Thyroid UK
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Methimazole treatment

My treatment thyroid stated with T3 0.87, T4 6.10, TSH 0.01.I was put on methimazole 5mg and Ciplar LA 40. I was also having IBS issue to simultaneously. During treatment with above medicine T3=0.59 T4= 2.34 & TSH=42 has been reported. On the day of blood test i was on Code liver Oil.

Was the result altered with my this intake or these may be correct. or is it possible. Kindly help.

6 Replies

Do you have the reference ranges for your results? Without them it is hard to see what is going on.

Despite the lack of reference ranges, I can definitely say you should change your doctor as soon as possible. You were never hyperthyroid in the first place and should not have been put on the methimazole.

A TSH of 0.01 might be below the reference range - but it really isn't that low. Your T3 doesn't look high which it would be if you were truly hyperthyroid. I'm not sure about the T4. But we need those reference ranges!

If you have a thyroid problem at all, I would suspect that you have Hashimoto's Thyroiditis (often referred to as Hashi's), which is an autoimmune disease rather than a disease of the thyroid itself. The other alternative is that you may have had a temporary form of thyroiditis that would have settled without treatment, perhaps because of a virus.

In Hashi's the body creates antibodies (there are a couple of different kinds) which attack and destroy the cells in the thyroid. When the thyroid cells are damaged/destroyed the cells release the thyroid hormone they contain into the bloodstream. This has the effect of raising blood levels of Free T4 and Free T3 and lowers TSH. The patient may feel hyper symptoms e.g. fast heart rate, for a while. But Hashi's attacks tend to flare and subside, then flare and subside, over and over again.

Over time (it could be many years) the thyroid gets more and more damaged and is less and less capable of producing the thyroid hormone the body needs and eventually the patient becomes permanently hypothyroid (underactive), and will need to take meds to replace the missing thyroid hormones.

The proper treatment for Hashi's is to try and reduce the numbers of antibodies and thus reduce the number of attacks on the thyroid. Doctors never get involved with this, they usually just wait for the patient to become hypo and then treat that.

To reduce numbers of antibodies you would probably have to change your diet. Going gluten-free helps lots of people. Going dairy free or lactose free helps some. Removing nightshades might help. It really is a case of trial and error which things work for you.

When you had the TSH of 42 you were severely hypothyroid (underactive). I hope you were taken off the methimazole then.

What you need to do :

1) Find out the reference ranges for your tests.

2) Ask for thyroid antibodies to be measured. You need TPOAb and TgAb to be measured. You should probably have TRAb measured to, since your doctor put you on anti-thyroid meds. See this link :

3) Stop taking methimazole.

4) If I'm right about the thyroid antibodies you need to research everything you can about how to control the disease or put it into remission if possible. Search for sites written by Izabella Wentz who has written extensively on the subject.

Could greygoose radd Clutter check that I haven't written something stupid, please.


Thanks humanbean

i am humbled by your detailed reply.

The range for T3 0.6 to 1.81

For T4 it is 5.01 to 12.45

For TSH 0.35 to 5.50.

Additionally i had gone through thyroid scinti_scan.

The results were for both Right and left with size,shape, volume, weight being normal, normal, 4cm cube, 8gm respectively. The concentration, modularity as intense and well defined respectively.


This is additional info. One thing more i am 46 age male.

I missed to add the above info previously.

Your kind help in terms of your valuable advice is kindly sought hereby.


Warm regartds.


I'm still convinced you were never hyperthyroid. The reference ranges show your T4 and T3 were low in the reference range, but someone who is truly hyperthyroid would expect to have high levels of both.

It has just occurred to me - are the figures you quote for T4 and T3 ...

Are they Free T4 and Free T3? Or Total T4 and Total T3?

If your results are for Total T4 and Total T3 then you have again been served very badly by your doctor. The Total figures aren't helpful. The useful results are Free T4 and Free T3.

I'm afraid I can't help you with your scan results. And the T3 Uptake test is never done in the UK so I don't know anything about that either.


Totally agree with you, humanbean, s123sharma was never hyper and should not have been put on methimazole. Myself, i would have suspected secondary or tertiary hypothyroidism, where the problem is not with the gland itself, but with the pituitary, or the hypothalamus.

s123sharma, your doctor is totally ignorant and dangerous. Personally, I would demand to see an endo immediately - that is if I didn't sue my doctor for negligence!

Your results have nothing to do with the cod liver oil.


Thanks for checking up on what I wrote, greygoose . :)

I like your suggestion of secondary or tertiary hypothyroidism more than what I came up with.

s123sharma When I was low in T3 and low in iron I had a fast heart rate. I'm assuming that is what the Ciplar (a beta blocker) was prescribed for. But so many people assume it is only a hyperthyroid problem, when that is simply not true.

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Totally agree with you that thyroid hormones were never high enough to diagnose HYPERthyroidism. Using ranges later provided by O/P prove both T4 and T3 way were BELOW halfway through range indicating HYPOthyroidsim..



Welcome to our forum.

Why were you put on thyroid meds in the first place ? . What symptoms were you exhibiting ? ? ... Great advice already given by HB.

In a healthy person, thyroid hormones are tightly regulated by the hypothalamic-pituitary-thyroid axis.

Thyroid (aka thyrotropin) releasing hormone (TRH) is secreted by the hypothalamus, and stimulates the release of thyroid-stimulating hormone (TSH) from the pituitary gland. TSH instructs the thyroid gland to stimulate thyroid hormone production and release.

The main thyroid hormone secreted is T4, which is converted to T3 (by deiodinase in the peripheral organs). Secreted thyroid hormone reaches the hypothalamus and pituitary, where it inhibits production and secretion of TRH and TSH, thereby establishing the hypothalamic-pituitary-thyroid axis (HPT-axis).

Your results are typical of a person with SECONDARY HYPOTHYROIDISM, in that there may be no problem with the thyroid gland itself but the pituitary gland has given up encouraging the thyroid gland to make further hormone .... OR .... TERTIARY HYPOTHYROIDISM when there is no malfunction within the thyroid or pituitary glands but inadequate secretion of TRH (by the hypothalamus) to keep the pituitary gland secreting enough TSH to produce enough T4 and T3 from the thyroid gland.

In this scenario thyroid function would always be determined by the FREE T3 LEVELS and NOT TSH which so many ignorant doctors will try to use. I don't think you should have been prescribed methimazole based on these results as you are HYPOthyroid and your increased TSH of 42 upon administering of methimazole quantifies this statement.

Low thyroid hormone can directly influence bones and growth, blood sugar metabolism, brain (anxiety, fogginess,etc), cholesterol and gallbladder, heart and cardiovascular system, intestines (gut issues), liver (congestion) and red blood cell metabolism. Low iron can also heighten anxiety in people with thyroid issues.. Many members have found that once adequate thyroid hormone replacement is administered, many other issues self resolve.

HB suggested asking your GP to test for thyroid antibodies TPOAb & TGAb but also ask for a referral to an endocrinologist for testing of TRH & TSH to establish cause of low thyroid hormone.. Also ask your GP to test Vit B12, Vit D, folate and ferritin as people with low thyroid hormone are often deficient in these very nutrients required for good thyroid hormone synthesis.

Cod liver oil is excellent for thyroid health as provides omega-3s and aids in synthesising of vitamins A and D together.


Over view of the Thyroid Gland


Getting a Diagnosis


Thyroid & Adrenal connection


Cod liver Oil


Cod Liver Oil & Thyroid Gland


Thyroid & Gut connection

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