Thyroid UK
84,192 members99,165 posts

new & would appreciate your advice/thoughts/ideas

T4,Free(Direct) 3.17 0.82-1.77 H

Tsh <0.006 0.450-4.500 L

Triiodothyronine,Free,Serum 4.1 2.0-4.4 N


51 8-25 H

Currently on 200 mcgs levothyroxine. 57 female 5'7" 107 lbs.

M A N Y symptoms for M A N Y years, unfortunately. At one point I had very high antibodies but they are normal now.

Thank you for your time!

11 Replies


Welcome to our forum and sorry to hear you are not feeling well.

Your T4 is over range and T3 near the top. TSH is suppressed and RT3 is very elevated indicating your dose is too high and thyroid meds are not working for you. Is your GP prescribing this dose ? ?..

Have you been checked for both TPOAb & TGAb as either can indicate Hashimotos ?

Have you had Vit B12, Vit D, folate and ferritin tested recently ? / ... Deficiencies are common in people with low thyroid hormone and are the very nutrients required for good thyroid hormone synthesis. Post any nutrient//iron test results complete with ranges, for members to comment.


Only Vit D tested and it's normal.



Can you post Vit D result for members to comment ? ? .. A doctors "normal" is not the same as a level that members have found to be beneficial to thyroid health.

Ask your GP to test the other nutrients and again post results.

Is your GP prescribing your thyroid meds ? ? ...


Vitamin D, 25-Hydroxy 58.4 30.0-100.0

GP and Endo have kept me on dosage because T3 is good.



T3 is good but T4 and RT3 is massively over-range.

I am surprised that your endo would keep you on this large dose of Levothyroxine. Do they know what they are doing >? ? ...

A RT3 result of 51 in a range of 8-25 will be hugely destructive and could be stopping thyroid hormones from working ... hence you feel so unwell.

This elevated RT3 level is probably the result of such elevated T4.

Your Vit D is too low .... Vit D is optimal about 75-100 ng/mL. Are you supplementing ?


yes...5000iu...1 tablet/day




I would guess you would feel a lot better medicating Levothyroxine with a little T3 added. This would allow you to reduce your high Levothyroxine dose whilst keeping the good T3 level. It is the T3 that gives wellbeing and so alleviates symptoms.

Unfortunately most doctors/endos don't like ( or aren't allowed) to prescribe T3 as although research is proving a subset of us need added T3 to function well, it remains controversial but you could ask endo about it.

Because your dose of T4 needs to be so high to achieve the required T3 levels, you are converting the excess T4 to too much RT3, which is cancelling out any benefits gained.

Having iron, Vit B12 and folate tested so allowing supplementation if required, will help thyroid meds to work better.

Good you are supplementing Vit D.

1 like

you have been very helpful. thank you.

1 like


People shouldn't supplement calcium unless calcium blood test shows low levels. Many people have deficient vitamin D with normal calcium.


You need to take K2 withyour D3 to make sure that calcium ends up in teeth and bones, not arteries




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