Thyroid UK

Power of Dr Toft article

Just wanted to share my latest Thyroid experience at the doctors. In a nutshell I wanted the doctor to increase my Thyroxine as I was/am still have symptoms of under active thyroid, in particular tiredness. I felt as though I was nearly there but not quite. I thought I'd have a "battle" so went armed with Dr Toft article. I'd read and re read the article as I suspected the Dr Doctor would state that based on my recent tests my Serum Free T4 levels were at the high end of the range at 20 (12-22) and therefore did not want to raise my Thyroxine any further as my TSH was/is at 1.4 (0.27-4.2). Long story short, this is what she did state and wanted to test me for Celiac disease and also run through some other vitamin tests.

I produced the article, highlighted relevant paragraphs and argued my case. She said to leave a copy at the reception and that she would consider the situation again once my latest results came back. Yeah right I thought!!

I then found out she was going to be away for 6 weeks and once my test results came back she had gone.

Anyway, I came back from work yesterday to find she had written me a letter to my home address and said she had considered Dr Toft article and latest BMA guideline on treatments of thyroid and agreed to up my doesage of Thyroxine slightly from 100 every day Monday to Friday and Saturday and Sunday 125 - to 100 and 125 on alternative days! She directly quoted the article in her rationale for this and asked me to be re tested in 4 months time. I'm so glad I went with my article, I would never have got an increase without it and to be fair, whilst quite negative in her initial response to me, appeared to listen and has taken on board specialist advice. I have now found out she leaves the doctors practice in December!!!!! So I will be on with my 4th Doctor then!!

I was negative for Celiac.

My T3 was 3.9 (3.1-6.8) .... is this a bit too low?

Erythrocyte sedimentation rate 2 (1-15)

Lots of different blood test results for platelets etc which appear to be in range

Tissue transglutaminase IgA 1 (0-10)

Various results for Urea and electrolytes, adjusted calcium, liver function, and Serum C reactive protein - all in ranges

Haemoglobin A1c level 31 (20-41)

Hope this gives some hope to people to keep going and research research research. Without this site I wouldn't have half a clue. Thanks to everyone for their help and keep going!! X

9 Replies

By my reckoning, taking 100mcg Mon-Fri plus 125mcg Sat + Sun = 750mcg per week = 107mcg average daily.

New dose - 100/125mcg alternate days = 250 x 7 = 1750 per 14 days = 125mcg average daily.

OK, an increase of 18mcg daily. It may make a bit of difference to your TSH and FT4 and possibly increase your FT3 slightly.

FT4: 20 (12-22)

FT3: 3.9 (3.1-6.8)

Was FT3 tested at the same time as FT4?

Your FT3 is very low in range. If tested at the same time then it shows poor conversion. Good conversion takes place when FT4:FT3 ratio is 4:1 or less, your ratio is 20 divided by 3.9 = 5.12 : 1

Increasing your Levo by 18mcg daily wont increase your conversion ratio. Your FT3 will still be much lower than your FT4. You could do with some T3 added to your original dose of Levo.

1 like

Yes both tested at the same time. Do you think when I go back after my next blood tests, I should ask for a prescription for T3?


You can ask but your chances of getting it prescribed are pretty close to zero. It's being withdrawn left, right and centre from people who have had it prescribed and are doing well on it, the reason being the extortionate cost. Plus an endo has to prescribe it initially.


What would you advise I do? Ask for a referral to an endo? I would worry they would alter my dose of thyroxine as that is the only thing that has helped e get my life back on track and functioning.


Oh dear, I'm probably not the best person to ask 'cos I've turned into a hard nosed cynic with as much respect for doctors as they have knowledge of treating Hypothyroidism.

Your could start a new thread 'Any T3 friendly endos in **my area** "

Or you could email for the list of thyroid friendly endos, see who is in your area and ask for feedback from members (they will have to reply by private message).

If you do get to see an endo and get refused T3 then you could just drop out "Well I don't have much choice then, I'll have to source it myself and self medicate". That should elicit some sort of reaction, might not be the one you want though :D

But like I say, I don't 'do' doctors any more if I can help it, too many years of being ignored, fobbed off, refused this, that and the other, and not treated when it was obvious I should have been.

Oh, and refuse to reduce your thyroxine as long as FT3 is within range. As you know, TSH and FT4 can be out of range like Tofty says. If they won't test FT3 and say you're overmedicated, just challenge them to prove it by testing FT3 otherwise you refuse to reduce.

Crikey, I sound like a bolshy c*w tonight :D


Thank you so much for your advice and no you are not bolshy!!! :-)

1 like

Your conversion might actually get worse at the new levels, because it will be converting to rT3 rather than FT3. If you have a conversion problem, the answer is not to keep increasing the T4.


Where can I find Dr. Toft article please? I'm new on here!




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