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Thyroid UK
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meds cut and still feel awful

Hi I need a bit of help. After my TSH dropped to 0.01, my gp cut my levo from 100 mcg down to 75. I still feel absolutely dreadful and have all the symptoms of hypothyroidism.

My results are..

TSH 0.01 (0.35-5.50)

Serum Free t4 18.1 (10-19.80)

Free t3 4.49 (3.1-6.8)

I have a b12 deficiency also and have been taking 3000 mcg of methylcobalamin a day for a month and a half. The following results are a little outdated (next is due in May) but here goes

Serum vitamin D 84 (30.00-200.00)

Serum vitamin b12 266 (246.00-911.00)

Serum iron level 17 (6.00-25.00)

I know something just isn’t right still. The brain fog is thicker than ever, I have no energy to do anything and have lost all interest and pleasure in things I used to like. Could that also be due to my thyroid?

3 Replies

link11 Yet another TSH obsessed doctor who knows diddly squat about treating hypothyroidism and is keeping his patients ill. There was absolutely no need to reduce your dose of Levo. Your FT4 is within range and your FT3 is less than half way through it's range.

From ThyroidUK's main website > Hypothyroidism > Treatment Options:

"According to the BMA's booklet, "Understanding Thyroid Disorders", many people do not feel well unless their levels are at the bottom of the TSH range or below and at the top of the FT4 range or a little above.

Dr Toft states in Pulse Magazine, "The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance.

But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)." "

Dr Toft is past president of The British Thyroid Association and leading endocrinologist.

You can obtain a copy of the article by emailing louise.roberts@thyroiduk.org.uk , print it off, highlight question 6 to show to your GP then ask for your Levo to be increased back to where it was and retest 6-8 weeks later to check your levels.


Are you taking a B Complex alongside your methylcobalamin supplement, this is needed to balance all the B vitamins.


Was ferritin tested? This needs to be at least 70 for thyroid hormone to work, recommended level is half way through it's range.


I have been taking folic acid alongside them but i'm not sure if that counts as b complex. Ferritin will be tested in May but i cant find my old results. Does this mean i need medication or supplements to boost t3 as well as t4? I am confused though as i can see in m old blood results a long time before my thyroid problems began it shows my ft4 being 12.7 and TSH 2.13. I felt ok at that time but now my t4 and TSH has increased i feel really bad.


link11 Folic acid will just boost your folate level, a B Complex is a separate supplement which balances all the B vitamins.

Your conversion rate isn't dire - FT4:FT3 = 18.1 : 4.49 = 4.03 : 1 - good conversion takes place at 4:1 or lower. However, as your FT4 is very close to the top of the range and your FT3 less than half way through it's range, the addition of a bit of T3 would help. Chances of getting it on the NHS are virtually nil even if your doctor agreed.

Supplementing with selenium 200mcg daily helps with conversion of T4 to T3 so that's worth trying, also optimal nutrient levels are important so these are:

Vit D - 100-150nmol/L

B12 - very top of range, even 900-1000

Folate - at least half way through it's range

Ferritin - at least 70, recommended is half way through range, and for females I've seen it said that 100-130 is best.


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