Thyroid UK
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Help please

My latest results:

Tsh 0.05 (0.35-5.5)

Ft4 18 (10-19.8)

I was on 75 mcg and then my tsh was the same and ft4 19.4. we decided to take 1 day 75 and 2 of 62.5. I felt fine for a couple of weeks and now back to feeling rubbish. What to do...

My results on 50mcg was

Tsh 2.8

Ft4 13.5

What do you advise? To lower my dose?

I don't feel well. All very tired still.

9 Replies

I am sorry you aren't feeling well at all. I am not medically qualified but I think too much emphasis is put on the TSH once we are taking thyroid hormone replacements.

I also think, unless you are very frail with heart disease, your dose is too low. Even though your FT4 is good you don't know how much T3 is circulating in your blood and it is T3 which is the active hormone. T4 (levothyroxine) is inactive and it's job is to convert to T3 (liothyronine) which is required in all of our receptor cells.

Doctors/labs rarely take T3 as the assumption that TSH and T4 are the only results to be considered but that's not helpful if patient is suffering.

Do you have your blood tests at the very earliest, fasting (you can drink water) and allow 24 hour gap between your dose of levothyroxine and the test? If not, your results will be skewed.

Your Doctor should test B12, Vit D, iron, ferritin and folate as we are usually deficient and that, too, can cause problems. We have recommended private labs who will do a Free T3 test and it is a home test and I'll give you a link, the first will give you info on FT4 and FT3.

Always get a print-out of results with the ranges for your own records.


Thank you.

It's so hard to get this right.

Have tested all vitamins and they were all fine

Vit Det was 75 is that enough?

Will try to convince them to test ft3 otherwise order it online. I just feel that if I do and it shows low levels then they won't give me any t3 anyway so what use does it do, except for me knowing.

Thank you for trying to help.

Would you recommend that I stay on this dose till ft3 is tested?


Have you posted the results of your vitamins/minerals? If not you should get a print-out from the surgery.

Even if your FT3 is low, they should raise your T4 (levo) to enable more T3.

Your Vit D is fine.

If your vitamin B12 was low, you should be supplementing with sublingual methylcobalamin B12 as that is another very important vitamin which can help avoid nerve damage/neurological damage if it is too low. Both B12 and Vit D are pro-hormones rather than vitamins.


No I haven't but all the others were at the top of the ref range. B12 over range 900. Did supplement the week before test but not 24 h before.

Do you think they would do that when I have a tsh of 0.05?

So I get it you think I shouldn't lower my dose?


If results were towards the top of the range you don't need to post them.

I am not medically qualified so cannot advise on dose I can only suggest - but others will be along who know more than I do and you'll have other comments. :)

What I will say is that if we have continuing clinical symptoms that our dose isn't sufficient. The TSH varies throughout the day, i.e. high early a.m. and drops throughout the day so if doctor treats/prescribes for the patients' TSH and not the clinical symptoms, the patient wont feel better.



It doesn't matter that TSH is suppressed. You are not over medicated because FT4 is within range and as FT4 was within range when you were taking 75mcg there was no need to reduce dose. Read Treatment Options in Email if you would like a copy of the Pulse article to show your GP.


Do you think I should increase to 75 again? Can't see doc before April unfortunately.



I would if I felt better on 75mcg than your current dose and had enough Levothyroxine.


When on 75 the half moons of my nails suddenly appeared again and the cuticles were not longer on the nail and less ragged. So it feels like my body needed that. But, I'm not sure if I felt better, was on Teva then. Just afraid that it will be bad to have a speed tsh. Thinking of the study someone's posted a while ago about high levels of ft4 increasing the risk of cancer.

It's never easy is it?


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