Thyroid UK
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Need help deciphering results

Hi Experts,

I got my thyroid panel report today and following are the results:

TSH - 3.75 (0.5-4.5)

Free T3 - 3.1 pg/ml (2-4.4)

Free T4 - 1.22 ng/dl (0.8-1.8)

I was put on 88 mcg synthroid last month (TSH - 13) and d doc has asked me to continue it after taking a look at my reports. Even though I have lost weight and my hypothyroid symptoms like dry skin and flaking have become better, brain fog and short term memory issues still persist. The funny thing is that my Neuro symptoms became worse after starting Synthroid. I know it's a vague question but do memory relapses/cognitive issues take a lot of time to become better? I am thinking of experimenting with armour. Any advice would be super helpful as I am not sure if the medication is adequate and if the side effects are transient or permanent.

4 Replies

The question is: why did your doctor test after only one month? It takes at least six weeks for the levo to be completely absorbed and take full effect. When did he schedule your next tests?

You are only on a starter dose, and your TSH is still too high. You are going to need at least one more increase before you can expect to feel any difference in your brain fog, etc. Probably two. But, does your doctor really know what he's doing? That's another important question to ask!


When first diagnosed and given Synthroid (Levothyroxine in UK) the aim is to have a sufficient dose to bring your TSH to around 1 or lower. Most doctors think anywhere in the range is fine. The purpose of thyroid hormone replacement is to relieve all of our clinical symptoms.

4 weeks isn't long enough to know whether or not it will relieve your symptoms. The dose should be gradually increased until TSH is 1 or lower. Your TSH is far too high yet.

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For your body to be able to make full use of the thyroid hormones you are giving it you need good levels of nutrients to enable your body to convert your T4 (what you get from the Synthroid) to T3 (the active thyroid hormone). It is low levels of T3 that make people suffer from hypothyroid symptoms.

Becoming deficient in nutrients is an effect of being hypothyroid. A good diet won't fix many problems (although it will help).

You need to find out your levels of vitamin B12, vitamin D, folate and ferritin (iron stores). Even better than getting ferritin is getting a full iron panel.

if any of your levels of the basic nutrients are below optimal (which isn't the same as being in the reference range) then supplementation is vital.

For more info on recommended labwork see this link :

If your doctor won't order tests for you, then you can order your own tests from the links on that page.

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Thanks a ton guys for those kind responses. I believe my understanding of how synthroid works is limited. It would be great if you could shed some light on it. So basically the way I understand this is that after 6 weeks your TSH becomes stable at that particular dose. And if you want to bring it a tad lower, you need to increase your dose. Also is it common for the symptoms to worsen during initial days of treatment? All of my B12, vit D and ferritin are towards the higher end of the range and I am ingesting ferrous gluconate (150 mg), methylcobalamin (5000 mcg) and active D3 (1000 IU) on a daily basis.


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