Thyroid UK
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Still on 100mcg levo. Test results gone from TSH <0.02 to 0.06 (0.35-6) and FT4 28.3 to 14.1 (9-26). GP baffled. Any thoughts anyone?

That's it really. I've been on levo since the beginning of June. Started on 75, raised after 6 weeks to 100 - feeling good at that level. Tested in August at TSH <0.02 (0.35-6) and FT4 (28.3 (9-26).

GP very twitchy although I had no signs of being over-medicated and I agreed to drop to 75/100 on alternate days. After six weeks and another major hair fall, sleep disturbances etc I went back to 100 every day and have stuck there. Feeling good, temperature now finally rising above 36 degrees.

Tested again at the beginning of the week and the results came back as TSH 0.06 (0.35-6) and FT4 14.1(9-26). The lab declined to do FT3, although it was requested, because I am on thyroxine! I will be dealing with that.

In the meantime, I think the FT4 is rather too low and would like to raise the levo by another 25mcg. GP won't play ball because my TSH is still suppressed. However, he has now given me a prescription for 100s on top of the 50s and 25s I already have. He also admits he doesn't understand my results and wants to refer me, but there's no way I'm going back to our local hospital - it will have to be Dr S or nothing if we're going that route!

What does anyone else think?


3 Replies

Can I make a totally uneducated guess? If you are feeling good and your FT4 has dropped that suggests to me that your body is getting better at converting T4 to T3. In other words, the FT3 test is the crucial one.

That is just a guess. Hopefully someone with better knowledge will add to it or amend it.


If you cursor down to the question dated January 25, 2002 of which this is an extract:-

The TSH level is not well synchronized with the tissue metabolic rate. (Probably most doctors falsely assume that studies have shown that the TSH and metabolic rate are synchronized. But despite my diligently searching for years for such studies, I’ve yet to find them.) Adjusting the T4 dose by the TSH level is like adjusting the speed of your car by a speedometer that's out of synchrony with the actual speed of the car. Adjusting the speed of a car by an out-of-sync speedometer, of course, will get the driver into trouble—either with other drivers who'll object to the car traveling too slowly, or with a police officer who'll object to the car going too fast. And adjusting the thyroid hormone dose by the TSH level gets most patients in trouble—almost always because their tissue metabolism is so slow that they are sick.

If you email and ask for a copy of Dr Toft's Pulse Online article wherein it states that some need a low or suppressed TSH. (question 6) and give a copy to your GP as it also has other info re other thyroid gland conditions. It also says that some need the addition of T3 to a reduced T4.


Your results are somewhat unusual, because you TSH has increased and FT4 has fallen. I agree with rosetree that it does look like you may be converting better. My TSH in July was

0.39 FT4 14.7. I've just had the test repeated and TSH was 0.26 and FT4 14.3 So my FT4 has more or less stayed the same around mid range but TSH has dropped which would suggest I'm converting better. I certainly feel better and my GP has kept me on 100 mcgs. until next year.


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