Thyroid UK
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Due another thyroid checkup

Hi Im due to see specialist again next second appt after wasting 4 yrs with GP. At my last app my TSH was 10 and TPO of 1875 and Free T4 of 14. The specialist increased my levothyroxine to 100mcg from 75mcg and told me my GP should have increased the dosage as soon as he'd seen these levels (4months previously) since the increase I don't feel much better in myself but my knees don't ache so much and I still get breathless sometimes. My biggest problems are fatigue and weight gain which I just cannot shift (1 and a half stone) .even after going to the gym 3 times a week for 6 months. My question is, will he just increase my tablets another 25mcg? This has been going on for over 4 years and Im really fed up with how long it's taking to get the levels right. Will I ever lose this excess weight?! It may not sound like much but Im only5 feet 2 and its not a weight I am comfortable at. plus the fatigue, I wake up feeling alright for a bit then a few hours later feel like Ive not been to bed.

6 Replies

breathing issues! and fatigue! will not be lifted from increasing your t4 only! i am living proof of it, i lost 2 years in that kind of treatment!


you need added real thyroid hormon into a therapy and that is t3 , i totaly realte to you!!

this increasing of t4 may even make you more sick a way that it will reduce your ft3 lvls further


Hi ivy I had results back from my Drs today which I shall post when I can find my reading glasses as the receptionist used the tiniest font when she printed it off


Ask if he will add some T3 to your T4 to see if it will give you (some) relief. Even Dr Toft says in his Online Pulse Article:-

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. Have your blood test as early as possible and get a copy of your results (with ranges) and post if you have a query.

1 like

I got results back from doctor today. Will post them when I find my specs :)


How's your B12? I had problems with breathlessness which wasn't asthma (I had that for about 50 years so I know what that feels like) and high dose B12 fixed it. Also need to get ferritin and folate checked.

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Not sure if B12 was on the results, I will post them when I find my glasses :)


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