Log in
Thyroid UK
91,897 members106,165 posts

Feel like I'm getting no where

Further to my Angry post the other day I've been to see a doctor today and the only results she gave me from my books test last week was T4 18.3 range 12-22 so she said it was good near the top and T3 4.1 range 3.1-6.8 . Surely that can't be right as I'm putting weight on even though I'm walking or on my cross trainer for 30 minutes. Any advise would be great.

10 Replies

jen23lilly The aim of a treated hypo patient generally is for TSH to be 1 or below and FT4 and FT3 to be in the upper part of their respective reference ranges, usually FT4 in the upper third and FT3 in the upper quarter.

Your FT4 is 63% through it's range so just shy of the upper third. However, your FT3 is only 27% through it's range, a long way from the upper quarter.

Also, your FT4: FT3 ratio is 18.3 : 4.1 = 4.46 : 1

Good conversion takes place when FT4: FT3 ratio is 4:1 or less, some say 3:1 so you might benefit from the addition of some T3.

From ThyroidUK's main website > About the Thyroid > 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."

The book is written by Dr Toft, past president of the British Thyroid Association and leading endocrinologist, and is available from Amazon and pharmacies for about £4.95 and would be worth purchasing to show this to your GP.

Also, 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)."

You can obtain a copy of the article by emailing louise.roberts@thyroiduk.org.uk print it off, highlight question 6 and show it to your GP.

An increase in your Levo will raise your FT4 which in turn will raise your FT3 which might be enough to not need the addition of T3.

1 like



Di you find the Pulse article helpful as suggested above 😊


I need to get a copy of it


E-mail address above - Louise is one of the Admins on TUK 😊


Thank you I will send an email

1 like

Excuse me being pedantic but measurements come in different flavors in different countries. Can you specify the units of those measurements and also are they total T4 and total T3 or Free T4 and Free T3?

IF they are Frees and the units are the same then yes indeed your FT4/FT3 ratio is 4.46:1 as SSS calculated above, otherwise it is meaningless.



That could be me. We have almost the same results and I'm still feeling very ill. What did you do? Increased levo or added T3? Are you feeling any better?

How much levo are you taking?



Been on the same dose of 150 Levo for 12 years at least . Not added T3 as hard to get and my doctor won't let me increase as they see it as I'm in range, just plodding along at the moment as very busy at work.

1 like

Oh, poor you!

I haven't been to the doctor's since my test but I have increased meds and I really hope they will let me keep that amount of levo since I'm feeling terrible still...

It's very hard with three T3 in this country. So sad.


You may also like...