Thyroid UK
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Thyroid follow up

Hi all,

My daughter got her blood results TSH 1.5 range 0.4 -4.

No T4 or T 3 checked.

Her weight,dry skin,dry eyes,fatigue and brain fog have not improved since she had a TSH of 8.5.

At the doctors consultation she told her all of this and asked for further tests.

Doctor said the labs automatically check T4 and T3 if the TSH is not in normal 8.5 no T3 was checked.

My daughter repeated she would like them tested and thyroid antibodies.

The doctor said no,but to reassure her she would do LFTs B12 folate U&Es and ferritin levels.

Doctors feeling is there's a lag between her now been on 300 mcg of thyroxine and her symptoms.....which I may add she has had since she was in her teens and is now 33.

My daughter has always felt there is more than thyroid going on and again asked for referral .....answer see what the bloods are and check TSH again in February.

Would appreciate your input .

My daughter was a size 10 she is now a size 18 and although eats a very healthy diet and exercises at least 3 times a week,would like to do more but finds it hard due to fatigue.

9 Replies

Your daughter's TSH might be 'within range' in the doctor's eyes so the assumption is she's on sufficient thyroid hormones. She could do with another rise in T4 as Dr Toft says:

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.

Dr Toft was the President of the BTA and if you want a copy of the article to give to your GP email

Labs don't normaly do T4 when TSH is in range but that's not helpful for the patient if there's insufficient T4 to convert to T3.

Your daughter is on a good amount of T4 but if she's not converting to T3, she will not feel much better. If you can afford a Free T3 blood test from one of our recommended labs, I would suggest you do this. There are finger-prick tests.

If your daughter has been ill since her teens and is now 33, she does need someone who knows what they're doing - i.e. relieving her of her symptoms.

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Thank you for your reply,I have suggested she goes private for a T3 test and will email Louise as you suggested.

I am also hypothyroid,and usually they do a T4 with TSH.

Grateful for your input and advice.


You should request a Free T3 blood test if you decide. For info read about FT3 on this link. Cursor down the page.

1 like

Hello Jeremy,

I am sorry to hear about your daughter.

Before adding T3 to my T4 (thyroxine) I followed your daughters pattern of initially doing well after a dose change, only for all symptoms (and sometimes more) to resume after six weeks. All your daughters symptoms could be down to low thyroid hormones or the accompanying conditions that hypothyroidism can bring.

If your daughter has been ill for a long time the adrenals may have been compromised. This would cause high or low cortisol levels (stress hormone) which may interfere with thyroid meds working so it becomes a vicious circle.

The goal of Levothyroxine is to restore the patient to euthyroid status and for most people that means TSH just above or below 1.0 and symptoms can lag behind good biochemistry by 6-8 weeks.

If your daughter has felt ill for so long and has optimal nutrient and iron levels, and eats a balanced diet of regular meals, it may be time to search further a field.

You could email for a list of sympathetic endos/doctors that members have had positive experiences with.



Disclaimer: I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal before applying any of these suggestions.


1 like

Your poor daughter, it sounds like such an uphill battle.

It's good that the doctor has said that B12 and ferritin will be checked - it's extremely common for both to be low, as many with hypothyroidism find their gut just doesn't absorb nutrients very well. Make sure she gets the results so that you can post them here - the "normal" range for both is massive, and as you might expect, normal often doesn't mean optimal.

1 like

Yes Jazzw,she always gets a print out of her results from receptionist well before seeing the doctor.

Thank you.


Oh and Vit D.


For dry skin and dry eyes look into vitamin A.

Vit A is often used to cure acne in teenagers, but it has helped my dry eyes, my facial skin and neck have lost their dryness, all nice and soft again.

I agree with others that there is a conversion problem, look into getting private bloods done for your Daughter Jeremy72, we used Blue Horizon's finger prick DIY home tests and so pleased we did, they are easy to do.

1 like

Thank you coastwalker.


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