Thyroid UK
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can anyone tell me what my blood results really mean

I am on T4 and T3 after going to doctor Skinner.I had years of complications.My doc keeps reducing my thyroxine now.Anyway I have very sore eyes ,swollen and puffy.I had this when i was first diagnosed 20 years ago ,so know that it is my thyroid .My hair is also going thin now.

Anyway my results are as follows

Serum free T4 7.7 pmol/L 12.00-22.00 pmol/L

Serum TSH level <0.05 miu/L 0.30-4.20 miu/L

It says it is abnormal and they say i am supressed

thanks in advance

3 Replies

If Dr S is prescribing your GP has no right in adjusting your dose of meds. I have a TSH of 0.01 and the labs say adequate levo. If you take T3 too your T4 will be lower in range.

If you email and ask for a copy of Dr Toft's article in Pulse Online, photocopy and send to your GP highlighting question 6. Excerpt

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.


NEVER let your doc reduce your meds based on blood test results. ALWAYS go by how you feel.


If you felt better on more t4 I would just up your dose to what you were on before.

Jo xx


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