Thyroid UK
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Latest blood results and still feeling exhausted

Hi. I have Hashi and have been diagnosed for 4 years. Most of that time I have felt pretty rubbish, tired, brain fog, hair loss, weight gain. However, over the summer I wasn't feeling too bad - I had a little more energy than normal and life wasn't quite so difficult! I started a part time job, which I was delighted about and was going well. Anyway a few weeks ago, bam - I feel like I've been hit by a train. I had to go home from work as I couldn't function. Just had my bloods done and these are the results;

Sereum bilirubin level - 4 (5-17)

Vitamin D - 45

TSH - 0.9 (0.2-4.2)

Free T4 15.3 (12-22)

Free Triiodothyronine - 4.2 (3.95 - 6.8) I am assuming this is free T3??

Haemoglobin - 262 (150 - 400)

I am taking 100 mcg Levothyroxine and 75mcg alternate days.

I can see that my Vitamin D is not sufficient and I am researching some supplements to take. Anything else stick out to anyone? Thank you so much in advance - I desperately want that "normal" back again, even if it isn't fantastic - normal is great :)

15 Replies

I am sorry you have had a 'blip' and hope it doesn't last long and you feel 'normal' once more.

Someone will comment on your blood tests but if you supplement with Vitamin D it has to be D3 and not D2.


Thank you for the pointer. I will ensure to get Vitamin D3 :)


What sticks out to me is that both your T 4 and T3 are quite low. Your T3 is only just in range and I wonder if your doctor would consider your taking the 100 mcg dose every day, instead of alternate. You probably felt better in the summer because people often need to reduce medication when it is warm. For you it helped and now that the weather is changing, you need more. That is my take on it. What do others think?


If I were to take 100mcg every day, would that reduce my TSH slightly? If so, would that cause any problems? Also I was thinking, how do you know if your T4 isn't converting correctly into T3?


Yes, probably would reduce it but as you perhaps know from reading other posts, thyroid health should be judged on how we feel, not on a TSH figure. Of course you may have a battle with your GP next time you have a blood test but if you feel better on the higher dose, it is worth a fight. I thought about whether you are converting properly and my guess is you are. I think your T4 would be higher if not. Mine was high, just over the reference range and my T3 was under the ref range.

Do hope you are allowed to increase and start to feel better. x


Thank you Hennerton for your input. Much appreciated and I hope you continue to stay well too :) x


Hi Wired have you had your b12 ,ferritin,folate and iron checked

please watch this

Diagnosing and Treating Vitamin B12 Deficiency these are all worth checking

my b12 was 276 told normal but i took b12 with folate and my level is now 648 and feeling so much better


Hi Suki, No they didn't test for the other things unfortunately. I am glad you are feeling alot better :)


I've been posting a series of five-minute videos pertaining to Hidden Causes of Low Thyroid.

It is difficult to become optimum on T4 treatment. There are 24 of them but I'll choose one about high cortisol and the other on progesterone deficiency and perhaps you can glean some useful information.



Thank you :)


Could it be that your brand of thyroxine changed

Some people react differently to different fillers in the tablets and sometimes the strength between brands differs

Ideally your free t4 should be in the upper quadrant of thecrange so closer to 20

Some people find they need a higher dose in the winter than the summer

You may be unknowingly wheat or gluten sensitive

Or you may need to change to natural thyroid

Its all a learning curve


Hi. Actually my brand did change a month or so ago - something to definitely note. I need to make an appointment to see the Dr and discuss other options I guess. Sometimes it's like banging your head against a brick wall :(


Its vital you stick with same brand

switching brands is known to cause rouble for either of the reasons I gave you


Your T3 is pretty low and if you are on just thyroxine then I would expect your T4 to be higher too. You would probably benefit from an increase in T4 and if your T3 remains low then it might be worth trying a T3 supplement too.


Thank you Natalie. I think to start with I will go on the Vit D3 and increase the T4 slightly and see what happens. I often think about T3 but I am scared about taking new medication (as I had a bad reaction to something a few years ago). Hopefully those small changes will show some improvement and then I can take it from there.


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