Help - Good T4 and TSH levels but still feel awful

6 weeks ago I had my Levothyroxine raised from 100mcgs to 125mcg. I still feel just the same with my symptoms (totally exhausted and needing daytime naps whenever I can, never feeling refreshed, very bad brain fog, lack of concentration, short tempered, and continuous weight gain).

I had my tests done again yesterday at 9.40am (unfortunately I didn't know I was having Thyroid Function Tests done as I was going to have my sex hormone levels taken, so I didn't fast and I took my Levothyroxine at 7.30am)

My test results are as follows:

22 July 2015 (taking Levothyroxine 100mcg)

Serum free T4 = 17.5 (range 12 - 22)

Serum TSH = 4.04 (range 0.30 - 4.2)

7 September 2015 (taking Levothyroxine 125mcg)

Serum free T4 = 23.1 (range 12- 22)

Serum TSH = 0.73 (range 0.3 - 4.2)

As you can see, in the last 6 weeks since my Levothyroxine has been increased my results have improved dramatically to the point of being slightly over on T4 and perfect TSH, but I still feel just as terrible as I did before the increase. What do I do next as it is affecting my work and my family life feeling like this and I thought that my test results would still come back requiring a further increase. I cant believe that I have got to carry on feeling like this in the long term.

Thank you in advance for any advice.

9 Replies

  • since theres no free t3 result and we have no idea what your




    vit d3

    results are theres no way of knowing

    it needs the levels of all 4 above to be halfway in their ranges or your body is unable to convert the T4 in levothyroxine into the T3 every cell in your body needs to function

    Hence why your doctor and the entire NHS testing system is wrong and why you still do not feel well

  • My Serum free T3 in March 2015 was 4.9 (range 3.1 - 6.8).

    July 2015

    Serum Vit B12 = 734 (range 197 - 866)

    Serum folate = 17.4 (range 4.6 - 18.7)

    March 2015

    Vit D serum = 48 (range 50 - 120)

    I haven't had Folate tested unless it's called something else on my print out

  • Foggy, FT3 4.9 was good in March, but isn't much clue to what it is now.

    VitD 48 is low, 100 is optimal and in the replete 75-200 range. Supplement 5,000iu daily for 3 months and then reduce to 5,000iu alternate days.

    B12 and folate are good.

  • Folate has been tested

    Its ferritin that is the missing link

    Your t3 was ok but might not be now

  • After a 20 minute telephone conversation with my GP tonight.... She has agreed to let me have my T4, TSH and Ferritin tests done again fasting and with my Levothyroxine but not for 6 weeks. She won't do T3 as she says it was fine in March!! She says I'm "clutching at straws" and that I might have chronic fatigue which I know I haven't. She has said she wants to see me and then maybe refer me to an Endocrinologist but thinks its a waste of time

  • By saying it maybe CFS she's clutching at straws. Dr Skinner died two years ago, unfortunatley for his family as well as the people who travelled all over the UK to consult him when they failed either to get diagnosed or undertreated. This is how he, a Virologist, became involved. He also appeared before the GMC as he diagnosed people by their clinical symptoms as he was taught as a medical student. No blood tests around then. At his Hearing there were 2,500 testimonials supporting him and his treatment.

  • Foggy73, taking 125mcg 2 hours before testing means the Levothyroxine was peaking in your bloodstream and that will be why FT4 is over range. A 25mcg dose increase will have improved FT4, but I doubt by more than 20.5 (which is good, almost top of range).

    Symptoms often lag behind good biochemistry by a couple of months so the last dose increase is probably still metabolising and you should notice improvement in symptoms soon.

    Have you had ferritin, vitamin D, B12 and folate levels checked? Deficient/low levels are common in hypothyroid patients and can cause fatigue amongst other things.

  • July 2015

    Serum Vit B12 = 734 (range 197 - 866)

    Serum folate = 17.4 (range 4.6 - 18.7)

    March 2015

    Vit D serum = 48 (range 50 - 120)

    I really hope your right that despite my improved results after an increase 6 weeks ago that my symptoms will improve soon

  • Foggy, B12 and folate are good. I advised on vitD above.

    If you've a copy of your Mar TSH, FT4 and FT3 result compare them with your latest results. Lower TSH and higher FT4 will usually mean higher FT3. You can order private thyroid tests from Blue Horizon and Genova via

    I described the symptom lag from my own experiences. I hope you'll feel better within 8 weeks.

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