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Are there any more articles to show GP to prove TSH needs to be in the lower part of the reference range?

Hello there.

I've been on 50mcg of levothyroxine for 7 weeks since first being diagnosed with Hashis (antibodies over 1000). I am still exhausted although many of my other symptoms are much better, possibly due to supplementing and/or starting the Paleo diet in addition to the thyroxine.

My latest bloods have just come back:

TSH 3.60 (0.30-4.20) . Nothing else was tested...

The GP has said 'no further action, results normal' whereas I was expecting a raise in my medication to alleviate the fatigue. I'm shocked the TSH is as low as 3.60 as I don't feel right yet. I still need a sleep every afternoon and fight fatigue all day etc.

I have a copy of Anthony Toft's article where he says the appropriate dose of levo is that which reduces TSH to 0.2-0.5. I have also printed off Thyroid UK's 'Getting a diagnosis and starting treatment'. I am seeing my GP on Tuesday- I wondered if there are any other pieces of evidence I can gather to present to her to persuade her to increase my dose.

Failing that, I am tempted to buy some levo online but am very nervous about that route...

Any advice would be hugely appreciated. Thank you in advance.


8 Replies

Hi kipsy, The TSH is a pituitary test which only shows what your pituitary has determined you need your thyroid to produce and that's why it went so high to begin with. Your thyroid production was obviously too low for some reason. If your antibodies are that high, obviously it is impeding your thyroid from doing a good job. It really is a terrible mistake to keep you on a low dose for too long as your body seems to settle for only managing some of your metabolic functions....important ones like your heart and maybe not your hair. If you are too nervous to add your own T4 or NDT be ready for more symptoms....some you will notice and some you won't. It is egregious what the medical system is doing by withholding an inexpensive hormone that your body is shouting for.

Of course there is more to this story since you have an autoimmune condition and that is an area you have to address if that hormone is going to work. Often gluten is instrumental in causing the attack on your thyroid. I've tried all types of hormone with or without my doctor and it is not complicated.



Heloise- your support and comments are so very much appreciated. I felt like crying when I posted earlier but I knew you marvellous ladies would have some sense to throw on the injustice! Thank you so much for taking the time to post. I will study the link in detail and I feel much stronger and ready to do battle.

Thank you so much


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Try the article which you get from the home page of Thyroid UK


On the right hand side under the box headed 'Recent News' is a box with

'Diagnosis and treatment of Hypothyroidism Read article here:'

It's fairly long, but you may only need the first 2 pages to show your doctor. Effectively says that you need more than the TSH test and that the Free T3 test is more important.

You need many more tests. If your GP won't do them it could be worth getting private tests from Blue Horizon or Medichecks.

Is the paleo diet gluten free? Gluten free helps if you have Hashi's.

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A brilliant article. Thank you SO much!


Actually, TSH of 3.6 is very high for someone on medication and statistically likely to mean someone not on medication isn't "normal". You could point out that TSH of 0.3 would also be in normal range so there is room for an increase. Can you see a different GP?


Great point- I will add that too! Thank you very much.


You could print out this graph and show it to your doctor :


It shows the distribution of TSH in healthy women with no known thyroid disease. Don't just look at the graph, read the text too. You'll see that a TSH of 3.6 is a long way away from where the majority of healthy people have their TSH.

The info for that graph was gleaned from here :


The best part of that paper is the right hand half of Table 3.

If you were female, under 40, and didn't have any known thyroid disease, for example, then you would expect your TSH to be between 0.37 and 3.3 with the bulk of people having a TSH in the bottom half of that range.

Hypothyroid people often need a TSH lower than healthy people in order to feel well.

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Thank you humanbean- I get what you're saying and it's brilliant to have such detailed evidence. My 'poor' GP isn't going to know what's hit her! I really appreciate your reply- thank you again.

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