Thyroid UK

Starting treatment with Levothyroxine

Hi Folks - Merry Christmas and I hope you are finding some peace and space to relax. I had a follow-up meeting with my endo on 23 Dec and the results of my MRI are that my pituitary is all clear, phew. 9am blood cortisol and other tests are here:


Oestradiol 84 Follicular 46.0-607.0 pmol/L

(this was on day one of my period, hence low)

Ovulation 315.0- 828.0

Luteal 161.0-774.0

Postmenopause <201.0

Testosterone 0.2 <1.8 nmol/L

DHEA-Sulphate 3.1 0.26 - 11.0 umol/L

Cortisol (8-10am) 236.4 133 - 537 nmol/L

Thyroid Function

TSH 1.20 0.27 - 4.20 mIU/L

Free T4 12.14 12 - 22 pmol/L

Endo has started me on 25mcg Levothyroxine for 2 weeks then rising to 50mcg. He says the Hashimoto antibodies are a separate concern and to go gluten free etc for this. He thinks I have a pituitary signalling issue which is causing the low-ish TSH despite low fT4 and low fT3. The Levo is to address this. He thinks stress is probably the likeliest cause and there is the possibility of reversal in a couple of years if I can manage my stressors, in the broadest sense - diet, relationships, work, environment, sleep etc. Meanwhile I also have to tackle the anti-bodies too of course. I'm taking all the supps recommended on here and in other books I've read. Still got neuropathy but seems to be decreasing as I'm hammering the B12.

Fingers crossed things start to improve as the meds and the regime kick in.

Thanks for reading and contributing to this wonderful supportive forum.

4 Replies

I am glad your news is positive and it's good Endo is raising dose in a couple of weeks. Autoimmune Thyroid Disease is diagnosed due to having antibodies in blood also called Hashimoto's.

Many members who have hashi's have found a benefit going gluten-free as this reduces antibodies which attack your gland.

I haven't heard before that someone can recover from a thyroid disease but I am not a Specialist nor medically qualified.


Thank you for the excellent links, the second article is particularly interesting as I do fit the profile of low TSH, low fT4 and fT3 and yet have anti-bodies and horrible symptoms.



It appears that you have secondary hypothyroidism which is due to lack of TSH stimulating an otherwise healthy thyroid gland. This is usually a pituitary dysfunction sometimes only causing isolated TSH deficiency but sometimes causing other hormone deficiencies too. If you have positive thyroid antibodies (Hashimoto's) too it is highly unlikely there will be any reversal of hypothyroidism as Hashimoto's usually destroys the thyroid gland over time.

There is no cure for Hashimoto's which causes 90% of primary hypothyroidism. Treatment is for the low thyroid levels it causes. Many people have found that 100% gluten-free diet is helpful in reducing Hashi flares, symptoms and eventually antibodies.

For maximum absorption Levothyroxine should be taken with water 1 hour before, or 2 hours after, food and drink, 2 hours away from other medication and supplements, and 4 hours away from calcium, iron, vitamin D supplements and oestrogen.

It takes 7-10 days for Levothyroxine to be absorbed before it starts working and it will take up to six weeks to feel the full impact of the dose. Symptoms may lag behind good biochemistry by several months.

You should have a follow up thyroid test 6-8 weeks after starting 50mcg Levothyroxine. Arrange an early morning and fasting (water only) blood draw when TSH is highest, and take Levothyroxine after your blood draw.


I am not a medical professional and this information is not intended to be a substitute for medical advice from your own doctor. Please check with your personal physician before applying any of these suggestions.

1 like

Thank you very much for the advice and Chris Kresser, he's such an informed and holistic doctor, very interesting. I've decided to take the Levo at bedtime, at least 2 hrs after eating or drinking. Will see how that goes. Thanks again!


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