Thyroid UK
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My memory is shot and I'm SO confused AND tired

Hi I'm new to this site but have had under-active thyroid for 18 years. I'm afraid this may be a lengthy post! I also have polycystic ovary syndrome (PCOS), and in last 2 years have been diagnosed with B12 deficiency and pernicious anaemia... I also have gastro intrinsic factor (GIF) which means I cannot absorb vitamins etc. easily from food. I recently ask my Drs. for the last 7 years blood test results and in reading them feel more confused than ever. Daily I take 125 mcg levothyroxine; 2000mg calcium and Vit D and 30mg lansoprazole (because of my stomach issue) and have B12 injected every 3 months.

The British Thyroid Foundation state that typical reference ranges for normal thyroids are:

TSH: 0.4 - 4.0 mU/L (milliunits per litre)

FT4: 9.0 - 25.0 pmol/L (picomoles per litre)

FT3: 3.5 - 7.8 pmol/L (picomoles per litre).

However when I put all my results in a spreadsheet my TSH levels are up and the T4 going down – I read also on BTF that usually a high TSH level with a low FT4 level: hypothyroidism (under-active thyroid) but a low TSH level together with a low FT4 level can indicate a disorder of the pituitary gland – so from the below is there now an issue with my pituitary as the T4 levels have dropped quite a bit?

My readings are

01/02/2010TSH 0.162 T4 21.46;

17/06/2011 TSH 0.178 T4 20.08;

19/07/2011 TSH 0.041 T4 24.25;

04/09/2012TSH 0.178 T4 21.88;

03/05/2013TSH 0.064 T4 24.12;

31/05/2014TSH 0.562 T4 19.11;

26/10/2014TSH 0.14 T4 19.8;

19/02/2015TSH 1.79 T4 14.3;

24/03/2016TSH 1.5 T4 13.6

Sorry there is so much information but I've been feeling rotten for a while and need to tackle this as I'm sick of saying "tired", "I forgot", "I don't remember" or the concentration is so poor that I cannot even recall being spoken to just a few moments ago!

3 Replies


A low-normal TSH with low FT4 when you are first diagnosed can indicate central hypothyroidism due to pituitary or hypothalmus dysfunction. If your TSH was high at diagnosis you have primary hypothyroidism due to failure of the thyroid gland.

Laboratory ref ranges are not universal and can vary considerably from what the BTF allege are typical ranges. You should always ask for the lab ref ranges when you ask for your results.

TSH rises when FT4 drops in order to prompt the thyroid to produce more T4 and T3 hormone.

TSH 1.5 is a tad higher than most people are comfortable with particularly as FT4 13.6 may be low in range (my guess as you have not supplied a ref range).

As you are having issues with brain fog and concentration it may be worth you ordering a private thyroid test to check your FT3 level. Low FT3 is what causes hypothyroid symptoms.

The medicines and supplements you are taking will affect absorption of Levothyroxine so make sure Levothyroxine is taken at least 4 hours away from calcium, VitD and Omeprazole.

If you need advice about PA, B12 deficiency and folate go to


Hi Clutter - I have never had T3 tested so will do that. For the last two months I have started taking my levo in the evening after reading on this site that that was the best thing to do - so well after I have taken the other medications; its beggars belief as I asked originally whether I could take them all together and was told it was fine! For the TSH 1.5 I do not know what reference range you mean so forgive the ignorance.

I am already checking out the PA site but thanks for pointing me in their direct.



Hi Clutter

I have received my T3 results and it is 3.6 and reference range is 3.1 - 6.8. So should I take T3 to increase this slightly to middle range.

I've been reading about (here) about bloating and oedema and taking T3 will help with that as I always suffer with swollen ankles so much that I tend to wear boots to keep the swelling down and never thought it could be due to thyroid illness.



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