Blood test result - advice on how I ask my GP to up my dose

[Dattichou]

Hi all!

Following a post I made 10 days ago, I'm sharing below my latest blood test (with Medichecks) result that I had done this Monday 31/03/25 :

C-Reactive Protein 2.91mg/L (Range <3)

Ferretin 103ug/L (Range 30 - 169)

Folate Serum 13.3nmol/L (Range >7)

Vitamin B12 - Active 55.5 pmol/L (Range: > 37.5)

Vitamin D 59 nmol/L (Range: 50 - 250)

TSH 3.980 mIU/L (Range: 0.27 - 4.2)

FreeT3 4.5 pmol/L (Range: 3.1 - 6.8)

Free Thyroxine 15.6 pmol/L (Range: 12 - 22)

Thyroglobulin Antibodies 163.0 kIU/L (Range: 0 - 115)

Thyroid Peroxidase Antibodies 405.0 kIU/L (Range: 0 - 34)

As a reminder here are the blood test results my GP had prescribed back in February:

Serum TSH - 2.1mlU/L (range 0.35 - 4.94mlU/L)

Serum free T4 - 12.4pmol (range 9.0 - 19.1 pmol)

My symptoms have become increasingly worse, particularly fatigue, brain fog, cold and constipation.

I'm willing to firstly try to improve my symptoms by taking supplements, so any advice based on the above results are welcome! But I can just feel that I'm backsliding into how I was before I was put on Levo and it's giving me a lot of anxiety.

I'd like to share these results with my GP and demand that my dose is increased - how would this lovely community suggest I approach this?

thanks so much!

[Regenallotment Ambassador]

Yep a T4 increase is a good shout, if GP is iffy, ask for a trial for 12 weeks, they seem to like ‘trial’.

Did you already know you have Hashimoto’s?

Vit D needs raising over 100, it’s common to be low in hypo and makes you feel rubbish. Take D3 with K2 2000iu in summer 4000iu in winter and 4000iu loading dose for 8-12 weeks to raise it from where it is.

Add separate magnesium (many forms, read up , personally I have mag biglycinate) for best results. People with historic constipation tolerate mag citrate but it goes straight through me.

Symptoms are classic hypo too, list these for GP.

Healthy diet, protein rich, calorie dense, low sugar, light on carbs, consider GF (ask to be tested for coeliac first if you haven’t already) and even dairy free helps some.

Absorption, ensure you take Levo 1 hour before food, and other medications 4 hours before or after iron/magnesium supplements.

[Dattichou in reply to Regenallotment]

Thank you Regenallotment.

I got my antibodies tested in August 24 at which point I was put on Levo for the first time, but I was told there’s a “90% chance I have autoimmune thyroiditis” but that they couldn’t officially diagnose me, and this was AFTER I suggested that I may have Hashimotos ( bc a friend doctor saw my results and told me I did)… otherwise they wouldn’t have told me.

I’ve begun a GF diet and have definitely felt a difference in my digestion but still unclear how this affects the rest of my symptoms, but it is early days.

Do you have any recs on the rest of my vitamin & mineral results?

Also, should I share all of my results with the GP ? Medichecks does a print out version of results with their GP’s recommendations, which states I could be up for a dose increase from my local GP.

Thank you!

[Regenallotment Ambassador in reply to Dattichou]

I’m not qualified but even I can see you 100% have autoimmune thyroid disease aka Hashimoto’s. 90% my *rse 🤣

Good for you 🤗

As per message above, get your vitamin D up over 100 (sun, chestnut mushrooms and eggs won’t do it believe me).

Active B12 could go higher, some reading I’ve done suggests over 70 pmol/L helps for those with autoimmune conditions.

Link here but disclaimer they are selling so take that into account. But they do explain the active B12 well.

forthwithlife.co.uk/our-ser...

We generally all benefit from a BComplex such as Thorne Basic B . Personally after a few months I found these too strong for me the P5P gives me finger tingles and the niacin gives me facial flushing and was better on separate Methylfolate B12 Methyl folate and biotin. Here is a long post about B Complexes. Many B Complexes dose at 2 capsules a day, for me after raising levels 2-3 a week was enough.

healthunlocked.com/thyroidu...

Other things to test would be zinc and selenium. Zinc needs to be balanced against copper and many of us with Hashi’s aren’t. Selenium is often low with hashi’s but I took it for 12 months and GP tested for me and I was over range without symptoms.

I highly recommend Thyroid Pharmacist Izabella Wentz books, I have 3 and constantly refer back to them. One is full of recipes to help with leaky gut and reduce inflammation I found these very helpful.

Side note: One thing I disagree with, is her (Izabella Wentz) use of the word remission which is misleading. Personally remission is for cancer patients when cured. Hashimoto’s can give us euthyroid periods of time (I’ve had decades of it while undiagnosed) but it’s not remission and once hypo, going back to euthyroid without thyroid hormone replacement is highly unlikely.

[Dattichou in reply to Regenallotment]

thanks so much Regenallotment! I’ve checked out some of Isabella Wentz’s stuff and it honestly freaked me out a little at first, especially her dietary suggestions which is essentially to eat meat and vegetables only! I’ll look into her books though! I’m only at the start of my journey and there’s so much to take in but I’ve already learnt so much from this community, especially after getting NOTHING from my GP!

So, thank you, and have a lovely weekend x

[SlowDragon Administrator]

Free T4 (fT4) 15.6 pmol/L (12 - 22)

Ft4 only  36.0% through range

Free T3 (fT3) 4.5 pmol/L (3.1 - 6.8) 

Ft3 only 37.8% through range

Most people when adequately treated will have Ft4 and Ft3 at least 50-60% through range or higher

Request next increase in Levo (to 75mcg daily)

Emphasise that you have had seen some improvements but plenty of hypothyroid symptoms remain

as Regenallotment says the word “trial” often helps

Guidelines are quite clear that once on levothyroxine dose should be slowly increased up to approximately full replacement dose

Even if we frequently start on only 50mcg, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or somewhere near full replacement dose (typically 1.6mcg levothyroxine per kilo of your weight per day)

cks.nice.org.uk/topics/hypo...

bnf.nice.org.uk/drugs/levot...

nhs.uk/medicines/levothyrox...

Adults usually start with a dose between 50 micrograms and 100 micrograms taken once a day. This may be increased gradually over a few weeks to between 100 micrograms and 200 micrograms taken once a day.

Some people need a bit less than guidelines, some a bit more

TSH should always be below 2 on levothyroxine

gponline.com/endocrinology-...

Graph showing median TSH in healthy population is 1-1.5

web.archive.org/web/2004060...

Comprehensive list of references for needing LOW TSH on levothyroxine

healthunlocked.com/thyroidu....

onlinelibrary.wiley.com/doi...

If symptoms of hypothyroidism persist despite normalisation of TSH, the dose of levothyroxine can be titrated further to place the TSH in the lower part of the reference range or even slightly below (i.e., TSH: 0.1–2.0 mU/L), but avoiding TSH < 0.1 mU/L. Use of alternate day dosing of different levothyroxine strengths may be needed to achieve this (e.g., 100 mcg for 4 days; 125 mcg for 3 days weekly).

sciencedirect.com/science/a...

The optimal daily dose in overt hypothyroidism is 1·5–1·8 μg per kg of bodyweight, rounded to the nearest 25 μg.

Helpful post if GP difficult

healthunlocked.com/thyroidu...

[Dattichou in reply to SlowDragon]

Thanks so much SlowDragon!

I will definitely be asking for a trial to see how they respond.

I now feel more empowered to make this request now that I have this research on my side