I’ve posted before about my blood results that I did via MonitorMyhealth. My GP repeated the bloods a month later unconvinced with the private test results, and she also saw me due to perceived swelling in the right side of my neck. I will leave the private test results too for comparison and my current symptoms: heart palpitations and fast heart rate from sitting to standing and upon little exertion , hair loss underarm, dizziness upon standing, tiredness.
21/01/25 I did Private TfTs. Results: (not done at 9am and not fasting): TPO 89 IU/mL (below 35 is within range) . TSH 4.46 mu/L (normal range 0.27-4.2mu/L.
Ft4 14.5 pmol/L (normal range12-22pmol/L).
Ft3 4.4pmol/L (normal range3.1-6.8pmol/L).
February 13th 2025 blood test results 9am fasting : T4 level:12.7 pmol/L, Normal range: 10.5 to 24.5
TSH level:7.66 mU/L. Normal range:0.27 to 4.2
Thyroid Peroxidase IgG Ab: 84 kU/L. Normal range: 0 to 33
Ferritin: Serum ferritin: 29 ug/L.Normal range: 13 to 150. August 2024 ferritin 37ug/L.
Vitamin D: Serum total 25-OH vit D level: 75 nmol/L. Under 50 they consider supplementing.
last test for b12 was August 2024: Serum vitamin B12: 613 ng/L.Normal range: 197 to 1000
Ultrasound results: Appearances of the thyroid gland are consistent with known thyroid disease. The echo texture of both lobes appear heterogeneous. Increased vascularity is present in the thyroid gland.
The palpable/pulsatile lump indicated by the patient corresponds with a prominent right external jugular vein.
todays appointment went like this: GP prescribed me 25mcg levothyroxine and repeat bloods in May. She isn’t worried about the prominent jugular vein. I can attach picture to ask does anyone else with hypothyroidism have this issue?
Do you think the GP prescribed too less of the dose for Levothyroxine?
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25mcg Levo is a very small dose, usually reserved for older patients or those with other medical conditions. It is likely you will need significantly more than 25mcg to get TSH under 2 (with most members here reporting they feel best with this closer to/ under 1).
Has GP said they will retest thyroid levels after 6-8 weeks?
Thanks for replying. The GP said repeat blood test to be done in May, so in 8 weeks time. It does seem really less. What dose is recommended at my levels?
If your GP is being very cautious, they will probably prescribe an additional 25mcg after your next blood test. It is hard to say what your ‘final’ dose might be as we all have different levels where we feel most well. As 50mcg is the usual starter dose, likely you will need 75mcg or more.
All your adverse symptoms may be linked to your auto immune thyroid condition not been treated adequately.
Do share your next thyroid blood test results with us
Regarding vitamins, ferritin is very low….According to guidelines issued by NICE, 30ug or less is deficient. As such, I would ask GP for a full iron panel test. I personally would not supplement iron without having the results from this panel…. As it’s possible to have low ferritin but high iron stores. Again, share results with us.
If you are then prescribed an iron supplement, take alongside Vitamin C (eg orange juice) as this aids absorption.
Also look to increase iron rich foods in your diet:
dailyiron.net has useful tips on this.
Also look at posts by SlowDragon as she provides comprehensive advice re improving vitamins.
Thank you, for the next bloods I will request full iron panel. Is the iron panel not to be confused with full blood count? This I’ve done and it’s all good.
Would you know anything about hypothyroidism causing the external jugular vein to the right side neck become prominent? I’ve attached a picture.
I had the same sort of swelling on the right side of my neck too-was sent for an ultrasound because of it which showed normal thyroid with a nodule but no mention of what swelling might/could be-it went away after about a year after I started thyroid (self) treatment
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
If taking any iron supplements stop 3-5 days before testing
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.
Thanks for the extensive advice and information to help me understand autoimmune thyroid issues. It’s appreciated so much.
In response to your question about folate, most recent folate test was done August 2024 and it was Serum folate: 6.2 ug/L. Normal range:3.9 to 9999.
I don’t take any supplements currently but took 10,000iu of vitamin D in December for a month.
Regarding gluten, I have been gluten free for 10 years by choice due to IBS and eat very little dairy due to Bile Acid Malabsorption diagnosis in 2019. I eat generally well and try to include iron rich foods in my diet but unsure why ferritin is low. Maybe iron panel test should be done as advised by another member in this group. Are full blood count and iron panels the same test?
My last question is have you heard or know anything about hypothyroidism causing a prominent external jugular vein on the right side of the neck? I will attach a photo. GP not worried but Dr google worried me.
Igennus B complex popular option. Nice small tablets. Most people only find they need one per day. But a few people find it’s not high enough dose and may need 2 per day and/or may need separate methyl folate couple times a week
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 can be difficult to find at reasonable price, should be around £20-£25. iherb.com often have in stock. Or try ebay
IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 3-5 days before ALL BLOOD TESTS , as biotin can falsely affect test results
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) and continue separate B12 if last test result serum B12 was below 500 or active B12 (private test) under 70
Thyroid Peroxidase IgG Ab: 84 kU/L. Normal range: 0 to 33
Your antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).
About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high TPO and/or high TG thyroid antibodies
Autoimmune thyroid disease with goitre is Hashimoto’s
Autoimmune thyroid disease without goitre is Ord’s thyroiditis.
Both are autoimmune and generally called 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 as per NICE Guidelines
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
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
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
With loads of vegan dairy alternatives these days it’s not as difficult as in the past
Ultrasound results: Appearances of the thyroid gland are consistent with known thyroid disease. The echo texture of both lobes appear heterogeneous. Increased vascularity is present in the thyroid gland.
The palpable/pulsatile lump indicated by the patient corresponds with a prominent right external jugular vein.
Suggests goitre might be pushing vein outwards
Ask GP to clarify (they may not know)
As dose levothyroxine increases over next year or so you should see thyroid shrink
When adequately treated likely to eventually have TSH around or below 1, Ft4 and Ft3 at least 50-60% through range and all four vitamins at GOOD levels
If GP won’t do full iron panel test yourself privately
The scan showed no goitre, showed increased blood flow in thyroid. I’ve read on the NHSthat hypothyroidism can cause heart disease due to hypothyroidism causing high cholesterol. Do you have any knowledge about this? Thank you 🙏
If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.
I does sound like thyroid could possibly be swelling & restricting vein from ultrasound scan.
Has doctor examined you? & checked you for bruit sound. Or asked you to raise your arms above your head & hold them there to check for Pemberton's sign.
I’ve been thinking about your worry that heart disease might have been triggered by untreated hypothyroidism. My sister is going through the exact same thing and I suspect my dads heart disease is caused by untreated hypothyroidism. As a first step do the following — Blood pressure measurement. High blood pressure is a major risk factor for heart disease
-Blood glucose test. To check for diabetes or pre-diabetes
-Electrocardiogram (ECG) - Records electrical signals in your heart.
The consensus on here is 25mcg is a very low starting dose. So I’d be very firm with your GP about getting your bloods retested at the times suggested on here. I would probably get that done privately if your GP won’t test t3 levels and various other things that have come up low.
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are these normal levels
Can I ask for advice please
Blood test results 
Test Results 
