Blood results back. Was taking 50mcg of levo, doc said at my level tsh 4.55, I didn't need any more, I told him I want to up to 75mcg,

My results now tsh 2.13. T4 12.9 cholesterol from 7.7 to 6.6. Do I need to up my levo. Doc was reluctant last visit, so he won't up them again. I've started d3 as it was abnormal. My b12 is 295ng/l. I also need advice on lymphocyte count 1.18 saying abnormal. But doc never mentioned this.

20 Replies

  • Please read my response on a previous question, scroll down to my comments about B12, yours is low:

    Have you had folate and iron/ferritin tested?

    Can't comment on the Levo as I don't take it, but you still look hypo to me (going on other people's comments).

    H x

  • Thank you. Folate is 8.5ug/l

  • It's not too bad, but would be better if it was in the top half of the range (do you have the range)? Do you have an MCV result (with range)?

  • No I don't have the range. What's mcv

  • It's normally on the full blood count, thought you might have had it as you mentioned Lymphocytes. It stands for Mean Corpuscular Volume and is a measure of the average size of your red blood cells. It is elevated when they are larger than normal (i.e. in B12/folate deficiency), and it is decreased when they are smaller than normal (i.e. iron deficiency). If you are deficient in B12/folate and iron your MCV appears to be normal (they cancel each other out).

  • Buy Understanding thyroid disorders by Dr Anthony Toft. BMA publication, Dr T past president of BTA, £5 from Amazon/chemists. P 41-42: for initial treatment; P 88 for specific details relating to Judging the correct dose of thyroxine; P 46 for possible future treatment involving T4/T3 combination.

    Also e-mail for Dr Toft's article in Pulse, gives further info your doctor obviously needs. E-mail:

    Louise currently on holiday, back mid-August. Meanwhile read all the valuable info on main site:

  • Thank you

  • I didn't feel 'good' until my TSH was 0.45 and I'd had B12 injections for deficiency. I'm on only 50ug of levo. Was started on 25 and it wasn't until the rise to 50 that my TSH fell below 1. I would take the 'how you feel' seriously with regard to pushing for somewhat higher meds.

  • Thank you that why I increased to 75. Feel a bit better.

  • You should aim for a TSH of 1 or below. Post a copy of the Pulse Online article to your GP before your appointment so he can read and absorb, not only about hypo but hyper etc. They don't have time during an appointment if you suddenly produce the article.

    Your B12 is too low and should be supplemented with methylcobalamin B12

    You cannot overdose as excess is excreted through urine and you should aim towards the upper range. Deficiency can cause problems.

    Hope you feel better soon.

  • Thank you

  • Can I just say if you are going to try and get further B12 testing done, such as active B12, you should not take any supplements until afterwards. Further info on pernicious anaemia found at the following 2 websites:


  • oh my goodness, poor you!

    low b12, low folate, thyroid UNDER treated :(

    you've had some good advice, go for it and educate your doctor x

  • It's bonkers that so many doctors do not accept/know that many people feel better when their tsh is under 1. It's hardly a fringe/crank thing. As I have enthusiastically documented here :-) my gp is not necessarily the creme de la creme, but when he told me he knew about the under-1 thing I decided to stick with him.

    If you have no joy with the Dr Toft book, maybe think about auditioning another gp? In future should I need another I'm going to go in for my first appointment and ask if they are willing to keep my dose of t4 high enough to keep my tsh under 1. It's as good a test as any.

    Good luck. Sorry you are having to struggle with this.

  • We're ALL different and for me, my TSH level of around 2.11 is optimal. This is where I am at present. I know this is optimal as I track my symptoms and watch out for them like a woman possessed! If my TSH went any lower I would become hyper. A TSH level below 1 isn't right for everyone... Bear in mind, the TSH test is not perfect.

    Good luck and hope you find your optimal - wherever it may be! :)

  • I'm assuming that Elaine22 doesn't feel well with a current tsh of 2.13 or s/he wouldn't be asking about an increase.

    Of course it would be as wrong and inhumane to insist that everyone kept their tsh under 1 as it is to insist that a tsh of almost 5 is normal and refuse an increase even when the patient feeling unwell.

    It is a matter of incredulity to me that most gps will refuse to allow a patient to experiment with doses which keep them in range and allow them to feel better. Levo is not kryptonite.

    Just as you feel bad on too low a dose, you may feel bad on too high a dose, but you can't know what will restore your health if your gp keeps you on a molecule of t4 indefinitely and sends you away when you say you still don't feel well. I can't understand the logic of it.

  • Hi PB

    Elaine's issues could be low B12 as this mimicks hypo and there seems to be an issue here. If there are multiple health issues going on then an increase of T4 isn't necessarily going to correct other issues. I agree that we should be able to experiment with doses of levo - this is how I now know my optimal - however it has to be done with a lot of care and advise to 'aim for below 1' is not right for everyone. My TSH was over 5 when one of my GPs insisted it was 'normal'! But I also know any lower than 2.11 for me would also be wrong. I'd like to see GPs really address vitamin deficencies as it seems to me that a lot of problems with thyroid health are down to additional issues which are not being looked at.

  • Thank you, I'm taking 800 d3 and I'm starting 50 b12 is this enough b12

  • Hi Elaine

    I hope you soon feel great. I don't have vit problems, all I know is low levels of vitD and vitB will give awful symptoms, and vits have to be taken at a different time to your T4. I'll be interested to see how you get on and hope that this is the answer.


  • Elaine22, depending on how deficient you are, that may not be enough vitd to help. That is a supplemental dose for people with a normal result. I was severely deficient and even a loading dose took months to bring it up to normal. This might be helpful:

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