Thyroid UK
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Have I been tested for T3 abnormalities

Hello. I wonder if anyone can help? I was diagnosed hypothyroidism approx 10 days ago. I notice lots of forums mention T3. Is it important that it is tested and from my results below do you think it has been tested? I feel a new symptom and worse each day I am on 50 mcg levothyroxine daily. Thanks☺.

Serum free t4 xaerr 7.7 pmol/L

Serum TSH level (xaelv) 62.1 mu/L.

Vit D 21.6 nmol/L

Serum cholesterol 9.2 mmol/L

Serum cholesterol level (44P5) 2.6 mmol/L

13 Replies

Angelfuzzy No, you haven't been tested for Free T3.

When posting test results, it's important to include the reference ranges as they differ from lab to lab. A result with the range would look something like

TSH: 62.1 (0.2-4.2)

Or the print out might say 'Norma Range' or similar.

It will take a while for you to feel better. If you've been taking Levo for about 10 days then it has only just started to get into your system, the full effects take about 6 weeks. Have you got your next test booked? It should be 6-8 weeks after starting Levo (or after any dose change).

Always book the first appointment of the morning, fast overnight (you can have water) and leave off Levo for 24 hours (take after the blood draw). This gives the highest possible TSH which is what is needed when looking for an increase in dose or to avoid a reduction. Do this every time and you can then accurately compare all your results.

Take your Levo on an empty stomach, one hour before or two hours after food, with water only, and away from other medication and supplements by two hours (four hours for iron, calcium, Vit D and magnesium) for maximum absorption.

By the way, your Vit D comes into the Deficiency category. Have you been prescribed D3? The recommended level is 100-150nmol/L

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Hi. Yes I take Vit D. Thanks for your help. My ranges are

Tsh 62.1 (0.2-4.0)

T4 7.7 (11.0-22.6).

Is my tsh very high?


Yes, your TSH is very high, but not the highest we've seen here. It will start to reduce and your FT4 will start to increase as the Levo starts to take effect.

The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it is needed for FT4 and FT3 to be in the upper part of their respective reference ranges if that is where you feel well.

I hope your GP has started you on a loading dose of D3 and not a maintenance dose. They're very fond of prescribing just 800iu which isn't even a winter maintenance dose for someone with a reasonable level.

NICE treatment summary for Vit D Deficiency:

"For the treatment of vitamin D deficiency, the recommended treatment is based on fixed loading doses of vitamin D (up to a total of about 300,000 international units [IU]) given either as weekly or daily split doses, followed by lifelong maintenance treatment of about 800 IU a day. Higher doses of up to 2000 IU a day, occasionally up to 4000 IU a day, may be used for certain groups of people, for example those with malabsorption disorders.

Several treatment regimens are available, including 50,000 IU once a week for 6 weeks (300,000 IU in total), 20,000 IU twice a week for 7 weeks (280,000 IU in total), or 4000 IU daily for 10 weeks (280,000 IU in total)."

Each Health Authority has their own guidelines but they won't differ much from that.

When taking D3 there are important cofactors needed, which your GP won't have told you about because they're not taught nutrition.

D3 aids absorption of calcium from food and K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems.

D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds.

Magnesium comes in different forms, check here to see which would suit you best and as it's calming it's best taken in the evening, four hours away from thyroid meds.


I am on 2 of 20.000 units once a week for 7 weeks so I think that sounds ok. My cholesterol is 9.2. Is that bad? I wasn't prescribed anything for it


Don't​ worry too much about your cholesterol. High cholesterol is quite usual with Hypothyroidism, once optimally treated your level should reduce. At least your GP hasn't pushed statins on to you, refuse them if he does.

Your loading dose is OK. Retest when you've finished. A maintenance dose might be about 2000iu daily, maybe less in summer if you get out in the sun. You will have to buy your own once you've reached what your GP considers 'normal'. Supplementing is for life so retest once or twice a year to maintain level. Don't ignore the important cofactors, they are need now.

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Thank you


What do you mean by important Co factors? Thanks so much


In my previous reply, where I mentioned Vit D, under the information about guidelines, I gave a link to the Vit D council where it discusses Vit D's cofactors. I take it you haven't checked the links I provided. I also mentioned two of them and their timing in relation to thyroid meds.

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I'm glad you mentioned the timing. I've been on a high dose of D3 for the last couple of years and I do feel better but maybe I'd feel better still if I wasn't taking it at the same time as my thyroid meds!


Also i am on escitalopram for chronic depression. 8+ years. I have tried to come off on numerous occasions but sends me straight into very dark mood. I would love to come off. Do you think it could be simply the hypothyroidism


Depression is a symptom of Hypothyroidism so it may very well be linked.

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Angelfuzzy, the advice you've had from SeasideSusie is all excellent.

Yes, your TSH result is pretty high. This means you will probably need quite a bit more than 50mcg a day to feel better. So it's really important you get retested regularly and have your dose adjusted.

The ideal is every six weeks for new blood tests. I was always made to wait 3 months. But it's likely you won't start feeling an improvement in symptoms until your dose gets close to what you need. So as you can see its a slow process to getting better :(

And as you ask above, depression can be caused by hypothyroidism. You will hopefully get big improvements as your dose improves. I also find that resting a lot improves overall fatigue, but also makes it improves low mood.

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In a nutshell, with a TSH of 62.1 miU/L you are seriously hypothyridic. This is the first thing to address. 50 mcg of Levo is a starter dose, you are way beyond starting this problem.

This is a good example of where the measurement of TSH is essential and meaningful. This measurement has been greatly maligned, with good reason, but on this type of scale it is an essential measurement. When a doc is fiddling around raising a .5 measurement to a 1.0 it is meaningless, then it depends on how the patient feels. However your first job is to reduce your TSH to at most 4.0. While my circumstances are different I start to feel hypothyridic at 1.15! You have a long way to go.

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