Thyroid UK
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Primary hypothyroidism

HI All

Am paying to see a specialist this week. Want to go armed so I at least sound like i know what I'm talking about.

1) I have 2.5 pages of symptoms

2) Id like to know what are considered to be optimal ranges for bloods please and then when they do the tests I have argument if I need one

3) how many days before the test would you stop taking all your meds? Would you also stop HRT and Anti D's?

4) What is the difference between all the different types of natural thyroid medication please and why would i ask to choose one over another? I currently take 100mcg of levo and 20mcg of lio (split into two doses) each day - all my symptoms seem to be creeping back and i feel really mentally and physically unwell

5) what questions would you be asking?

Thanks for your help all

3 Replies


On T4+T3 combination optimal thyroid levels are likely to be low TSH <1.0, low-mid range FT4, and FT3 in the top third of range.

You'll skew results if you stop taking thyroid medication before your blood test but you should take Levothyroxine and T3 after your blood test.

Natural Dessicate Thyroid (NDT) is combination T4+T3 derived from pig thyroid. Patients who don't feel well on synthetic Levothyroxine (T4) and Liothyronine (T3) may do better on NDT. NDT isn't licensed for UK use so it's rarely prescribed on NHS but your private specialist might be willing to prescribe it.

Do you have TSH, FT4 and FT3 results since you've been taking 100+20? It's also important to have optimal levels of ferritin, vitamin D, B12 and folate.

1 like

Thanks Clutter -

Serum TSH 0.03mu/l (0.35 - 5.0)

Serum Free T4 13.4 (9 - 24)

serum free T3 5.1 (3.5 - 6.5)

serum ferritin 59 (15 - 250)

serum total vit d 93 (75 - 200) Optimally replete

serum calcium 2.17 (2.10 - 2.60)

calcium adjusted 2.15 (2.10 - 2.60)

total alkaline phosphate 56 (30 - 130)

b12 388 (200 - 900)

serum folate 9.2 (2 - 17)

I quite literally could sit and sin with exhaustion.........



Results aren't optimal but aren't so bad that you should be feeling exhausted. There is scope to increase T3 dose a little to raise FT3 a bit higher which may improve symptoms.

B12 is a little low, 1,000 is optimal. Supplement 1,000mcg methylcobalamin and take a B Complex vitamin.

Ferritin is optimal >100 through to half way in range. Supplement iron with 1,000mcg vitamin C to aid absorption and minimise constipation.

VitD, calcium and alkaline phosphate are fine.


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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