Thyroid UK
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since july 2012 been on 150 gms levothyroxine my blood test then was serum

Tsh level" 0.92 mIU/L [ 0.35 - 3.50] felt fine

then had blood test july 2013

serum TSH level " 0.01mu/L [ 0.35 -3.50 low

serum free t4 level "27 pmol/L [ 8 -21 } high

serum free t3" level 3.3 pmoL [ 3.8 -6.0 ] low now on 125gms levothyroxine now getting joint pain and feeling tired again

blood test sept 2013

serum free t3 level " 4.0pmol/L [3.8 - 6.0

serum free t4 level 25 pmol/L [8.21 ] high

serum free t sh level 0.03mu/L [o.35 -3.50 low now been put on 100 gms levothyroxine

and now feeling ill and can sleep for england also my husband say i must be eating crocodile sandwiches now had blood test done to day

3 Replies

I am sorry you are now feeling worse. It would appear that the GP is concentrating on your TSH levels and adjusting your hormones trying to keep you from going too low.

This is an excerpt from Dr Toft who was the President of the British Thyroid Association. Please note he says it is o.k. to have a suppressed TSH and also recommends the addition of some T3 if still not feeling well:

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.

This ‘exogenous subclinical hyperthyroidism’ is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l).

Even while taking the slightly higher dose of levothyroxine a handful of patients continue to complain that a sense of wellbeing has not been restored. A trial of levothyroxine and tri-iodothyronine is not unreasonable. The dose of levothyroxine should be reduced by 50µg daily and tri iodothyronine in a dose of 10µg (half a tablet) daily added.

While taking both hormones it is important serum TSH is normal and not suppressed.


This is a link from Dr Lowe and you will see that it is a mistake to adjust meds according to TSH as it messes up our metabolism - go to the date January 25, 2002.

If you want a copy of Dr Toft's article to show your GP, email The article was in Pulse Online.



serum free t3 level "2.4pmol/L [3.8 - 6.0 low serum free t4 level 19 pmol/L [8.21 ]

serum free t sh level 0.22/L [o.35 -3.50now been put on 100 gms levothyroxine one day and then 125 gms next day


thank you


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