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Thyroid UK
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Levo - less is more?

Would a lower dose of levothyroxine perhaps make my thyroid work a little?

I've got Hashi's, currently on an average 57mcg levo daily, & have just heard from my GP that I can increase it based on my latest test:-

TSH 4.1 mu/l (0.55-4.80)

Free T4 10 pmol/L (9-23)

Free T3 3.2 pmol/L (3.50-6.50)

Kudos to my GP - she got FT3 measured! Ferritin, folate & B12 are all good, vitamin D is getting there gradually. Based on my symptoms I do need an increase.

She suggested 75mcg daily, so about 30% more. My question is, if I start with a smaller rise & see how my symptoms develop, could that theoretically encourage my thyroid to work a bit more? And a lower dose now would leave more room for an increase later. Or would it be better to take the full dosage suggested by the GP & so help lower my antibodies?

I suppose it's mostly "suck it & see", so see how I feel in 6/8 weeks, but I'd like to know what you knowledgeable people would recommend first.

4 Replies

No, it wouldn't encourage your thyroid to work a bit more. Poor little gland is already doing its best, but is being attacked and destroyed by the Hashi's. You need your TSH suppressed to try and stop the attacks, and prevent any further damage. If you delay the increase, which you clearly, desperately need, your thyroid will continue to be open to attack. Your FT3 is below range, for goodness sake! You must feel dreadful!

And, I can't understand why you would want to do that, anyway... To what end? Over-working your thyroid is not going to repair the damage that has already been done.


To what end? To try & get it to work was the gist. I don't consider it a "poor little" thing, I think of it as the %^&$ that makes me ill, sends me off to the GP regularly, restricts my diet, makes me take loads of tablets every day & so on. There was also a bit of "treat the symptoms, not the lab results" as I haven't been too bad on my current dose, as long as I don't overdo it.

But you're right about not repairing the damage already done, and of course it's my immune system at fault not the thyroid. OK, 75 it is then. Thank you for the advice.


You're welcome. But, you do understand that it isn't going to work, don't you?



You are under medicated and should accept the dose increase your GP recommended which will increase FT4 and FT3 and will bring down TSH and probably antibodies. You should have a follow up thyroid test 6-8 weeks after starting Levothyroxine. Arrange an early morning and fasting (water only) blood draw when TSH is highest, and take Levothyroxine after your blood draw.

The goal of Levothyroxine is to restore the patient to euthyroid status. For most patients that will be when TSH is 0.4 - 1.0 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 thyroiduk.org.uk/tuk/about_...

Thyroid peroxidase antibodies are positive for autoimmune thyroid disease (Hashimoto's). There is no cure for Hashimoto's which causes 90% of hypothyroidism. Treatment is for the low thyroid levels it causes. Many people have found that 100% gluten-free diet is helpful in reducing Hashi flares, symptoms and eventually antibodies.



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