Thyroid UK
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Palpitations and T4

Further to my previous queries I attach my latest blood results with previous one.

I am seeing my endo. this week.

6.4.16   TSH    28.7        FT3   3.8      FT4  6.3        Vit D  -  74

2.3.16   TSH    11.6       FT3    3.8      FT4 10.5       Vit D     23

Still getting some palpitations and taking T4 - 25mcg.  and   T3 - 15mcg. 

I will be interested to hear your comments.  Many thanks.


5 Replies

hi pandaH, sounds like it's a dosage problem, TSH is way too high. but I'm no good on bloods and suggesting things about the readings, other than to say, there are different labs around the country that can use different testing methods. 

What did your doctor say about the results and did he adjust meds? 

I see you haven't posted including what the (normal ranges) are for all those different results. Can you edit and/or repost including the ranges which are in Brackets (  ).  I'm sure the admins or others will soon comment for you, but the ranges will help them - possibly even methods used, typed underneath as they are,  on some of my own results. 

I'm sure you won't have to wait long. 


Sorry didnt put in range:-

TSH  (range 0.27 - 4.20mu/L)    28.7

FT4   (12.00 - 22.00pmol/L)        6.3

FT3   (3.10-6.80pmol/L)              3.8

1 like

Your are on too low a dose of thyroid hormones according to your high TSH. You must be feeling absolutely awful. Whoever is treating you doesn't know anything about treating people who are hypothyroid.

When diagnosed the usual starting dose is 50mcg of T4 with an increment of 25mcg around every six weeks till you've no symptoms or the addition of some T3 if not feeling better.

At present your combined dose is the equivalent to approx 70mcg I am not surprised either that you have palpitations with such a high TSH when on thyroid hormones.

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pandaH -     Hope you can get things sorted out sooner rather than later after the info given by the admins. :-) 



FT4 is below range, possibly because you are taking proportionally more T3 than Levothyroxine, but FT3 hasn't moved and it's staggering how much your TSH has increased when you are taking the equivalent of 60mcg Levothyroxine. I'm not surprised you are having palpitations! 

For maximum absorption Levothyroxine and T3 should be taken with water 1 hour before or 2 hours after food and drink, 2 hours away from most medications and supplements, and 4 hours away from iron, calcium and vitamin D supplements and oestrogen.

It's unusual that your endo prescribed Levothyroxine and T3 combination.  75-100mcg Levothyroxine is a more common starting dose with TSH >10 in patients <50 without ischaemic heart disease.  You will need regular dose increases until TSH is around 1.0 and FT4 in the upper range which will raise FT3 too.  Read Treatment Options in

Please be cautious driving.  Research shows TSH >20 can impair driving reactions more than being over the drink drive limit.


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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