Dose increase???

MAY - TSH - 2-1 ( 0.27-4.2)

Ft4- 1.1 ( 0.8-1.7). 75mcg daiily


Ft4 - 1.4

FT3- 2.06 (2.2-4.2). Dose increased 25mcg one time a week

OCTOBER - TSH - 2.92

Ft4 - 1.0. Do I need to increase by another 25mcg a week?

Ft3 - 2.2

It's good my TSH has decreased just a little, but my FT4 has decreased, my FT3 is just now on the radar!

I am in Saudi and difficult to find a good Dr, my last Endo only took note of TSH and seemed lacking in knowledge so I have decided to self medicate.

Is an increase needed again?

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4 Replies

  • Hi Susan

    I am concerned that you have no ranges for your FT4 tests - these can vary quite a lot even within different areas of the UK. Please can you supply the ranges.

    No one here can advise you on how much to take, they only advise from their own personal experience.


  • Hi Louise, in May I wrote the ranges for TSH and FT4 these ranges apply for Aug and Oct.

  • The usual way to know when the level of thyroid medication has reached the optimum level is when the symptoms have subsided and you feel well. Dr Toft says that (in question 6 in an article in Pulse Online):-

    6 What is the correct dose of thyroxine and is there any rationale for adding in tri-iodothyronine?

    The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range – 0.2-0.5mU/l.

    In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance.

    But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.


    No-one can advise what you should increase by, it is up to you. Before the TSH came in patients were dosed according to symptoms.

    Your T3 is a little on the low side.

    I hope you can resolve the dose which will make you feel well.

  • Many thanks Shaws. I feel so very alone at the moment trying to deal with this. But is an increase of 50mcg once a week a big increase?

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