Thyroid UK
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Bit surprised to be diagnosed with Hypothyroidism!

Hello everyone. I'm so glad to have this forum to find out what this all means! I went to my GP last week as I've been getting daily palpitations and thought it might mean a heart problem. I'd put it off for ages as I don't like going to the doctors. Apparently I've got the above and have been prescribed 50mg of Levothyroxine. I wish I'd asked the following: if I am taking this medication do I need to change my diet too? My levels are: Serum Free T4 level = 10.6 pm/ol/L and the TSH level is 10.79. Does anyone know what that might indicate ie is it borderline, high etc. And my cholesterol was 7.4 mmol/L, HDL 2.3 and LDL 4.8. I would be very grateful for anyone who wouldn't mind giving me the benefit of their wisdom. Am I normal to feel a bit bewildered to be given this diagnosis when I had no idea I had a problem? Thank you all!

10 Replies

Welcome to the forum, Malmeslady.

Palpitations is a hypothyroid sign but some people have TSH in the hundreds at diagnosis whereas others can barely function with TSH 4.0-5.0.

TSH >10 is overtly hypothyroid (high). You haven't included the range for FT4 so I can't be sure whether it is low or below range and I suspect it is the latter.

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

It takes 7-10 days for Levothyroxine to be absorbed before it starts working and it will take up to six weeks to feel the full impact of the dose.

You should have a follow up thyroid test 6-8 weeks after starting Levothyroxine. Arrange an early morning and fasting (water only) blood draw when TSH is highest, and take Levothyroxine after your blood draw.

Ask your GP to test thyroid antibodies at your next blood test. If antibodies are positive for autoimmune thyroid disease (Hashimoto's) it may be beneficial to adopt 100% gluten-free diet which can reduce the symptoms of Hashi's and antibodies. Otherwise eat whatever you like with the exception of unfermented soy which is very bad for the thyroid.

Most people will find symptoms resolve after their TSH drops to around 1.0 with FT4 in the upper range but symptoms can lag a couple of months behind good biochemistry.

High cholesterol was one of the diagnostic clinical signs of hypothyroidism prior to blood tests being introduced. As your thyroid levels improve your cholesterol will usually drop.


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.


I am very grateful for your reply and the invaluable information. I was wondering about whether to take the medication before a blood test as well. The detail you've given me is really great because my doctor didn't say much at all and it took me by surprise! So high cholesterol is a symptom too! I only know he blood results because I asked for a print out. The receptionist looked thrown and asked if I needed them for a consultant! Thank you again.

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Really good advice from Clutter.

Definitely get your thyroid antibodies checked for Hashimotos. I've been hypothyroid for years but have only recently found out I have Hashimotos which is an auto immune disease. Leaky gut is one of its causes and you need to be gluton free. Dairy free does also help. I'm just on that journey. Not easy but I think it is making a difference to how I feel already.

With hypothyroidism you may feel exhausted, have weight gain, achy, have bowel irregularities, brain fog, low mood...

I also have high cholesterol and I believe that if you take Natural Dessicated thyroid which contains T3 your cholesterol should come down. I was on Lrvothyroxine for years and my cholesterol only went up. Levothyroxine only supplements us T4 and we need All the T's to be healthy. Sadly it's not available on the NHS but you can buy from abroad. Look at Armour, Thyroid S, Erfa information.

Some other information here.

There's so much to learn at the beginning, this site is s great start, well done!

Mary Shomon has some great books out there Living well with hypothyroidism and the Thyroid diet ate good.

Dr Datis Khazzarian is so informative.

Good luck.

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Thank you very much for this information. I was wondering about whether to get a book but there are so many and it's great to have your recommendations. I'm going to Waterstones! I presume I would ask the nurse taking the blood test to do an antibodies check. Never heard of Hashimoto!! I do have gut problems so that would be something to investigate. And yes, this site will be a wonderful place to go to and not feel alone. Thank you Katepots.


If you can't get the books at Waterstones then they are on Amazon. I'd never heard of Hashimotos either! The NHS are not up to speed at all re thyroid issues and the medication we need is expensive so not funded, although they are very happy to dish out anti depressants, HRT, pills for dizziness, statins...then treat our heart disease.

So in the long run it would be far cheaper to fund T3 medication!

Rant over :)

Ideally bloods you need checking are;

TSH, FT4, FT3,

Thyroid antibodies(will show if you have Hashimotos)

Reverse T3, iron, B12

Vitamin D

Ferritin and selenium.

You are likely to be deficient in some of these.

There are private blood tests (not cheap) if the Drs surgery are not interested. Quite common.

Post your results back on here, there's some very clever people who will read them for you as most GPs will tell you levels are ok when they really are not.


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Thanks Kate, I want to know all about it - hypothyroidism - and have now ordered the books you mentioned. I'm a real pushover when I go to see the GP as I feel extremely nervous for some reason (not to do with what they may tell me, just the going in, sitting down etc, I've been like this since childhood) so I just nod and can't take in half of what they say. So, if you don't mind replying again, would I just say I have read up on the subject and would really like to be tested for the ones you've mentioned above? I've written them down so I have them in front of me! Also, you mention Natural Dessicated thyroid - so would I take this in conjunction with Levothyroxine? Thanks again, I really appreciate your advice.



Why are we like that with Drs??! I'm just the same, we need to learn to be more assertive as they are suposidely there to help us.

Say you got the information from thyroid uk.

The NDT you take instead of Levothyroxine but it's not available on NHS. I feel so much better on it the brain fog is finally lifting although still a way to go.

Stay on Levo until you get your bloods done that will be a good indicator of where you are. Levothyroxine works well for some although it is only T4

Good luck with the dr. Stay strong and insist.

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FT3 is rarely tested on NHS unless TSH is suppressed <0.03. The lab is looking for signs of hyperthyroidism not low FT3 in hypothyroid patients. According to my consultant endo rT3 isn't tested on NHS. I've not seen anyone post NHS rT3 results so he's probably right.

Your FT3 is likely to be low when FT4 is low and TSH high. Levothyroxine replacement will raise FT4 and FT3 which will lower TSH. I don't see any point in ordering a FT3 test until TSH is 1.0 or lower.

I think it's unlikely someone who has just started taking Levothyroxine will have high rT3 which is usually caused by a build up of unconverted Levothyroxine.

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At the moment, apart from the palpitations, do you have any other symptoms? If not I would be cautious about rushing to add t3 just yet. We are all different and some propel do fine on t4 Levo so wait and see what happens. It also takes time for your cells to absorb what it needs, I was started on 25 mcgs then went up to 50 after my next bloods, this was 1994. You may find it best to add it slower too. The best book in my opinion for overall information is Stop the thyroid madness - I don't think water stones do it, you can buy it online. It will explain everything and more than any endocrinologist could from a sufferers point of view. Good luck.

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Thank you for replying and for your advice. I will get that book too, as knowledge is power as they say! I went to see the gp for palpitations but didn't realise that I had several symptoms for the disease until I went on here. Constipation and general gut problems all my life (3 intestinal blockages), hands that go to sleep at night and wake me up, anxiety. No weight problem or aches and pains. Nothing that I would be driven to see a doctor for, but I'm hoping these symptoms (as I now see they are) will reduce. This is just amazing - hypothyroidism has so many symptoms that I would put down to getting older and I'm sure so many other people would feel the same, don't want to bother the doctor with such general symptoms. Its a revelation. Thanks again!

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