Thyroid UK

Test Results - Is my Levo working ?

So I'm currently on 100mcg Levothyroxine and feeling better than ever and just got my lab results back for some private thyroid tests:

Thyroid Function

TSH 1.98 0.27 - 4.20 mIU/L

Free T4 20.53 12 - 22 pmol/L

Free T3 5.46 3.1 - 6.8 pmol/L

I appreciate the TSH is still above 1 but the T4 and T3 seem pretty decent.

Can I deduce from the above that the Levo suits me and is working well ? I hear so much talk of combined T4 + T3 meds on here that I just wanted to check in because from a laymens point of view things look good.

Many thanks guys !

6 Replies

I'd say it's all about how you feel. If you are feeling better than ever, I see no reason for you to change your current treatment.

Some claim the TSH had better be below 2, and many people seem to do well with a TSH between 1 and 2.

Some people with Hashimoto's disease (autoimmune hypothyroidism) feel better with a really low, suppressed TSH (I'm one of them), as that can calm down antibody activity, but it's not necessary to have a suppressed TSH if you feel fine. And doctors seem to prefer it that way...I have to say I envy you these labs and the feeling of well-being. It would be so much easier to be able to just take T4, have labs in range and feel fine. T4 drugs are cheap (unlike NDT), and you don't have to constantly fight your doctor who claims you are overmedicated and therefore hyperthyroid...

To me, your lab results show that you are adequately converting T4 to T3, which is ideal. If this conversion is working, you don't need additional T3.

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Thanks very much for the comments Anna.

Since I increased to 100mcg it's like the world has suddenly to come into 'focus' again and things feel a hell of a lot better.

I did have problems initially with the higher dosage with feverish symptoms and some anxiety but that's died down now and the labs confirm that I've not 'swung' towards the hyper end.


Millions of people do well on levothyroxine and they certainly wont be on the internet looking for advice. Both your frees are at a good level.

The fact that you feel good suggests you are on an optimum dose at present.

If any symptoms occur you should have a blood test to check your levels before you increase. Usually increases are 25mcg each time until you are symptom-free but some doctors only go by the TSH and sometimes adjustments are made which are unnecessary. The best way for patients to judge is by how the feel.

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Thanks Shaws.

Quick Q - since I'm using the levo to replace what my body makes naturally I assume my Thyroid gland will gradually produce less and less T4.

Does that mean a dosage increase will definitely be on the cards or does the gland continue to function for life ?

I have Hashimotos btw.


I am not medically qualified but assume that some T4 might be produced naturally by the gland but not sufficient. The main fact of taking T4 is that it converts to T3 and it is T3 which is the active hormone which runs our metabolism.

Once diagnosed it is assumed it is a life-long condition and in the UK as it is classed as a serious condition if untreated, so any other prescriptions we get for any other conditions we don't pay.

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