Thyroid UK

Ideal levels

I was found to be hypothyroid about 6 months ago and started on 25mg Levothyroxine per day. After two months my TSH blood test was redone and my dose was increased to 50mg a day. When my TSH was done 2 months ago I was told it was satisfactory and kept on 50 mg. My T4 and T3 have never been tested and my gp hasn't said anything about any more blood tests. I have since found out that my last TSH was 3.8 but I'm sure I read somewhere that ideally it should be lower on Levothyroxine. My fatigue is still very bad but as I also have myasthenia gravis and seronegative Sjögren's syndrome it's hard for me to know what to blame for what. Any help would be appreciated.

3 Replies


I think you are under medicated. The goal of Levothyroxine is to restore the patient to euthyroid status. For most patients that will be when TSH is 1.0 or lower with FT4 in the upper range. FT4 needs to be in the upper range in order that sufficient T3 is converted. Read Treatment Options in Email if you would like a copy of the Pulse article to show your GP.

If your GP won't test FT4 and FT3 (few GP practices test FT3) you can order private thyroid tests but I would wait until your TSH is around 1.0 before paying for a private test because FT4 and FT3 are low when TSH is high.


ask your gp to test




vit d3

unless all 4 are at least halfway in their ranges the levo /t4 cannot be correctly utilised in the body and the fatigue will continue no natter how much levo you take


Hi jackie-2124, I empathise with you. I am new to this site. I had hypothyroidism diagnosed 27 yr ago. Managed well. Recently diagnosed with sjogrens syndrome. O my goodness. What a nightmare as you say not knowing which is causing what!

I am very hopeful we will learn a lot on this site. I am very happy with how much I am learning so fast from users of the site sharing.

I do not feel knowledgeable enough yet to offer advice other than tell you sjogrens is very dibilitating especially as not a lot is known about it.

I have joined BSSA British Sjogrens Syndrome Association. I have found it a very informative site. I now get uptodate literature through the post. I will be attending my first self help group in March! So looking forward to it.

Invisible illness causes misery because people can be ignorant, dismissive and/or unkind. Sharing with people suffering from sjogrens can only be of benefit.

I send you best wishes for your fatigue to improve soon. Take care of yourself. I am learning to do just that everyday..

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