Thyroid UK
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Feeling Positive

Just got my 6th mth blood test results. Remembered not to take levo before the test this time (thanks to advice on this forum.) TSH up from 1.7 to 2.5 which is still mid range. Saw a young female locum who tried to say "carry on with current dose and back in 6 mths". She agreed my raised cholesterol could be thyroid related. My usual Dr says it isn't.

As she seemed a bit more clued up than my GP i thought "right, go for it". I told her that I have been following this forum and trying to understand my disease and I have read here that people feel better when TSH is close to 1. When she shook her head I said so how come I still have all these symptoms; tired, sore scalp, failing hair, dry skin, lump in throat, difficulty swallowing etc.etc. She started asking about menopause but I'm way past that so clearly that's not the reason I feel lousy.

She examined my throat - a first! Then said she would up my dose. RESULT!! I am delighted.

I'm not expecting a miracle but I do hope this will make some difference and along with some dietary changes I've been making, help me back to something like normal. It's the first time I've stood up to a Dr with the weight of this forum behind me. It feels great.

4 Replies

Well done, Rosemaryanne. It will take about six weeks to notice the full impact of the dose increase and symptoms may lag for a few weeks more but I'm sure you'll feel better with the increased dose and lower TSH.

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Thanks, I was wondering how long it would be before I would feel a difference.


You did well by remaining calm and letting her make the decision. You definitely needed an increase. Your GP is wrong that a higher cholesterol isn't connected to hypo. It is. Two educational links for your GP:

If you need evidence for your GP of how low our TSH can go, or the addition of some T3 (some GPs refuse to acknowledge this) email for a copy of Dr Toft's Pulse article. Ignore his following para which we should take with a pinch of salt. Extract:

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.


Very useful, thank you.


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