Thyroid UK
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Exhaustion back any advice?

Diagnosed hashi 's few years ago recently back to work but now very exhausted on days off

I am currently on Liothyronine 20 mcgs

Levothyroxine 175

last bloods

TSH 0.01 (0.35-5.00

T4 21.2

Last time Free t4 done was in May feeling bit better then

FT4 (20.5)

ferratin 121 (10 to 275)

Really need some advice have cut hours right down at work but still very exhausted seriously thinking I need to change from Levo but no one to ask When I take my dose of T3 I feel bit better but effect wears off quite quickly any advice appreciated Should I try NDT and how would I get this ?

5 Replies

Although T3 is absorbed quickly into bloodstream, the effect (of one single dose) lasts for between 1 and 3 days. 20mcg of T3 is equal in effect to around 80mcg of levo so your combined dose is equal, roughly, to

280 mcg levo. Maybe an increase in 20mcg to a reduction of 50mcg levo. It is trial and error to get to an optimum level.

Your blood levels look o.k. but it is how we feel that is the main point of being on optimum medication. Is it the T4 not being converted to sufficient T3? This is the active hormone all our receptor cells need for us to feel well.


Spacestar, Do you have the lab ref range the figures in brackets after your results) for your FT4 results? 22 or 24 are usually the top of range so yours is good. You don't look to be undermedicated but you may not be converting very well to T3. You can order private FT3 tests from Blue Horizon and Genova via if your GP won't order it.

You may feel better by reducing your T4 to 150mcg and adding an extra 10mcg of T3 which you should take 4/8 hours after your first dose or try to time it 90/120minutes before you get an afternoon slump.

Ask your GP to test ferritin, vitamin D, B12 and folate as hypothyroid patients are often deficient/low and these deficiencies can cause musculoskeletal pain, fatigue and low mood similar to hypothyroid symptoms. Post your results with the lab ref ranges (the figures in brackets after your results) in a new question and members will advise whether supplementation is required.


I have just come across this link which may be helpful to you.


Thanks all who answered I suspect that it is a conversion problem as I have only ever felt better when I take my T3 . I don't have lab range as it was not FT4 just T4 which I believe is not as good at showing the full amount of circulating thyroxine When you put it like shaws I am on a massive dose but not getting the benefit really need a rethink to get better will try reducing to 150 Levo and upping T3 Thanks everyone


HI It may be that your T4 is too high.It should only be in the top third of range. Worth also having a Free T3 test, often the answer. If GP cannot then on line.



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