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Thyroid UK
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Variable TSH Levels and more severe symptoms after Thyroid "disappeared"

Being diagnosed with hypothyroidism 25 years ago and currently on 150-175 mg Thyroxine and no thyroid glad. For 24 years thyroid problem well controlled and no major side effects, however since thyroid glad "disappeared" (a situation described as normal after many years of hypothyroidism), symptoms more pronounced and cannot seem to stabilise the situation.

5 Replies


Welcome to our forum and sorry to hear you are feeling unwell.

The thyroid gland can become atrophied through little or no use and this may happen quickly or over many years. The implications are as thyroid hormone output is reduced, the more would need to be replaced so your med dose would be raised according to test results.

Thyroid hormone replacement depends on many factors to work well and it could be nutrient or iron deficiencies (common in hypothyroidism) caused by years of medicating are effecting the workings of your meds.

Ask your GP to test Vit B12, folate, ferritin, Vit D and post results complete with ranges (numbers in brackets) for members to comment. Also post any recent thyroid test results, as our requirements for hormone replacement can alter as we get older and you may be under medicated.


Thanks very much. Will do.


Most recent Thyroid tests were as follows: Free T4 16.5 (normal 9-23); free T3 4.5 (normal 2.5-5.7); TSH 0.07 (normal 0.3-4.2); Vit B12 normal; Ferritin 19 (normal 20-300); Transferrin saturation (%) 13 (normal 16-55); with weakly positive adrenal antibodies. Following these results i have reduced the Thyroxine from 175mg to 150 mg and subsequent test of TSH within normal range; symptoms have worsen with painful legs and muscles, sometimes shortness of breath, dry skin in hands, legs and mouth, dizziness and low heart rate. These symptoms coincided with the diagnosis of an atrophied thyroid glad; Obviously something is not quite right but as is the case with Thyroid problems, the question is what?



Iron//nutrient deficiencies are common in hypothyroidism due to gut malabsorption issues (hypochlorhydria).

Both T4 & FT3 just over halfway through range. Most medicating Levothroxine function better with hormones in upper third of range. This doesn't always mean you are under medicated but that maybe the meds are working properly.

Your Vit B12 result is only shown as "normal". A doctors "normal" may not be the same level as that which members have found to be most beneficial for good thyroid function. Your Vit B12 result should read at least 500 but nearer to a 1000 is preferable.

Your Ferritin is not " normal" but deficient as results are under range ! ! . The body needs iron for carrying oxygen throughout the body and to assist in digestion (enzymes), but more importantly when levels are low it slows down the conversion of T4 to T3 (deiodinase activity) as requires iron containing enzyme Thyroid Peroxidase to produce the thyroid hormones ...... ... .so impairs good thyroid hormone synthesis.

Optimal ferritin levels are usually about 70 -90 so you will need to supplement. Members supplement Ferrous Fumarate, taking each iron tablet with 500mg-1,000mg vitamin C to aid absorption and minimise constipation. I don't supplement iron so repost a question re dosing.

Consuming dairy products, coffee, tea, chocolate and eggs with iron can interfere with the absorption. Medicating antacids, proton pump inhibitors (to treat acid reflux) or calcium supplements with iron can inhibit absorption.

Ask your GP to retest after 6 months and take the tablet four hours away from Levothyroxine to prevent it from binding and reducing thyroid hormone availability..

..[... painful legs and muscles, sometimes shortness of breath, dry skin in hands, legs and mouth, dizziness and low heart rate ..]... can be symptoms of low thyroid hormone but also nutrient//iron deficiencies. Post your Vit B12 result. Have you had Vit D & folate tested ? .





Iron & Thyroid connection



Thyroid & Important Nutrients



Thanks very much for a very helpful and informative response. Very grateful. Will follow up the kind suggestions.


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