T4 in the middle, still feel like crap?

So i finally booked saw my gp last night to discuss my thyroid levels from August. I dont have a copy of the results btw.

He said my TSH has gone down to 3, my t4 is 15 (range 8-20) and he didnt mention my t3.

He said that when the t4 is in the middle, i should be feeling better, but im not and i told him this. He then decided to increase my dose of levothyroxine from 75mcg to 100mcg.

Does anyone know if i should be feeling normal? Or could there be something else going on?

I am constantly tired, have deep leg pain, left arm and shoulder sometimes aches, pain in the left side of my neck, swollen lyphm node that sode (not sure if its related), slight weight gain, headaches, feel cold all the time..

5 Replies

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  • You might begin to feel a bit better the higher your dose goes. It does take time until we reach an optimum level of hormones and that's when you have relief from all of your clinical symptoms. That could mean your TSH around 1 or below or suppressed but doctors don't like suppressed but some of us need it to feel well.

  • Emily, most patients won't feel well with FT4 mid range on Levothyroxine. It needs to be in the upper quadrant >17 with TSH just below/above 1.0 before most patients start to feel well and symptoms may lag behind good biochemistry by a couple of months.

  • You are undermedicated. Most people feel better when TSH is 1 or under and Free T4 is in the upper quarter of the range. Some people can't convert T4 to T3 and need NDT, or T3 added to their levo, but you won't know if that is the case unless you have free T3 tested. You also need ferritin, folate, D3 and B12 to be optimum (not just "in range") in order to convert T4 (inactive) to T3 (active).

    The dose increase should make you feel better, but it often takes a month or so to see a difference. You should get another blood test 6 weeks after a dose change.

  • Thankyou all for your replies :) im aware that gps arent educated about the thyroid to an extent where they know everything like an endocrinologist which is probably why they dont understand how i feel. They just say "oh its normal" but im glad he let me increase my dose.

    I did tell him that the endo said they were aiming for my tsh to be 1. It has come down from 9 to 3 in the last 5 months! So i should be there soon fingers crossed :) i just hope i start feeling better soon.

  • i've found most endos to be even worse than GPs! just to confirm that i can't function at all with a TSH of 3 and reaffirm that it sounds like you're undermedicated. i couldn't tolerate levo at any dose and have to use NDT. maybe you could get private testing of free T3 because that's much more telling than free t4 levels?

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