Thyroid UK
87,472 members102,189 posts

Under active thyroid advice

hi there,

I am 32 was diagnosed with hypothyroidism approximately 5 years ago. I struggle with excessive sleep, exhaustion,excessive coldness, depression, weight gain etc. I am on levothyroxine 100mcg and have been since I was diagnosed. Over the past year things have been up and down, I have been tested every 3 months however the doctor has not explained why but I know myself that all hasn't been well. Experienced a period of increased energy, palpitations, disturbed sleep and anxiety and from looking at my blood results during that period I was bordering under active. I am back to feeling tired and lethargic now with heavy irregular periods. My latest results are tsh 3.8 (range 0.35 - 5) and ft4 20.8 (11-22) I know they are in range however I still feel pretty dreadful and I just feel that something is being over looked. Had full bloods this time and everything but my lymphocytes 4.7 (range I am unsure the start but told it was 4 at the upper level). Is there anything more I should be doing or requesting? I am going to get my previous results from the past year for reference.

Thank you for your help


7 Replies


I'm surprised TSH is so high when FT4 is almost top of range. FT3 is rarely tested in primary care so it would be worth you ordering a private thyroid test to check your FT3 level. Blue Horizon Thyroid Plus 6 will test TSH, FT4 and FT3 but if you can run to Thyroid Plus 11 that will include thyroid antibodies and vitamin and minerals too.


sounds to me like your body simply cannot convert the t4 in levo into the t3 that every cell in your body needs to function

its likely that




vit d3

are below the halfway in their ranges thats vitally needed to perform this conversion or that you have the DIO2 gene

1 like

Sounds very much as though got a conversion ptoblem but you need your FT3 testing to show that. Testing your vitamins as well is good as you could well be low in these and you need these to be high to help conversion it does work, I've done it me self but it needs time to start working.


Thank you for the replies. It sounds as though I need to get t3 tested, this has never been done on nhs so I will do this privately. If there was a problem with t3 would I be better requesting either an addition of t3 medication or a combination medication?

I have recently had vitamins tested as there was a query of anaemia due to dizziness and tiredness but told they are within range. If I get copies of them is someone able to have a look at them? I'm not sure where in range they are,

Thank you for your help 😄



Post your results with ranges (the figures in brackets after results) in a new queston and members will advise.

Combination T4+T3 medication is not available in the UK. Some CCGs insist a NHS endo recommends Liothyronine (T3) before a GP can prescribe it. If you can't get it prescribed you can buy it online without prescription.


Never accept NHS interpretation of "in range" by our standards you will probably be under medicated and low in vitamins etc. T3 is really important as that is what your cells use and some of us can't convert t4 to T3 properly.


Yes never accept "normal" as a result. You are entitled to the full results.(including the ranges- figures in brackets) The ones that need checking and need to be at very good levels are B12, folate, ferritin and vitamin D

Also have you had thyroid antibodies checked? There are two sorts TPO Ab and TG Ab. (Thyroid peroxidase and thyroglobulin) Both need checking, if either, or both are high this means autoimmune thyroid - called Hashimoto's the most common cause in UK of being hypo.

(NHS rarely checks TPO and almost never checks TG. NHS believes it is impossible to have negative TPO and raised TG. It's rare, but not impossible, there are a few members on here that have this.)

If you can not get GP to do these tests, then like many of us, you can get them done privately

Blue Horizon - Thyroid plus eleven tests all these.

This is an easy to do fingerprick test you do at home, post back and they email results to you couple of days later.

Usual advice on ALL thyroid tests, (home one or on NHSu) is to do early in morning, ideally before 9am. No food or drink beforehand (other than water) If you are taking Levo, then don't take it in 24 hours before (take straight after). This way your tests are always consistent, and it will show highest TSH, and as this is mainly all the medics decide dose on, best idea is to keep result as high as possible

As you have Hashimoto's then you may find adopting 100% gluten free diet can help reduce symptoms, and lower antibodies too.

You do not need to have ANY obvious gut issues, to still have poor nutrient absorption or low stomach acid or gluten intolerance

Best advice is to read as much as you can. Vitamin and minerals levels are very important, but standard NHS thinking, doesn't at the moment seem to recognise this. You will see, time and time again on here lots of information and advice about importance of good levels of B12, folate, ferritin and vitamin D, low stomach acid, leaky gut and gluten connection to autoimmune Hashimoto's too.


You may also like...