Confused with my results, can anyone shed some light

February of this year I was diagnosed with underactive thyroid, TSH 7.11 and T4 10.8. I was put on 100 mcg levothyroxine. Second blood test done in April TSH 0.16 and T4 19.9. My Dr kept me on same dose of Levothyroxine. I have still not been feeling well. Asked for my dose to be lowered and had to have another blood test done (two weeks ago). My reading now TSH 0.05 and T4. 22.0. Doctor has reduced Levi to 75 mcg. But what is happening, does this mean I am going from being underactive thyroid to overactive thyroid. I feel so confused.

19 Replies

  • Philly2748, it's not unusual to require occasional dose adjustments. You won't swing from hypothyroid to hyperthyroid but you can be overmedicated, in which case a dose reduction is appropriate.

    75-100mcg Levothyroxine is the recommended starting dose for patients under 50 without heart disease. FT4 22 and TSH 0.05 are optimal for a lot of patients, but some may feel slightly hyper and unwell, and require slightly lower levels which will be achieved by reducing dose.

    If hypothyroid symptoms feel worse after a few weeks on 75mcg, ask your GP whether 75mcg/100mcg alternate days can be tried. Sometimes, very small tweaks to dose make a positive improvement.

    Vitamins and minerals can be trashed in hyopthyroid patients and can make one feel very unwell. Ask your GP to test ferritin, vitamin D, B12 and folate. Post the results and ranges in a new question for comment and advice.

  • Thank you for explanation. Dr a has suggested I have another blood test in October after six to eight weeks on lower dose and see where we go from there. I had Vit B12 which was normal, folates with note saying a folate result at the lower end of the normal range may not exclude folate deficiency if clinically suspected. How would folate deficiency be making me feel ? Normal range for folate was 4.6-18.7 and mine was 7.7.

    Iron was also checked and came back as 21 (normal range 8.8-27.0)

    She did not test for ferritin or Vit D. Are there any links to website where I can have these tests done privately for Vit D and ferritin? Thank you

    I sadly have got so very low and have now been put on sertaline, an anti depressant. A week in and no improvement yet but I know it takes a while.

  • Philly, I doubt you have folate deficiency unless your red blood cell count showed abnormally large red blood cells.

    Ask your GP receptionist for your B12 result.Normal range for B12 is very broad. Normal means you are not deficient. Nevertheless, if B12 is low in range it will be beneficial to supplement.

    Ferritin is stored iron and is often tested to indicate iron status. Your iron result rules out iron anaemia.

    Private tests are available via

  • You can feel just as bad being over-medicated as you did when you were first diagnosed with hypo. I felt much, much worse when my dose was too high.

  • May I ask you how you felt at your worst. What symptoms did you have? Thank you

  • I had fatigue, body aches, nausea, loss of appetite, horrible anxiety, insomnia, frequent bowel movements, rapid weight loss.

  • I have most of those symptoms. I truly hope they can get my medication right so I can start to feel well. Thank you, it helps me to feel less alone and afraid.

  • I really hope you feel better soon. I am still in recovery from being over-medicated. It was 4 weeks ago when my dose was changed. I'm better, but not 100%. I know you must be feeling low because being sick for a long time can really take joy out of your life. I still feel quite sad at times. It feels so cruel to have to wait for weeks or months for medicine to take effect.

  • When I was diagnosed with hypothyroid my TSH was 17. After 3 months on 50 mcg thyroxine daily it came down to 3. So when I read your first post Philly, my thought was that you seemed to be on rather a high dose for your readings. I've been on the 50 mcg dose for 15 months now and am doing well. I'm 63 and also take nitrates for a heart condition. I read early on that the thyroxine must be taken at least an hour before any other medication and 4 hours before vitamin supplements. I think that was on the British Thyroid Association website ( and I have stuck to it!

  • Thank you Karen247, I am just confused and very low as I have felt ill for 14 months now, initially having nausea which still comes and goes but my appetite has gone completely at the moment. Dr has put me on anti depressants this last week in a bid to get me into a 'better place' to be able to cope. She says the lack of appetite, losing weight and not coping is all connected to the depression and anxiety and also my thyroid levels playing a part in it too. Thank you for your post, much appreciated

  • Hi Philly - I see no mention of a Free T3 Test Result in your posts ? Your meds

    are reflecting the lowered TSH, the FT4 reflecting your Levo intake, but are

    you converting the T4 to the all important active FT3 ? As your still feeling

    hypo & your T4 level is optimal makes me wonder.

  • Hello and thank you for replying to my post. I did have a private thyroid test in April and the result was Free T3 was 4.48 (normal range 3.1 - 6.8) so I am assuming that result is good and I am converting the T4? Would you agree?

  • Just typed a reply - pushed submit & it seems to have disappeared ! So, again,

    loss of weight, anxiety, etc - have you had an Adrenal Test ? Yes, your FT3

    just below mid range, so not bad. But if you were to reduce your meds, then

    your FT3 level would possibly lower & you will notice that. I had a FT3 level

    within range - low end, but was found to have elevated RT3. Have you had

    RT3 tested ? As far as how you feel, go easy on yourself. Rest up as much

    as you can, eat little & often, try to relax & stop worrying. Easy to say I know,

    but these things take time & you will get better.

  • Hello. Thank you for your reply. I have had a saliva test done to check for adrenal fatigue and yes my cortisol levels were high. Not sure though what I can do about that as I think it is all linked in with my anxiety, lack of sleep, no appetite, worry, fear etc. do you have any suggestions? One suggestion was to buy melatonin 1g and phosphatidyl serine 100mg but too scared to take any supplements in case they mess with the levothyroxine and sertraline (anti depressants that I have just been put on)? I am not an expert and I find all this scary. Maybe I just need to give my body time to settle with the lower dose of levo. Now 75mcg instead of 100mcg.

    Many thanks. Always good to chat and share

  • Just re read your post. Not sure what RT3 is and how I can get that one tested as the source I used only did TSH, Free T3 and 4.

  • Well, at least you haven't got Adrenal fatigue, which a lot of us suffer with

    low Thyroid issues, so that's something to smile about ! However, too

    higher levels will make you feel anxious & keep you hyper of a night.

    It sounds as though you have a good Dr who is looking into it with testing,

    another little something to smile about, as some of us are still searching !

    Your high Cortisol levels could hinder conversion & uptake of your FT3.

    Have you tried a decent Multi Amino Acid supp rather than Serotonine ?

    Which of the 4 Saliva Results were high or low ? Have you checked your

    Glucose & sodium ? If your adrenals on the go, you will probably need to take

    sea salt. You have nothing to feel scared about, you just need to find

    what thyroid meds & dose suits you. Low Thyroid state at cellular level

    will be a stressor on your Adrenals.

  • Not my doctor who tested for adrenal. I contacted a naturopath who was most helpful and he suggested Genova Diagnostic for adrenal test. He tried to help me with a diet plan and various supplements but sadly the diet really messed me up and betaine HCI so I had to stop. Not his fault but I think I had spiralled too far down. I do not want to go against doctors advice as I do need the help with the sertraline as I am not coping. My four saliva samples showed the two highest were first thing in morning, 9am and then 12pm, both over reference range. Sample 3 was within reference range at 5pm and last one was slightly higher than reference range at 11pm. I do have a mineral complex he suggested I take which has magnesium, zinc, copper, magnesium, selenium, chromium. He also suggested 3mg sea salt a day so you are so right on that one 😃. no appetite at the moment . Thank you so much for posting, I really appreciate it. Trying not to be scared is hard as I have felt unwell now for 14 months, really hoping sertraline will kick in soon as only been on it a week. Sleep deprivation is also not helping. Many thanks

  • It's a while ago now I had it done, but seem to think it was Genova Diagnostics.

    I'm sure if you look in this forum under Reverse T3 Test you will find info.

  • Yep, you will certainly need the multi vit & mineral. Perhaps you might

    do better with a food drink. Blend a load of goodies & drink might be

    easier on digestion. Yes, I've been there, so understand you have to

    go easy with what you take. Have you considered consulting with

    a specialist Dr ? Such as one on the Thyroid UK list ? More expense

    I know, but sometimes useful initially. Dr. Barry Pearfield's book gave

    me a good overall understanding initially & easy to digest. But you

    won't have an easy time until you manage to ease the Adrenal output.

    Some might suggest a gentle Herbal Adrenal Adaptagen, like Ashwagandha.

    Or perhaps just a Herbal Calmer to ease your anxious state. Something

    gentle on your system. Think I tried something like Nutra Calm (can't

    remember if that's exact spelling). It just took the edge off & aided

    sleep. I would look on Forums for elevated Cortisol - see if any useful

    info there.

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