Thyroid UK
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Urgent please!!

I'm seeing my GP at 3.30 so would appreciate some urgent advice please!

I was all set to tell her that because the lab had seen fit to only test TSH and TPO antibodies I was going to have a private test done. However, I've just been looking through my papers and saw that my free T3 was just done in October (damn brain fog!!!).

In Oct:

Free T3 4.5 (3.5-6.5)

TSH 1.96 (0.3-4.7)

Free T4 19.9 (9.5-21.5)

After increasing Levo from 100mcg to 125 my current results are:

TSH 1.88 (0.30-4.70)

TPO antibodies 564 (<34.00)

Does this look OK? I still have some symptoms but doubt I will get anywhere with my GP :-(

Thanks so much :-)

10 Replies

Bit of a conversion problem there? The free t4 is towards the top ond of the range but the free t3 isnt. The tsh really ought to be lower.

antony Toft, the retired endocrinologist who used to be head of the british thyroid association, wrote a booklet for patients, endorsed by the BMA.

In it, he says that the correct dose of thyroid hormobe is one which alleviates symptoms... He would expect t4 to be at the top of or just over range and the free t3 to be at top end of range.... If this doesnt happen then trial t3,

Your doc first needs to try you on more t4. (Levothyroxine)... Unless he or she knows better than the soecialist endo.....

Here is the link to the kindle edition.... Download it asap and start flipping through it..... Not sure which page the dosing info is.....

G x

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For the Free T3 range you've been given mid-range is 5, and your result is lower than that.

People with hypothyroidism usually feel at their best when the Free T3 is in the top third (5.5 - 6.5) or top quarter (5.75 - 6.5) of the reference range. So I would say your conversion from T4 to T3 is not working well enough.

Have you got optimal levels of Vitamin B12, folate, Vitamin D and ferritin? Improving the levels might improve conversion. If you don't have recent levels for these ask to be tested.

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Your GP (probably) won't like that your TSH has decreased further and try to reduce the levo. This is ok as long as you can start medicating T3 as your levels are too low.

Many of us have a conversion problem (T4 - T3) and are unable to bring T3 levels up to a place where hypothyroid symptoms are relieved. Adding a little T3 will also help the T4 convert so you receive an even higher amount of the active hormone.

Your GP may not agree with this as they aren't good on thyroid psychology so you could ask for an endo referral or self medicate as many are forced to do.

Optimal thyroid hormones will help to reduce the high TPOAb's as will supplementing selenium which also helps with thyroid hormone conversion.



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 physician before applying any of these suggestions.


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Thank you all so much-the info was greatly appreciated. By me that GP? Not so much!

As expected she started off by saying everything was perfectly fine. I told her I still had symptoms, and listed them but she reckoned any symptoms could not be due to my Thyroid. So...I had no option but to take out the dreaded notebook! My GP is a nice lady and seems more clued up than some I've heard of so I HATE having to contradict her :-(

I said I didn't think I was converting properly and mentioned about folate etc needing to be optimal then she proceeded to blind me with science! She reckoned my T3 was fine but also said that T3 levels can change in a matter of minutes so it was difficult to determine. Is this correct? She did not believe that any GPs prescribed T3, even though I read out the info from Dr Toft suggesting to trial it. She said that if she was sitting where I am there is no way she would take T3. I was fed up arguing by then!

So the upshot is I have to go for another blood test and take it from there. I am praying there is some deficiency somewhere so I can just take some supplements and Bob's your uncle, but I doubt it.

Incidentally, I queried my Folate and Vit D which she declared were both perfectly fine but can I have your opinion please?

Serum vit b12 644 (170.00 - 700.00)

Serum folate 9.1 (4.60 - 18.70)

Serum ferritin 143 (> 60 deficiency unlikely

> 200 may indicate overload in pre meno women)

I haven't a clue how to interpret the Vit D, sorry.

Thanks very much for all of your help. I feel like a complete dunce :-( xx


She reckoned my T3 was fine but also said that T3 levels can change in a matter of minutes so it was difficult to determine.

Depending on your point of view she was right or wrong about the T3 changing in minutes.

If she's right, then TSH is a useless measurement too because Free T3 has a circadian rhythm to it which lags behind the TSH circadian rhythm by about 90 minutes. The amount of variability in T3 is much less than the variability in TSH. So if doctors are happy with TSH changing then they can't quibble about the T3 changing too, particularly since it changes less than TSH.

But if your doctor thinks TSH is a very useful measurement, then T3 is too, for exactly the same reason.

Take a look at the graphs on page 2.

She said that if she was sitting where I am there is no way she would take T3.

Her brainwashing obviously took really well. And she clearly has no idea what T3 does or what it feels like to have too little of it.

Regarding your vits and minerals...

You haven't included the vitamin D. Can you just tell us what is written?

B12 : I prefer my B12 to be at least 1000. (In reality it is >2000). But it is entirely up to you whether you want to boost your B12, it is not bad compared to many results I've seen. The Japanese consider the bottom of the healthy range to be 500.

Folate : I prefer mine to be in the top quarter of the range. But again, your level is not outrageously bad, so supplementation is a matter of choice.

Ferritin : Yours is fine.


I know what you mean about brainwashing! There are loads of people who have managed to get their lives back by using T3. I think she is just toeing the party line as most of them seem to do regarding T3. I just get so tired of trying to put my case when I don't fully understand what's going on myself!

I tried supplementing with B12 ages ago and I broke out in acne which put me off. I have since been taking a vit b complex and hoping for the best. I will wait for the next lot of results and see what my folate is like then. I googled it earlier and low levels can cause problems with the hair so I may consider a supplement for a while to see if it does anything.

I've finally worked out what they mean re Vit D :-)


<25nmol/L - Vitamin D deficiency

Consider treatment

25-50nmol/L Vitamin D may be insufficient

>50 vit d sufficiency

Thanks a lot for your help and advice :-)


Here's something that's in agreement with 50nmol/L VitD being sufficient, but cautions against supplementing:


That's going to be a bit of a shocker for a lot of people isn't it? I think I'll just be content with my levels the way they are then ;-)



"It takes relatively little sunlight exposure to acquire adequate stores of vitamin D and few people wear enough clothes to prevent that from happening. Ten to 15 minutes of sunlight or daylight exposure to a small area of skin (e.g., the forearm or

face, etc.) twice a week (without sunscreen) supplies all the vitamin D necessary for health."

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"Excessive vitamin D can be toxic to humans and to animals (it's used as Rat Poison). It is difficult to ingest too much vitamin D from food, and natural mechanisms regulate the amount of vitamin D3 photosynthesized from sunlight; within about 20 minutes of ultraviolet exposure in light-skinned individuals (3–6 times longer for pigmented skin), the concentrations of vitamin

D precursors produced in the skin reach an equilibrium, and any further vitamin D that is produced is degraded. However, elevated 25(OH)D and hypervitaminosis-D can occur due to vitamin D supplementation."

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