Thyroid UK
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Levels worse after starting levo


I started 25mcg levo as a trial as my tsh was 4.64, T4: 14.01 and T3 4.9 (same ranges as below) and had been consistently mildly elevated on 3 tests since December (tsh 5.05 was the highest).

Started 25mcg levo daily on 10/03/17 and have just got the new results from medichecks:

Tsh 6.53 (0.27-4.2)

T4 12.49 (12-22)

T3 4.18 (3.1-6.8)

Vit d 55.82 (50-200)

B12 399 (140-724)

Folate 9.51 (3.89-26.8)

Ferritin 59.43 (13-150)

TPOab 36.78 (0-34)

TGab 255.1 (0-115)

Would there be a reason they've got worse like maybe levo not agreeing with me or it being caused by something else which levo won't help? Or do I just need an increase?

I know my vit d is low again, it was good at last test but I keep forgetting to take it and I'm due another b12 injection in 2 weeks.

Also my TPO antibodies have dropped from 80 and TG antibodies dropped from 565.1

Thanks :)

6 Replies


You need a dose increase. The goal of Levothyroxine is to restore the patient to euthyroid status. For most patients that will be when TSH is 1.0 or lower with FT4 in the upper range. FT4 needs to be in the upper range in order that sufficient T3 is converted. Read Treatment Options in Email if you would like a copy of the Pulse article to show your GP.

VitD is optimal around 100 nmol/L so you need to resume supplementing. Take D3 4 hours away from Levothyroxine.

It's good that thyroid antibodies have dropped. Have you adopted a gluten-free diet?


Thanks clutter, no I haven't managed GF yet. I've tried and failed :)

I didn't expect a big improvement but didn't expect them to get worse. Just worrying incase it was something else. But at least now my gp can't refuse a dose increase or say it's still a trial to avoid giving me the medical exemption! X


Hi there, you will usually require higher amounts of T4 as time goes on unless you manage to find a way to lower your antibodies such as adopting a GF diet etc.

My result always differ depending on what time of day I do the blood test, whether I've eaten too soon to my meds etc etc so I always try and do the blood tests at the same time and take my meds at the same times every day with no food. Maybe this could explain them? I think it can also be a bit up and down at first with autoimmune thyroid disease. I would agree you need an increase too but how do you feel and how are your symptoms?


I feel like crap and my symptoms are still the same. Actually I'm lying sorry, my periods have returned to monthly and are shorter but still irregular. I felt better in the second week of starting levo but gradually back to where I started. My last three tests have been around the same time in the morning before any food or drink. Not sure why my antibodies have reduced but tsh raised. hopefully I can get an increase in Friday. Thanks x


It can take a while to see improvements - it often takes me three months before I feel any changes to medication. I don't think you'll have any issues with getting an increase when you see them next so will hopefully help :-)

Your periods becoming more normal is a good sign you're going in the right direction - I'm currently having periods every blinking two weeks lol!

Good luck :-)

1 like

No thank you, I'd rather go back to one every two months than 2 weeks haha hope you get sorted soon x


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