Thyroid UK
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Advice please

Please could someone help advise, I am new here and I am a 25yr old female diagnosed with hypothyroidism in 2012. I am currently taking 200mcg levothyroxine and 20mcg T3 but my symptoms are not easing at all and I don't know why. I am feeling the cold, I am more anxious and feeling low, periods coming more frequently, losing hair, eyes going puffy, joints in hips aching, constipation, tiredness, trouble sleeping, ears ringing, pins and needles in feet, headaches. The endocrinology department I was with have transferred me to another hospital. I am sure it is because they don't know what to do with me and are at a loss as to why my thyroid levels are not improving as well as they should be. I am due another thyroid test because of my dose being raised but I am holding off testing because I am waiting to feel better first so I know that my dose is working. Feedback is appreciated thank you.


++Thyroid peroxidase antibodies 275 (<34)

++Thyroglobulin antibodies >2000 (<34)

Serum TSH 2.01 (0.27 - 4.20)

Serum free T4 14.9 (12.0 - 22.0)

Serum free T3 4.1 (3.1 - 6.8)

12 Replies

You seem to be on a very high dose. What were your test results before you were put on medication. Sometimes a very high dose and overmedication can make you feel as bad as not being on enough. But need to know your lab results before medication.


Thank you before I was put on medication my results were

++Serum TSH 21 (0.27 - 4.20)

++Serum free T4 10.2 (12.0 - 22.0)

Serum free T3 3.6 (3.1 - 6.8)

++Thyroid peroxidase antibodies 88 (<34)

I was put on a starter dose of 25mcg levothyroxine.


Blu is on a high dose but according to the results is also under-medicated (high TSH, low FT3)



Welcome to our forum.

Your FT4 & FT3 are below half way through range and many members find a TSH of around 1.0 brings well being. You are medicating quite a substantial dose of replacement meds but remember your results are only indicative of the amount in your blood stream and not what is working on an intracellular level.

You have elevated thyroid antibodies which can impact how thyroid hormone replacement works. Because the immune system is in a heightened state, many experience an over reaction to gluten ( and dairy) which can cause autoimmune damage to the intestines resulting in pain & poor absorption of nutrients.

Good thyroid hormone synthesis requires healthy gut flora, adequate iron and nutrient levels and balanced adrenal hormones. Adrenal fatigue and gut problems are common in thyroid disorders as the insidious nature means a late diagnosis when the patient feels quite unwell.

A gluten free diet and optimal nutrients will help the bodies immune responses to dampen, and slow the progression of Hashimotos. Supplementing selenium has not only been shown to reduce TPOAb but encourages the T4-T3 conversion of thyroid hormones. (T3 is the active hormone that is required for well-being).

A good read is "The Root Cause" by Isabella Wentz. Having one auto immune disease may predispose you to others and common ones found together with Hashimotos are Rheumatoid Arthritis, Pernicious Anaemia and Celiac Disease.




Gluten & Thyroid Connection


Selenium Reduced TPOAb.


Selenium also helps with T4-T3 conversion


Medics seem to disregard the Hashimotos aspect (your high antibodies) but many of us with Hashimotos find we don't feel better until we tackle this

Going strictly gluten free helps a great many. Lots of us find it lowers TPO antibodies slowly over time (mine have halved in a year of being gluten free)

See explanations why at The Thyroid Pharmacist website or Chris Kresser or Amy Myers sites good too

Checking and maintaining good levels of vitamin D, folate, ferritin & B12 very important

Always get copies of all your test results including ranges

Look at gut infections as well

Also best to avoid all soya

As you improve gut you might need to take less thyroid replacement


Thanks I have results of vitamins and minerals and I supplement them but they are not improving either.


January 2017

Serum ferritin 17 (15 - 150)

Serum folate 2.38 (2.50 - 19.50)

Serum vitamin B12 241 (190 - 900)

Total 25 OH vitamin D 33.1 (25 - 50 vitamin D deficiency supplementation is indicated)

I am taking 800iu D3 and 5mg folic acid and they are on prescription.


These are all far too low. No wonder your thyroid hormones are not doing much at all.

See many of SeasideSusie excellent replies on supplements about what you need to take to improve all these

Start with one supplement at a time. Probably improve vitamin D first. You will need loading dose for few weeks - typically 5000iu - can buy your own - soft gels are recommended. Read on here about also taking magnesium & vitamin K2 when supplementing vitamin D

B12 & folate - are so low ask GP for full testing for Pernicious Anemia & intrinsic factor

Improving gut by going gluten free and good probiotic should also help improve nutrient & Levo absorption


You're under medicated with your TSH being at 2.01. The goal is to get the TSH to 1 or under, when on T4/T3 combo normally you'd be under 1 or even under the range (might scare a doctor who doesn't know what they're doing as some doctors only know to keep results "within range".

Along with that I side with the other posts here mentioning your vitamins and minerals you need your B12, D, ferritin and folate to be at optimal levels for conversion, you may find that would might be able to lower your dose of T4 if you optimize them. But in the meantime you I believe you need a dose increase, how much I don't know I don't feel confident enough to advise that maybe another member with more experience there can help. Either way you need to get that TSH down, and your FT3 should come up (so I think you need more T3), you still have hypo symptoms and with your results that's not surprising.


It would appear you have an absorption problem - which is not unusual with hypo - but it's another thing doctors don't seem to understand.

You probably have low stomach acid. Do you suffer with acid reflux? Are you taking anything for it?


Thanks I do get a lot of acid reflux like symptoms. I was taking Lansoprazole up until May last year but I have taken nothing else for them since then.


Well, the lansoprazole would have don't nothing to improve your absorption! Glad you're not taking it anymore.

Read this article, and do a home test to see if you have low acid :

If you have, there are things you can do to help. :)


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