These are my thyroid blood test results, unfortunately I never know when the district nurse if coming out to do the blood test so I can’t leave the recommended 24hrs between Levothyroxine and blood test.
I took my Levothyroxine at between 12am and 1am and the district nurse came out at approx 11.45am to do the blood test.
Serum TSH - <0.02 (0.27-4.20) (on 4th Jan my TSH was 2.5)
Serum Free T4 - 20.4 (11.9-21.6)
Serum Free T3- 4.1 (3.1-6.8)
Serum B12- 623 (145-569)
Serum Folate- 18.3 (8.8-60.8)
Serum Ferritin- 120. (12-150)
Serum 25-HO vit D- 99 (no range)
Why has my TSH dropped so much? The only difference between the 2 tests is that I have changed from taking my levothyroxine in the morning to taking it at night. I have always left 4hrs between levothyroxine and other medications.
The only other difference is that the January blood test was taken just before 9am and 24hrs after my last levothyroxine dose and the June test was done at 11.45 am and only approx 11hrs after my last levothyroxine dose.
My GP has asked me to make an appointment to speak to her and the notes by the recent TSH blood test results say ‘recommend lowering the dose of levothyroxine’.
At the moment I am on alternate days Levothyroxine 100mcg/125mcg.
When I spoke to my GP before my blood test I asked her whether I had ever been tested for thyroid antibodies and whether my hypothyroidism was autoimmune. She told me that only hyperthyroidism is autoimmune and hypothyroidism isn’t. So I would not need to have antibodies tested as I had hypothyroidism and it couldn’t be autoimmune. I know from reading on here that is not true.
I am also slightly anaemic although both my iron levels and B12 are good. I asked my GP what could be causing this and she told me I am always like that so it is normal for me. I never remember being told that before and certainly don’t remember ever having any tests to find out what maybe causing it. Maybe because my red blood cell count is only slightly low they don’t think it’s worth bothering about.
Can hypothyroidism affect your red blood cell count? I can add my full blood count results if they would be helpful.
I have had low white blood cell count for the last 18 months but my GP has finally decided to refer my to a rheumatologist.
Any advice gratefully received.
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AlphaWolf5195
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You're certainly not over replaced going by free hormone results. You don;t seem to be converting well and may even benefit from adding some T3.
You can email info@thyroiduk.org for a list of T3 friendly Endo's.
It may be that you're absorbing Levo better by taking it at night, hence the change in your TSH. You could argue to stay on the same dose by taking responsibility for low TSH as per NICE guidelines:
The first paragraph in the NICE (NHS) Thyroid Disease, Assessment and Management guidelines says :
nice.org.uk/guidance/ng145
"Your responsibility”
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian. “
11hrs after Levo isnt quite enough time, also a later time of testing will have lowered TSH.
Has GP done a full iron panel? If not then ask for it. Iron can be low even if ferritin is good.
Have you had an active B12 test done? This is a more accurate indicator of B12 status than the serum B12 often run by the NHS. You can get one done privately if GP unable to do it.
See link for companies offering private blood tests & discount codes, some offer a blood draw service at an extra cost. thyroiduk.org/testing/priva...
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.
If you got a private blood test you could also include antibodies. Your GP clearly hasn;t a clue what shes taking about regarding autoimmune hypo!
Hypo doesn't usually affect blood count but low B12 or iron can.
Should I try to fight to stay on the same dose of Levothyroxine and not reduce it then?
Unfortunately I wouldn’t be able to find a T3 friendly Endo as I am housebound and the only way I can get to appointments is if they are in a hospital that the hospital transport will take me to. That has always meant the nearest NHS hospital that my GP refers me to.
I will mention T3 to my GP but I don’t hold out much hope as I don’t think she understands hypothyroidism, the only thing I can hope for is that she will refer to an Endo but I wouldn’t guarantee that.
I only have blood tests results since January 2024, before that I was never given my actual results. Although I have recently asked for all my previous results, I have been given a few random ones but not ones that included anything to do with thyroid.
I don’t remember having either a full iron panel or an active B12 blood test done, definitely haven’t had them done this year.
I take the following supplements prescribed by my GP
Fultium D3 800 iu x 1 a day,
Cyancobalamin (B12) 100mcg x 1 tablet once a week, (GP recently reduced my dose was once a day)
Ferrous sulphate 200mg x1 tablet once a week, (GP recently reduced dose was originally 1 a day, then every other day, now once a week)
I also take the following supplements that I buy
Calcium+ vit D 400mg calcium, 2.5ug vit D x 1 tablet a day(From Tesco, the Adcal my GP prescribed upset my stomach and this one doesn’t, so she said to take this)
Omega 3 x1 or 2 capsules a day, I alternate (Dr Vegan, recommended 2 capsules a day)
Magnesium Triple complex 100mg x 1 or 2 capsules a day, (MagsUpp, recommended dose is 3 capsules a day)
Vitamin C +Zinc x 1 a day (Tesco, 100mg vit C and 15mg Zinc)
My GP recommended I take the omega 3 and Vitamin C and also said it was ok to take the magnesium.
Do you need to know my prescribed medication as well?
I can’t tell whether I have any symptoms from my hypothyroidism or not as I also have CFS/ME and Fibromyalgia so I feel constantly exhausted, ill and in pain.
I would definitely fight to stay on current dose if it were me.
When was your vit D last tested? It should be tested twice a year until you know how much you need in the seasons. You need to know you're taking enough. The NHS only prescribe low doses that wont get your level to optimal where it needs to be.
Suggest you do an at home finger prick vitamin test to see your levels and if you need to change anything, especially as you're anaemic. Randox are probably the cheapest but check if its an active or serum B12 test.
Has your GP suggested you need calcium? Its one thing thats better to get via diet unless you know you really need it.
I dont need to know any other prescribed medication.
As someone with chronic illness its vital to get on top of vitamin levels so testing them is the next step and look up Roseway pharmacy.
My Vitamin D was last tested on 9th May and Serum 25-OH vit D level was 99 nmol/L which my GP says is normal. It says no range but does also say >50 sufficient for almost all population, >200 Potentially toxic. Where does my level need to be so that it’s optimal?
As I am housebound and sometimes bed bound, I never go out in the sun, so don’t get any vitamin D from that.
I’ll see what my GP has to say about T3 and my levothyroxine but if I get no luck from her, I’ll look into Roseway pharmacy, many thanks for suggesting them.
My GP has said once I have finished the B12 tablets she prescribed, then to come off them so as soon as they have gone I will look into a B complex supplement.
I have had low calcium for approx 15+ years, if I stop the calcium supplement then my calcium levels drop too low. I can’t take dairy products as I get crippling stomach issues with them.
My GP did prescribe me calcium she tried me on 2 different types, one that was chewable and one that was a powder you mixed with water but unfortunately both caused me stomach issues. I found one that I swallow and that seems to be ok on my stomach.
I have also been on Fludrocortisone, (a corticosteroid) for the past 10 years to help my low sodium levels and I think this can affect your bones and calcium levels, so I always try to make sure I keep my calcium levels within range.
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