Thyroid UK
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Hypothyroidism, but no symptoms? Is this typical?

I'm 26 years old, 5'4" and 108 lbs. I have no hypothyroidism symptoms except my TSH level was 7.56. (Also low Vitamin D)

I moved recently and found a new GP, so she did bloodwork to get a base. I never really had a full blood work up before. I mentioned both my mother and my younger brother have hypothyroidism (both are also overweight) and my aunt has Graves Disease (She is having surgery for her eyes).

I also have high cholesterol so I'm currently changing my diet drastically. I really liked fried and processed foods, but I've stopped cold turkey. I'm committed to eating very healthy now and, honestly, I'm surprised after toughing it out for a week it's much easier!

Anyways, She started me on 25mcg Levothyroxine and I'm going to get an ultrasound on my thyroid to see if I have any nodules (apparently my brother has one on his.). I'm also going back to get blood work done in 1 month. She seemed a little concerned with my TSH level as I have no symptoms and mentioned recommending me to an endocrinologist after these tests.

Should I be worried about loosing too much weight? Not only am I eating way healthier, but also starting on Levothyroxine? I've been reading up here on this forum a little. Should I ask for other tests? Like T3 and T4? Is this typical or not really? I guess I'm looking for general opinions and information.

1 Reply

Welcome to the forum, WynafredAbernathy.

High cholesterol is a symptom of hypothyroidism. Cholesterol will usually drop once the patient is optimally medicated on Levothyroxine. Some patients are found to have high TSH during incidental blood work and may not have the obvious symptoms of hypothyroidism. There is nothing sinister about lack of symptoms, you are fortunate that treatment has commenced before you are symptomatic.

It would be useful if your GP added thyroid peroxidase antibodies to your blood order to see whether autoimmune thyroiditis (Hashimoto's) has caused your hypothyroidism. It is preferable to have TSH and FT4 tested rather than just TSH but it depends what agreements your practice and CCG have with the lab as to what will be tested. FT3 is rarely tested in primary care as NHS is looking for evidence of hyperthyroidism not low T3 in hypothyroid patients.

You should be concerned if you lose too much weight and should make necessary dietary adjustments to maintain a proper weight.

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

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 Levothyroxine. Arrange an early morning and fasting (water only) blood draw when TSH is highest, and take Levothyroxine after your blood draw.

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