what are optimal levels for thyroid hormones

hi , my tsh is 5.58 my T4 is 15.6 T3 5.0 and im on 25mg levothyroxine. i asked dr to increase to 50mg he doesnt agree thinks it will make me go hyper as im subclinical in his opinion. what is my ideal TSH T3 and T4 levels for feeling optimal treated?? any ideas

also id id test positive for antibodies Thyroglobulin Antibody *786.8 IU/mL 0-115(Negative)

Thyroid Peroxidase Antibodies*150.8 IU/mL 0 - 34

so looks like i have hashis thyroid

11 Replies

  • I'm just too cross with your GP to reply - am going out and will see what others say on my return. You will have support from many people here - so just hang on and many will explain what is really going on....

    I am speechless.....back soon....

  • its funny his initial response to my private paid blood tests was tsh 5.58 would only usually be treated until its tsh 10, good job i had my antibodies tested and said but this proves it won t get better on its own (hashis). he then agreed to trial me on 25mg of levo. so if i hadnt had antiboides tested he prob would have said lets wait and see! arrrgh how annoying. it bothers him i have done research on internet says lets just take it one step at a time after all your levels arent that high 5.58tsh and your T4 is only slightly low 15.6 he wants it to get up to 20 then he thinks i shall be optimally treated, i asked about tsh whet number would be optimal, i said would TSH 1 or 2 be ok he said yes for tsh 1-2. what does everyone think?

  • No way!!when your ft4will be 20 your ft3 will probably go down to 3.1, and you will have all the hypo symptoms, i had otpimal tsh at 1 on 150 mcg levo!!and TRUST me its waaaaay out of optimal, i had the same lack or energy i had before!..dont target your TSH you may find it that you feel the best at 2.4!!...also tsh stablizies only after 3 months on a therapy

  • Having Hashimotos - suggests your thyroid is under attack and needs some support. The 25mcg is a very low dose and may make you feel worse. So do go back for a blood test sooner rather than later and insist on your dose being increased.

    Have you had all the other tests done - Ferritin - Folate - Iron - B12 - VitD ? They are usually low with thyroid illness and all need to be optimal and do not allow your GP to say they are normal when they are only just in range. We need good levels for the T4 to work efficiently in the body and for us to feel well.

    You may well feel better when your TSH has lowered - but doubt this will happen on 25mcg of T4 :-( Hashimotos people have problems with conversion on occasions too.

    I have Hashimotos - diagnosed in 2005 at 59. It has been a long journey of reading and learning and adapting my treatment...but am now feeling well and strong. Also Hashimotos and other auto-immune issues often start with gut problems - so healing this first will enhance anything you do and will improve absorption of vital vitamins and minerals. Many go gluten free which helps many but not everyone. We are all individuals.

    Do wish you well and a more supportive GP. Sad they have so little knowledge and are at a loss with Auto-immune illness it seems.

  • It does look as if you have hashi's and that means you swing between hyper and hypo. We cannot really tell what is the optimum blood levels are as we are all different, the only way we can tell if we are on 'optimum' medication is if we are well.

    Some doctors are sticklers to the blood test results alone and disregard clinical symptoms and think they are due to something other than a failing thyroid gland. Your TSH is far too high at present and his aim should be to reduce your TSH to around 1 or below. I have no idea why he would want to prolong your wait till you get to an 'optimum' which I doubt you will with this doctor.

    I am hypo so someone who has hashimotos will be able to help you.

    This is a link which members have found helpful:-


  • Minus, yes both sets of positive antibodies mean you have autoimmune thyroid disease (Hashimotos).

    There is no optimal level for thyroid hormone levels. Optimal medication is that which resolves your hypothyroid symptoms. Most people on medication are comfortable with TSH just above or below 1.0 but some need it in the lower range 0.2-5.0 and some need it suppressed <0.04 to feel well. FT4 and FT3 are considered 'ideal' in the top 75% of range.


    Your doctor is wrong in saying that 50mcg Levothyroxine will make you hyper. Hyperactive means suppressed TSH and FT4 and FT3 elevated above range.

    You may do better to see another GP at your practice for another thyroid blood test when you have been on 25mcg for 3/4 weeks.

  • I will have to disagree with you dear Clutter, i learnt some awesom new stuff but i will not jump to conclusions, was thinking to write a post but will give it more time, read some awesom book, that fits my experience 100%....so just this now for the sake of all people looking answers

    I know i was hyper with tsh close to 1......TSH below 1 for this kind of patient( starting at tsh5)....could most probably be hyper....been there...its so subtle difference....my optimal tsh was 2.4......now i know....but not important the lvl this may chnage, most important are the symptoms

    And yes i agree with you completely, there is no optimal number that can be generalized for all, but there is his optimal number and he can find it .......

    Problem is that t4 works and stops working, then t3 should be added but in doses less then 6 mcg, most probably less then 4 mcg....

  • How long are you on a tehrapy, for TSHto show its good value after taking levo takes 3 months, so i agree with your doc, take it slowly, more hormones may not work for you especially since your tsh is that elevated, it means that decreasing it will make you even more shitty becasue your ft3 that is at good lvl now will only reduce..

    How did you feel when you started therapy? Better, much better? .....

    There is no optimal number of tsh its very individual , the best is to look ft4 and ft3 and symptoms are the king!!

    For 80% of patients t4 only therapy wont work long term.....t3 should be added but in much much much smaller doses then what you will hear here on the forum:-)

  • Ivy, what you usually see on the forum is that a little T3 may be beneficial when the member is optimally medicated with thyroxine and it still doesn't resolve their symptoms. When T3 is prescribed the UK generic is only available in 20mcg and although it can be cut down to 10mcg it is difficult, almost impossible, to cut down to 5mcg or smaller.

    Thyroid hormone levels are individual and unless one knows what one's levels were prior to becoming hypothyroid it becomes a matter of trial and error to find the right dose and the right thyroid hormone replacement for each individual. Unfortunately, in the UK patients are constrained by the TSH range and the medical opinion that Levothyroxine is the only replacement necessary.

  • Yes i know trial and error can last a life time..one should get proper test and not guess it, so taking blood before taking meds should be done......we can discuss it then forever like this......its very much ignored that following the gauss curve there must be a protocol that will fix 80% of all patients problems!and i have not seen it so far.....saying everyone is different is actually what created all this mess! Its nonsense if you ask me...also i read a book that mirrors my view , its from a doc that is normal to my standards and his experience is as good as dr lowe or dr willson....no difference why dr lowe would have priority...based on what results exactly?:-)

    Dr blanchard is also successfuly treating his patients over 33 years of his career, and he has common sense too, is in the middle of all this mess

    I know i wonder so much why there is no pills that can be cut to 1 mcg increments

    This new doctor i have now also confirmed he doesnt like overmedicated patients i.e. TSH below 1! We can not call just all medicine comunity stupid and override every fact just becasue everyone is different, no 80% of people are so simmilar, and the thesis everyone is different did not prove correct in any field they reserched, ie. Its the opposite we are so much more simmilar then we think! So this is all so illogical what i have read in forum...but cant say it was not helpful:-)

  • Dr. Blanchard has T3 compounded for individual patients. That isn't an option for most UK patients even though his protocol would probably be successful for many of them.

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