Thyroid UK
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Results OK - What next?

I am 36, diagnosed Hypo 2009 after first child. Been on 100mcg Levo for years. Never seen an endo. I know I had antibodies done at first diagnosis and was told they were positive but I was told nothing more about it and I did not know what to ask. Just had my annual blood test and the results were OK. I really expected them to show I needed a dose change because I feel so rough.

TSH 0.8

T4 18

T3 5

Not got ranges as I was given them over the phone but the ranges from tests last April were TSH 0.4-5.5 (mine was 0.09)

T4 11-26 (mine was 20)

T3 3-6 (mine was 4.8)

I imagine the same lab this time.

Nothing else was tested this time although last April they did full blood count, Feritin, Vit D and glucose - all OK other than vit D was borderline but summer was coming so GP not concerned. I think B12 and folate have been done in the past.

I think if I go back to the GP they will think I am a moaning hypochondriac since my bloods were good but I am constantly cold (especially my feet), Irritable, enlarged tongue, terrible memory (most worrying - forgot to fetch my son yesterday), my hips hurt, dry eyes, fatigue, insomnia (which I have never had before), bad skin and gaining weight (granted I am not exercising or eating very well because I have not got the energy).

Also having abdominal pain and occasional diarrhea, been tested for coeliac and had ultrasound with no problems. They are reluctant to send cameras in because I had them a couple of years OK and nothing was found.

Do my symptoms sound Hypo or do they indicate something else? I need the confidence to go back to the GP without them thinking I am wasting their time. Or is there something I could try myself?

3 Replies

Hypo32 First of all, it really doesn't matter what they think, don't let that bother you, you have symptoms which are caused by something and they should be helping you to discover what is causing them.

Also, even when given results over the phone, ask for the ranges.

Let's assume the ranges are the same

TSH 0.8

(.4-5.5) - previously 0.09

T4 13

(11-26) - previously 20

T3 5

(3-6) - previously 4.8

So your TSH has lowered, FT3 virtually the same, but strangely your FT4 has decreased quite a bit, very close to the bottom of the range now whereas before it had just about reached the upper third. That's very strange if you are still on 100mcg Levo only, it would be more undersandable if you had added some T3 and maybe reduced your Levo at the same time.

"Nothing else was tested this time although last April they did full blood count, Feritin, Vit D and glucose - all OK other than vit D was borderline but summer was coming so GP not concerned. I think B12 and folate have been done in the past."

What does 'OK' mean, what were the actual results? OK usually means anywhere within the range, even one point up from the very bottom wand that would be dire.

There isn't really a 'borderline' with Vit D, according to the NHS there is

Less than 15 nmol/L : Deficiency

15 – 50 nmol/L : Insufficiency (consider supplementation)

50 – 140 nmol/L : Adequate

And the Vit D Council recommends 100-150nmol/L. So whatever your GP considered 'borderline' would be nowhere near the recommended level of 100-150, so you should have supplemented because unless you are a sunworshipper and went out every day when the sun was at it's highest, and exposed a fair amount of skin with no sunscreen, there's not much chance you could have improved your level to the recommended amount.

You really need current levels of all of them. They all need to be optimal for thyroid hormone to work properly, and ferritin needs to be half way through it's range, with an absolute minimum of 70.

Your positive antibodies mean that you have autoimmune thyroid disease, aka Hashimoto's. This is where the antibodies attack the thyroid and eventually destroy it. Even though you weren't told anything about it, it's not hard to find information.

You can help reduce the antibodies by adopting a strict gluten free diet which has helped many members here enormously. Gluten contains gliadin which is a protein thought to trigger antibody attacks. It's nothing to do with being coeliac.

Gluten/thyroid connection -

Supplementing with selenium, L-selenomethionine 200mcg daily, is also supposed to help reduce antibodies, as is keeping TSH suppressed.


Thanks for replying. T4 was 18 and I have absolutely no idea why I typed 13. The selenium comment is interesting as many years ago when I had an intolerance test I was told I was deficient in that but I never knew the link. I will get some.

My vitamin D was 70 and the printout said over 75 was adequate and 50-75 give lifestyle advice. I think I should maybe try supplementing that too.


Hypo32 OK, so we have (assuming ranges are the same)

TSH 0.8 (.4-5.5) - previously 0.09

T4 18 (11-26) - previously 20

T3 5 (3-6) - previously 4.8

I apologise, I previously said that TSH had lowered, it hasn't, it has risen (it was late!!! :) ) and FT4 has lowered.

Generally people feel best when FT4 is in the top third of it's range, and FT3 in the top quarter. Your FT4 is now 46% so below half way, and FT3 66% so two-thirds of the way through it's range. Those results, plus your symptoms, would indicate an increase in dose. Unfortunately, that may be hard to achieve as doctors just go by the numbers being within the range, not whether they have changed or where they lie in the range. You may, or may not, be able to persuade your GP by discussing these numbers. This may help, from 'Treatment Options' on ThyroidUK's main website

'Dr Toft (leading endocrinologist and past president of the British Thyroid Association) states in Pulse Magazine:

"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance.

But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)." '

You can obtain a copy of the article by emailing to discuss with your GP.

A good D3 supplement for you, as your level is 70, is one that isn't a very high dose but will raise it slightly and maintain that level. A dose of 2000iu Vit D daily should be adequate. As there are important co-factors needed when supplementing with D3 then a combo supplement will be easier. D3 should be taken four hours away from thyroid meds.

Co-factors -

Vit D aids absorption of calcium from food and K2-MK7 directs it to bones and teeth rather than arteries and soft tissues.

Some combo supplements: (I use this one) (check how many drops you'd need) (check how many drops you'd need)

When supplementing with Vit D, level should be checked once or twice a year. You can get this done privately with a fingerprick blood spot test for £28 from City Assays

Magnesium comes in different forms, check to see which would suit you best and as it's calming it's best taken in the evening, four hours away from thyroid meds.

It would be a good idea to get current levels of Ferritin, B12 and Folate.


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