Thyroid UK
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Confused - fight to keep dose or decrease

Hi I read the replies to 'Anybody at their best Ft4 16-17?' yesterday and am now confused about my own results which is a problem as I have GP appt tomorrow.

Clutter was the only person to reply when I put these results on my last post 'Exercise and TSH - new blood results !' and we seemed to agree that though my T4 is high and TSH low, as long as my FT3 was in range and no hyper symptoms then fighting to stay on 125mcg was reasonable.

I feel 'normal' the best I have since diagnosis, bar some tiredness which I think is explained by my vitamin results, definately NO hyper symptoms. My dry patches/splits are finally healing and I appear to be producing oil in my scalp and skin again which bodes well for my hair loss issues. My brain fog is greatly improved and again probably vitamins

I felt awful on 100mcg and really do not want to mess things up when I feel so well, but then I read replies on the mentioned post like - TSH stimulating conversion - stimulting deiodinase activity - keeping TSHhungry........ and my brain hurt.

Research found this paper which suggests my TSH is low but not quite suppressed so no identified risk of heart/bone issues

I was beginning to suspect a conversion issue as both my TSH and FT4 were rising together, albeit T4 slowly (see bio) and symptoms not improving - no FT3 done by lab of course. Now Ive had this huge jump on a little increase. I am assuming no issues with pituitary itself??

So...... in light of below results I would appreciate advice. Please dumb down anything too technical, Ive been on nights !!!!!!

NHS ranges - TSH -0.3-4.2. FT4 -12-22 noFT3

23/01/17 - 5.1 - 16.7 - raised to 125mcg from 100mcg

22/03/17 - 0.05 - 23.3

MEDICHECKS ranges - TSH -0.3-4.2 FT4 -12-22 FT3-3.10 - 6.8

22/03/17 - 0.051 - 21.81 - 4.78


B12 164 pmol (140-724) -sub optimal

folate 6.54 ug (3.89-26.80) - sub optimal

25 OH D 15.24 nmol (50-200) - dire

ferritin 141.2 ug (13-150) - slightly above optimal?

Antibodies negligible

(No exercise for 2 days due to heavy cold)

(fasting early morning tests before levo)

Should I ask to keep 125mcg until we sort out vitamins, which may be interfering with conversion of T4 hence the need for so much of it to get decent T3 level where I feel normal?.

2 Replies


As I said previously, suppressed TSH doesn't mean you are over medicated because your FT4 and FT3 are within range. Read Treatment Options in Email if you would like a copy of the Pulse article to show your GP.

TSH responds to T4 and T3 levels. When pituitary senses sufficient T4 and T3 TSH will be low. TSH does stimulate conversion of T4 to T3 in the thyroid gland but conversion also goes on in the major organs without TSH. Comments like "keep the TSH hungry" are rubbish. That basically means TSH should be kept high and the only way to do that is to under medicate.

VitD is severely deficient. My GP prescribed 40,000iu D3 x 14 days followed by 2,000iu daily x 8 weeks and vitD rose from <10 to 107. Good levels of vitD do help conversion of T4 to T3. VitD should be taken 4 hours away from Levothyroxine.

Ask for advice about B12 and folate on

Ferritin can be raised by a cold or infection at the time of testing. Your ferritin is within range so nothing to worry about.


Thanks Clutter, I was a bit sleep deprived when reading and wasnt sure some of the replies made sense but there were unfamiliar technical bits too. Didnt want to try and fight doc and get shot down for using bad info as once that credibility is gone I would never get it back!!


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