12% through the range and although not routinely tested T3 is more than likely low as well.Low T3 is what causes the symptoms and fatigue,joint pain and brain fog are all common hypo symptoms along with weight gain and constipation.Playing the mental health card is just the easy out for the GPs.What they really mean is I’m not well enough educated on thyroid issues but your TSH is in range so here’s some antidepressants now off you pop.
Quick question - how are you calculating the T4 to 12% apologies in advance to my ignorance. Trying to read my tests as well. What should TSH, T3, T4 percentages be to be optimal for hypo?
you can work out % through range with fairly simple maths that escapes my brain at present , but it's much easier to use a % through range calculator, such as this one : thyroid.dopiaza.org/
just input your result and the upper and lower lab ref ranges that came with the result and it will do the calculation for you
(make sure you put the decimal points (full stop) in the right places .. don't use a comma instead of a full stop.. or this calculator won't work)
as for 'optimal' ? ........ what is optimal varies A LOT between individuals.... people without thyroid problems (and not taking any thyroid hormone replacement) tend to have a fairly stable and quite narrow individual range for where their fT4 / fT3 'usually' sit , and for their corresponding 'usual' TSH level ,
optimal fT4/ fT3 levels for an individual could be pretty much anywhere within the 95% population reference range .. top end / middle or bottom end may be perfectly ok for that individual (if that is the level they usually have in health), but that same level would not feel ok for someone else (who's level was usually different)
it is by far the most common for TSH to sit around 1 ish in healthy people.... anything over 3 is a MUCH less common finding in healthy people.
See this example of healthy people's TSH / fT4 / fT3 results (taken over 6 wks) they are all very different.... and all stay within a narrow 'personal range'.
if you took person 9 and magically gave them the lower end T4 / T3 levels of person 3 , you'd expect them to start feeling hypo.
and if you gave person 3 the higher end T4/T3 levels of person 9, you'd expect them to feel hyper.
Once someone is taking thyroid hormone replacement the interpretation changes a little , because it's not possible to totally replicate the complexities of a functioning thyroid ..
people with healthy functioning thyroids will tend to have T4/ T3 levels relatively close together ( ie. both at similar %' s)...but once on levothyroxine patients tend to end up with relatively more T4 / relatively less T3 (ie. fT4 75% , fT3 25%) , and with a relatively lower TSH .
unfortunately most of us have no idea what our own healthy levels looked like before our thyroids went wrong , cos thyroid levels are rarely tested until we feel unwell .
The graphic is really interesting and so is variation between people. I can imagine the healthy young people much more as people, and wonder about them and their lives then and in the future. i think it would be so good if researchers did a big longitudinal study taking baselines for thyroid and over time.
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
Test early morning, only water to drink between waking and test. Avoid high iron rich dinner night before test
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
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.
Thank you for your incredible patience while you have been awaiting the outcome of our ferritin reference range review. We conducted this with Inuvi lab, which has now changed the reference ranges to the following:
Females 18 ≤ age < 40. 30 to 180
Females 40 ≤ age < 50. 30 to 207
Females 50 ≤ age < 60. 30 to 264l
Females Age ≥ 60. 30 to 332
Males 18 ≤ age < 40 30 to 442
Males Age ≥ 40 30 to 518
The lower limits of 30 are by the NICE threshold of <30 for iron deficiency. Our review of Medichecks data has determined the upper limits. This retrospective study used a large dataset of blood test results from 25,425 healthy participants aged 18 to 97 over seven years. This is the most extensive study on ferritin reference ranges, and we hope to achieve journal publication so that these ranges can be applied more widely.
Oh wow. Lot to read, thank you. I'm vegetarian but eat iron rich veggie foods. I'm also mid 40s so potentially peri. That was one of the reasons I went to see the GP.
I had to ask about the ferritin but he wasn't concerned as not anemic. In the end he said take iron for 3 months then come back. Very dismissive.
I take 4000IU vitamin d and did so before the tests, stopping one week before.
My daughter is having follow up tests today to see if vit d absorbed but also doing thyroid function tests.
I'm wondering whether to continue supplementing with iron and then going back, or paying for private thyroid tests or simply going back and pushing, seeing a different GP.
Iron is more difficult to absorb from veggie foods like, for example, spinache. Spinach is very high in iron but the human gut cannot absorb it:
Spinach contains high levels of oxalic acid, which binds with iron and blocks absorption in the gut. The oxalic acid found in spinach appears to be higher than most other green vegetables, such as kale and broccoli. The majority of iron in spinach is not usable for the body and studies have shown that as little as 2% of iron from spinach is actually absorbed by the body! Other examples of foods that inhibit iron absorption include, peas, lentils and chickpeas due to the high phytic acid content.
What time of day was the blood draw for that test? TSH is highest before 9 am and fasting. It then drops sharply to its lowest poing around midday. So, the time of the blood draw is very important to the results.
Hi, Listen to Slow Dragon. She has helped me understand my needs. When my vit D levels are as low as yours, i am sluggish, have painful joins have severe brain fog. I have also noticed there seems to be a corraltion between my T4 T3 coversion rate and my vit D levels. I take 7500ui a day to keep myself feeling almost normal. High I know. But it keeps my levels in the 70s.
Your free T4 level is pretty near the lower limit of the reference range, and so is your ferritin (though your haemoglobin is good and your haematocrit high normal), yet your TSH is one I'd love to have! Your creatinine is low, which might just mean low muscle mass. What is your heart health like? Here in the US, cholesterol and oral glucose levels are about all doctors bother to test these days. I've known heart patients via other forums who had lower TSH and free T4 levels. But I have to admit your other test results are great.
I'm assuming my heart health is OK. Never had any issues. Resting heart rate of 56.
I did read females can have lower creatinine. I'm way below average height wise, normal BMI, exercise but do have a desk job. Exercise is the one thing that gives me energy and stops the aches. But I have to force myself to do it, rather than go to sleep.
I'm sorry you are not feeling well. Because your thyroid levels are in good range your GP opted to do nothing about your associated symptoms. I would suggest consulting with someone who specializes in thyroid issues such as an endocrinologist. Its your health you need to be satisfied with your treatment. Good luck!
I found high cortisol is giving me the same symptoms as hypo thyroid, still working on lowering mine! One thing that wasn’t tested it seems. Just a thought! I have had 20 years of a stressful job now trying to heal.
Hi ArinEla, your ferritin definitely needs addressing. Are you the age to be Perimenopause? These are your typical symptoms for being peri amongst other things. Thyroid and peri symptoms can be similar amongst other conditions too, it can be hard to decipher what causes what.
Bloods are not reliable when in perimenopause as they are like a roller coaster. This is why gp's refuse as one day your estradiol could be 200 and next week 3,000..I know mine were.Symptom lead, age big one, fatigue, body aches, anxiety is a massive one, brain fog, rage, low mood, just not yourself, normal/ irregular/heavy/ light periods , night sweats, hot flushes just to name a few.
Read as much as you can. I like the menopause support website/ fb group or Louise Newson is a good place to start. Newson Health website, the resources page. Also her balance app although I find the app a bit awkward to navigate. Join a few groups if you haven't already and arm yourself with knowledge is my advice
Hi, are you supplementing B complex, folic acid or folate, or B12, or are those unsupplemented results? Folate is high, which could reflect supplementation or be poor metabolism/low B12. The low ferritin could obscure your MCV so you cannot rule out a B12 issue.
OK, the folate might be high due to your food intake, being vegetarian. Hopefully sorting the iron will help and if you do have a concurrent B12 problem, your MCV should rise to show it as the iron improves. There may well be more than one deficiency here, usually is I'm afraid. You said the GP was more interested in your mental health issues and that you are very stressed, but both could be thyroid, or iron, or B12 and folate metabolism (common). Magnesium should help, but probably not enough in its own. Best wishes
Please ask him to check calcium, vitamin D, phosphorous and PTH (parathyroid hormone) from the same blood draw preferably early morning before meds and food. The parathyroids control calcium and phosphorous in the blood. Your symptoms could be caused by high calcium. Your creatinine and ferritin are very low too. They needs to be checked out.
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Help with making sense of my results please?
T3 / weight gain 
please see my latest test results 
Results back, GP says 'normal' and no increased Levo needed, gutted... 
blood results back - feeling worse than ever
