Hello I'm new on here. I was diagnosed with an underactive thyroid about 6 years ago and have been on 50mg of Levothyroxine ever since. Still suffering with awful tiredness, very dry skin, my eyebrows are thin & barely grow, feeling cold & other typical symptoms. My recent bloods test say normal no action yet I feel awful. My doctors have been good enough to request t4 & t3 levels as normally they only do TSH.
Serum TSH level - 3.5 mu/l - (0.35 - 5.0)
Serum T4 level - 15.6 pmol/l (9 - 24)
Serum T3 level - 3.6 pmol/l (3.5 - 6.5)
Vitamin D Serum total 25-OH 64 nmol/l (75 - 200) advised to take a supplement as a bit low.
any thoughts would be appreciated
Can I get some thoughts on these blood test results?
Recent Hashimotos diagnosis - latest blood tests ‘normal’ but feel awful 
3rd blood test result (with ranges) on Levothyroxine, feel awful advice please.
Hashimotos, recent blood test results, feeling awful :(
Is my blood test normal?
Hi Denny333 and welcome.
I think your doctor's have let you down big time
50mcg Levo is a starter dose. After you were diagnosed and prescribed your starter dose, you should have been re-tested after 6 weeks, dose increased by 25mcg, retested after another 6 weeks, dose increased again, etc, until your symptoms alleviated.
The aim of a treated hypo patient is for TSH to be 1 or below or wherever it needs to be for FT4 and FT3 to be in the upper part of their ranges.
Your TSH is far too high for someone on Levo. Your FT4 is less than half way through range and your FT3 has just scraped in at the bottom of range, no wonder you are still suffering all those symptoms.
Dr Toft, past president of the British Thyroid Association and leading endocrinologist, wrote this in a Pulse Online magazine article:
"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.
In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance.
But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.
This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."
Maybe your GP would be interested in this. If you email louise.roberts@thyroiduk.org.uk she will let you have a copy of the article which you can print out and show your GP because he seems to need educating.
Whilst at your next appointment ask for the following tests
Thyroid Peroxidase antibodies
Thyroglobulin antibodies
The antibody tests will rule out, or in, autoimmune thyroid disease.
Plus
B12
Ferritin
Folate
All these vitamins and minerals need to be at optimal levels for thyroid hormone to work properly.
Also, when having blood drawn for your thyroid tests, always book the very first appointment in the morning, fast with water only from the previous night's meal (breakfast when you get home), and leave off Levo for 24 hours. That will give you the highest possible TSH which is what we need for a dose increase.
For your Vit D supplement, buy a decent D3 (I like Doctor's Best as it only contains D3 and olive oil) 5000iu and take daily for a couple of months. Retest and when your level reaches the recommended 100-150 reduce to 5000iu alternate days. If your GP won't retest you can get it done with City Assays for £28, an easy at home fingerprick blood spot test.
With D3 we also need to take K2-MK7. Vit D aids absorption of calcium from food and K2 directs the calcium to bones and teeth rather than arteries and soft tissues. Magnesium is another co-factor when taking D3 so you should also take that.
That has been so helpful. Thank you! I will definitely email for this article & take it to my next appt and I will also ask for the other tests. Thank you also for the recommended vit d to take as the dr didn't advise on what I should take.
Too low a dose can also cause other serious problems and I fail to reason why doctors/endos appear to be the least people to know how to diagnose/treat patients' symptoms rather than the TSH. You state:-
"Serum TSH level - 3.5 mu/l - (0.35 - 5.0)
Serum T4 level - 15.6 pmol/l (9 - 24)
Serum T3 level - 3.6 pmol/l (3.5 - 6.5)"
Once diagnosed our TSH should be down to 1 or lower.
T4 (inactive hormone) is low and the most important T3 (active) is at the bottom of the range instead of towards the top.
No wonder you feel bad. I hope you can now impove your symptoms as we have to read/learn in order to feel much better.
Always have the earliest appointment for the fasting blood test (you can drink water) and allow 24 hours approx between our last dose of levo and the test and take it afterwards.
I wish I had found this site years ago. In less than 24 hours I have been given so much information and with that a better understanding of my results. I will be going back to the dr as soon as I can get an appointment. I will let you know how I get on. Thank you all ☺️
Your GP may not want to change your dose, so change your doctor. They really haven't much idea how bad we can feel when undermedicated. Some doctors pay no attention to Dr Toft's (ex President of the BTA) article. Any increases should be by 25mcg increments every six to eight weeks until you have no symptoms.
Tell your doctor undertreatment can cause more serious illnesses and that you've taken advice from the NHS Choices for thyroid gland dysfunctions.
Some of our members cannot get well on levo although thousands do (but they wont be on this site) there are a few alternatives but may have to self-source as the BTA state that levo is sufficient. However, I think as your dose is increased you will feel much better.