Thyroid UK
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underactive thyroid

Hi, I have an underactive thyroid for quite a few years now but I am still feeling extreme fatigue memory problems, muscle aches and weight gain. I am taking 150mg eltroxin one day then 125 mg the next. My last results said my tsh level was 6.63 but yet they say it is within *normal* range and that I do not need my meds increased, is this right? I thought I would need to be at around 3.0 or just above to be in the right range. I am so fed up of feeling unwell I am going back to my doctors today to tell her I want my meds increased as I am still having symptoms but I know I am going to have a battle on my hands... I persuaded my gp to refer me to an endo some months back as my hypothyroidism has not been under control for about 5 years and Im so fed up of feeling they way I do. Gp told me the wait list would be long due to the fact the endo has to see really sick people and I am not in other words! Do I need to be asking her to test my T3 ad T4 ? Any help or advice would be so helpful thanks.


3 Replies

As far as I know, if you don't have a thyroid gland problem, the range may well be up to 5 or 6, but if you have been diagnosed you should be given enough medication to make you feel well and most times that means having a low TSH.

Email and ask for a copy of the Pulse online article by Dr Toft and show your GP question 6 (Dr Toft ex President of the British Thyroid Association). This is an 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.


Insist on tests for








all must be in upper quadrant of their ranges NOT JUST IN RANGE OR NORMAL

be sure to get a print out inc ref ranges

i will bet your ferritin and folate are incredibly low

i bet your cholesterol is high

you could do well to also request free t4 too

tsh of 6 is in no way normal it should be below 1


I'm glad to hear it's not just me that feels unwell having under active thyroid, I kept going back to the Doctor to be brushed off with "your just having a bad day" that didn't help at changed Doctor and my test came back as just in the normal range! I couldn't understand why I felt so ill, went back again after a year and saw a different Doctor took bloods saw result he said

it's in the normal range but as I felt so bad he upped my levothyroxine by 25mg to try!

feeling better most of the time now, but you have to insist that you know your not well.


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