Thyroid UK
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What do results mean?


I have only recently discovered this great forum. I have been living with Hashimoto's disease for 19 years, and have blithely carried on without ever thinking about my test results. I am currently on 250 mcg thyroxine which struck me as a bit high. I had a blood test today and results were Free T4 22.75 (range 12.0 to 22.0) and TSH 0.01 (range 0.27 to 4.2). I did as the lab recommended and had the test in the morning before taking my medication (Euthyrox). I do feel tired these days but recently discovered I am slightly anaemic and have yet to start on iron tablets. I have an appointment with an endocrinologist next week, so any advice on these results would be great. Thanks in advance

8 Replies

Low iron seems to be common in people who apparently need a relatively high dose of levothyroxine. My advice is to get that addressed as soon as practicable.

Have a look here:

The other thing we try to remember to ask is this: Do you take your levothyroxine well away from food, drink (other than water), supplements and other medicines? Not doing so can result in both less than optimum absorption and erratic levels (e.g. with breakfast one day, skip breakfast the next). Usually suggest taking it two hours away from anything else (four hours for iron).

Hence I usually point people at this poll:

Also advise you get tested for vitamin B12, folates and vitamin D.



Jinx! ;)


Ya boo! CarolynB! :-)



These results look quite good although many doctors wouldn't be happy with them and would want to reduce your dose because they don't really understand what is going on. 250mcg isn't a high dose, it's just higher than most doctors are happy to prescribe. Many people on thyroxine are not prescribed enough and continue to have symptoms. As you have hashimoto's it may be that you are better when your own thyroid function is totally suppressed so that you are not constantly fluctuating. That might be why you are on a higher dose than maybe other people would be.

The anaemia will most likely be causing your symptoms to some degree. Not only are the symptoms of anaemia similar to hypothyroid symptoms, but it is believed that iron is important for thyroid hormones to get into the receptors in the cells to be used to make energy. You get a kind of double-whammy with anaemia.

Vitamin C and vitamin B2 help with absorption and storage of iron so you may want to consider taking those as well as the iron (B2 is in B complex too). If you are anaemic you may well find you are deficient in B12 and possibly other B vitamins. You may want to consider taking a B complex and a separate B12 supplement in the form of methylcobalamin (more easily absorbed).

What you may find is that, when you get your iron (and possibly B12) levels up, you are using more of the thyroxine and your blood levels drop slightly. Ultimately you need to go on how you feel. The blood tests only tell you how much is in your blood. It doesn't tell you what is going on in your cells. You could have plenty in your blood but not be using very much, thus making you feel hypo.

Also make sure that you don't take your iron at the same time as your thyroxine as it can affect absorption.

I hope that helps :)

Carolyn x


thank you all, very helpful indeed


Hi UpaMountain,

If you use the blue "Reply to this" the person you are responding to gets an alert email!

Don't worry - pretty much everyone misses that to begin with.


Reply you have a good level of FT4 circulating in your blood it does not mean you are converting it into T3. As you probably know T3 is the most active thyroid hormone and needed in so many of our cells - trillions of them ! So maybe it would be a good idea to have your FT3 tested to check the levels.

I have Hashimotos too and after over 6 years of treatment on T4 - low dose - my FT3 was always at the bottom of the range. Probably the cause of lingering symptoms. I have read somewhere - sorry can't remember - that Hashi's people have more difficulty with conversion for some reason.

I tried a combination of T4/T3 last year and am now on just T3 and doing fine. Had a test recently which revealed that in spite of not taking T4 my thyroid was producing it still - but even with taking T3 the result was still on the floor so am assuming it has gone straight to my cells and is not circulating in the blood !! It's my Enid Blyton imagination that runs riot when visualising what's going on inside !!

Will we ever solve the mysteries of the thyroid - no wonder doctors despair !!

Am sure all the above advice from others will prove very helpful and help you to feel less tired. It will also help the conversion rate when you take good levels of B12 and VitD. I went quite hyper for a while until I realised what was happening - !


Hi If the endo is any good they will do all the related tests you need. You certainly need a Free T3 test and diabetes. hashimoto`s is autoimmune. There was no distinction known years ago about types of thyroid disease. Are you having problems swallowing,? Voice etc if so you need an ultra sound of the thyroid. Nodules and enlargement of thyroid are common with Hashimoto`s. If something shows on the scan, then a biopsy is usual, by specialist radiologist under ultra sound.If the endo good it will make a huge difference. I was tested for all these and more when I first saw my endo ,although I had been seeing a thyroid doctor ( who did not test).

I hope it goes well.

Best wishes,



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