Hypo with normal t3,t4: I have all hypo symptoms... - Thyroid UK

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Hypo with normal t3,t4

I have all hypo symptoms:

-hair loss

-dry skin

-can not sleep

-low energy and sleepiness

-my morning temperature is 36,4 C (97,52 f), afternoon 36,7 C (98,06 f).

I tried in the past forskohlii which made me a good lift. In third day I had better skin on my face, had a lot of energy, my afternoon temperature went to 37 C and I had a good sleep. But after it went back and I haven't felt positive results anymore, probably due feedback loop or tolerance.

On the other hand I feel negative results if I eat cruciferous vegetables. If I eat small amount of it for 2 days I will feel more tired.

This further confirms that I have some problems with thyroid. Which makes me confused because my blood tests always seems to be fine. I made in the past years 3 times and it was always something like that:

TSH 3,01 (ref. 0.27 – 4.20 mIU/L)

T4 17,42 (ref. 12-22 pmol/L)

T3 4,82 (ref. 3.59-6.8 pmol/L)

Do you think I would still be a good candidate for NDT?

21 Replies
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My ferritin is just a bit above ref range, also iron is the same. I tested b12 2 times and it has never been issue, probably due the fact I eat enough meat. D was very low in the past, but now I am keeping it high with supplements. I am adding also Selenium, Zinc, Mg, Iodine and vitamin c. I was thinking if there is deficiency of other trace mineral (such as valenium, manganese, ...).

But I have been hypo since I was child. I remember I was always very sleepy and tired. I don't know also if the fact that my mother was taking thyroid med when she was pregnant with me makes any difference. Because I was hypo from when I was child I think there must be some other reason for my hypo, not mineral deficiency.

So it would be better to add only T3 since T4 is high enough but my body can not convert it to t3 properly. Am I right?

HiddenThis reply has been deleted

I am not on meds right now. Is TSH 3 too high also for somebody not on meds?


If your ferritin is only just above the reference range you need to build up your iron stores. Have you tested for autoimmune antibodies? Since your mother had thyroid problems, it seems very likely you have these.

I also was more tired than my peers throughout childhood, walked and moved strikingly more slowly, had less stamina, had an irregular heartbeat as a child, was very pale, dry hair and skin.....

Is that your picture too?


Why to built up iron stores if it is already too high? My iron has been always high. I tested for all autoimmune antibodies and it is negative. Similar excepting hearbeat which was normal, but allways low blood pressure.


Many GPs make a big mistake when they believe that when the TSH is somewhere in the 'range' that the patient is on sufficient levothyroxine (or thyroid hormones, i.e. NDT etc).

If you've been hypo since being a child I feel very sorry for you because you'll never have experienced good health for years.

Your TSH is too high for someone on levothyroxine. We feel best when it is 1 or lower but this is advice from an ex President of the BTA Dr Toft:-

'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."

The above is from a quote in an article in Pulse Online (doctors magazine).

When you go for your next blood test, make the appointment as early as possible and fast *you can drink water) and leave about 24 hours from your last dose of levo and the test and take it afterwards. This keeps the TSH higher as it drops throughout the day. Also ask for a B12, Vit D, iron, ferritin and folate as we are usually deficient. Get a print-out of your results with the ranges from the surgery (we are entitled to them for our own records) and you can post them for advice.

Ask for a Free T3 blood test rather than a T3. If you cursor down the page on this link you will see the reason.


In many countries if someone has a TSH of 3 they will be diagnosed as hypothyroid so it stands to reason (although in the UK they don't prescribe until it is 10) you aren't on sufficient levo. You need an increase.


P.S. I didn't add this at the end:-

"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 physician before applying any of these suggestions"


You wrote: "Your TSH is too high for someone on levothyroxine". I am not sure why you think I am taking levothyroxine, I am not on any medication yet.


I assumed you were taking levothyroxine as you made two statements:-

1.But I have been hypo since I was child.

2. Do you think I would still be a good candidate for NDT?

There was no thyroid gland history in your Profile, i.e. if diagnosed, when diagnosed, medication, dose etc.

Also another responder 'assumed' like I did as the response was:-

but since you are Hypothyroid your TSH should be 1 or below so you need more meds that's for sure/

My assumption now is that you have never been diagnosed but you have been having clinical symptoms which sound hypo and due to your TSH being just over 3 your GP hasn't diagnosed you. In the meanime this is from Thyroiduk.org the main website for dysfunctions of the thyroid gland.


On that site under 'hypothyroidism' there is a list of clinical symptoms which you can tick off to discuss with your GP along with 'interpretation' list.


Newbie85, picking up on a few things that you have mentioned:

1/ cruciferous vegetables, goitrogens, would make you feel the way you do if you have iodine deficiency as they contain compound called glucosinolates which could interfere with thyroid hormone synthesis or compete with iodine for uptake by the thyroid.

2/ forskohlii usually kick off your thyroid into producing thyroid hormones but if you don't have all the other associated components that go hand in hand with it to produce T4 (iodine and Tyrosine) to be later converted into T3, you'd continue to struggle and feel as you do. Your symptoms are evidence that your thyroid is struggling a bit and you are sitting on the fence perhaps due to an iodine deficiency.

If you don't want to have a leap into taking replacement for thyroid hormones ie NDT, thyroxin etc is to give your thyroid some support, 6 months, and see how it goes.

Pure Encaspulations Thyroid Support Complex has forskohlii and guggul to kick off the thyroid along with tyrosine and iodine from kelp, Ashwagandha to support adrenals and also helps with T4 production and indeed selenium, Vit. A, and zinc needed for the conversion. One more ingredients is turmeric or curcuma, anti-inflammatory and boost the conversion to T3 by working at factors that inhibit the conversion. All ingredients are at the therapeutic essential doses.

In addition to take a good B-complex (with 400-500 mcg of b12) and Vit D (safe to take 2000 iu - 3000 iu a day without testing) will help as well.

The final element required is iron..not sure if you have this tested but certainly if you are also deficient and supplemented at the right dose, you'll get that added kick that is needed. Iron works hand in hand with T3 (both are interdependent on each other).

If all of these elements are well balanced and at very good levels within your blood stream, your hair loss with stop, have the energy needed, and you'll sleep better.

I hope this helps. Best wishes for a great 2016.


You are right. I have iodine deficiency because I was on salt free diet for 3 years until 3 years ago. Also iodine loading test confirmed it. But the problem is that I can not go higher than 500mcg of iodine. I was trying many different methods in past 2 years. Low dose of iodine, mega dose up to 50mg, every day, every second day, ... Every time with selenium, zinc, vitamin c, mg, vitamins b together. But as soon I go with dose larger than 500mcg I am starting to be more hypo.

1 like

There is no need to go as higher as 500 mcg/day.

Daily RD is 150 mcg, you can double it with ease should you wish to do so.

Top up slowly until you start feeling better then reduce to maintenance dose of 150 mcg. Taking Selenium should offset the initial side effects if any. Moreover, kelp, natural form of iodine, has lesser side effects than potassium iodide.

If for any reasons you don't tolerate 300 mcg/day take 150 mcg for about 6 weeks then double it.


This is what I have been doing for the last 20 months. When I realized I can not go with more than 500mcg I continued with 150-300mcg per day. I am using kelp from NOW company. But goitrogens still make me more hypo, even with very small amount.


Perhaps you need to switch to another brand.

What are your folate levels? All dark greens veggies are high in folate. May be you have very high levels already.


Where are you located?

UK salt is (in general) not iodised.


I am located in Slovenia. I am taking kelp for iodine, getting 150-300mcg per day for the last 20 months.


Newbie85, Your TSH 3.0 indicates your thyroid is struggling to produce and convert hormone. FT4 is good for someone not on replacement but FT3 is very low. This doesn't mean you aren't converting, it may be that your FT4 needs to be higher to enable good conversion.

You won't get a NHS diagnosis until TSH is over range, but some private doctors will treat when TSH is >3.0. Some members have been very symptomatic with TSH 3.0 and have felt improvement when they self-medicated thyroxine, T3 or NDT. None are an instant fix as it is necessary to titrate dose slowly but you should feel some improvement in 6-12 weeks after self medicating if your symptoms are due to low thyroid.




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 physician before applying any of these suggestions.


Newbie85, did you get tested for antibodies - TPOab and TgAB?

When you say your B12 'isn't a problem', what exactly was the result? Because just being 'in range' isn't good enough, optimal for B12 is 1000, no matter what the range.

Why did you go on a salt-free diet? That's a very dangerous thing to do. I hope you're getting enough salt now, because the adrenals need salt. :)


I get tested and they are both negative. b12 was 1012 pmol/l (ref. 141 - 489). Salt-free diet was because of fitness instructor. I was young, I thought he knows what he is talking about and it took years before I realized I should run away from him advices. I have been taking enough quality salt after that.


Ok, well, you're B12 is fine, then. That's good. Glad to hear you're back to eating salt! Some people ought to be shoot for the rotten advice they give! :(


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