Thyroid UK
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Could I please get advice on dosage for T3

Hi I'm hoping to go from Levo to T3 I'm not sure what dosage as I'm undermedicated and not supported by my GP or Endo who think these results are ok on 25mcg of Levo and have said will permit my TSH to go back up to 10 ! increases make me feel awful palps and I just feel really ill I have got other problems since my dental op went wrong nerve damage too now I'm just hoping that if I change to T3 only I may feel a little better

Any advice would be very appreciated

TSH 4.05 (0.3-5.5)

Serum free triiodothyronine 4.6(3.1-6.8)

Serum free T4 14.4 (12-22)

TPO Antibodies 450(34)

5 Replies

Why do you want to go on T3 only?

With those results, you actually need to get TSH down to nearer one to see how well you convert T4 to T3 before making any decision about T3 only.

I think your endo needs educating, and here's a good start from > 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 booklet is written by Dr Anthony Toft, past president of the British Thyroid Association and leading endocrinologist. It is published by the British Medical Association for patients. You can buy it in pharmacies or from Amazon for £4.95 and it might be worth highlighting the relevant section to show your GP and endo.

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 email for a copy of the article, print it and highlight question 6 to show your GP or endo.

Then ask for an increase in your Levo to achieve the results recommended by Dr Toft.


TPO Antibodies 450(34)

These high antibodies confirm autoimmune thyroid disease aka Hashimoto's which is where antibodies attack the thyroid and gradually destroy it. The antibody attacks cause fluctuations in symptoms and test results.

You can help reduce the antibodies by adopting a strict gluten free diet which has helped many members here. Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks. You don't need to be gluten sensitive or have Coeliac disease for a gluten free diet to help.

Supplementing with selenium l-selenomethionine 200mcg daily can also help reduce the antibodies, as can keeping TSH suppressed.

Gluten/thyroid connection:


Are all your vitamins and minerals at optimal levels to allow thyroid hormone to work properly

Vit D - 100-150nmol/L

B12 - very top of range

Folate - at least half way through range

Ferritin - half way through range

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You have very high antibodies, this is Hashimoto's

Most medics ignore this aspect (they don't understand it) but we MUST get antibodies down to feel better

With Hashimoto's then highly likely hidden food intolerances may be causing issues, most common by far is gluten.

Changing to a strictly gluten free diet may help reduce symptoms and eventually start to lower antibodies.

Very very many of us here find it really helps and can slowly lower antibodies, improving symptoms

Low stomach acid can be an issue

Lots of posts on here about how to improve with Apple cider vinegar or Betaine HCL

Other things to help heal gut lining

Bone broth



Before even considering T3 we must have very good vitamin levels and if gluten is causing issues be on strictly gluten free diet. (You won't know till you try it ) there is no test for gluten intolerance. Over 80% with Hashimoto's find gluten free diet helps reduce symptoms

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Thankyou for the great advice I will print out these articles and show my GP my Endo does not want to see me again he was extremely vague and as Shaw's commented he really would make me ill if I took his advice and allowed my TSH to go up to 10 once again ! ( I don't think so ) I am on gluten free diet and have noticed that I feel better for it I've cut down on diary too ! My Vit D I'm taking 3000 daily K2 and B12 I've started the magnesium the only thing I haven't done is Selenium 200 which I will do I will increase my iron and Vit C . Il try an increase again to see if being undermedicated could be contributing to me feeling so awful tired and drained so hopefully once my vitamin levels are all optimum and my Levo increase il see how I go from there 😄 Thanks Again for the fantastic advice and support x


Retest your vitamin D after 2-3 months. Even 3000iu may not be enough to increase levels with Hashimoto's

You need a new Endo. Email Louise at Thyroid Uk for list of recommended thyroid specialists

Most GP's and Endo's have no idea about importance of vitamin levels or the gluten connection to Hashimoto's

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Thankyou Slowdragon I've increased my Levo to 50mcg hopefully the palpitations won't be too bad fingers crossed ! and also brought higher strength Vit D and selenium 200mcg I'm already gluten free I'm hoping to see some improvement and feel a little better Thanks for the support and I think I'm going to make an appt to see Dr Peatfield and try get my life back again with just a little more energy that's all I want ! 😃 Kazbe

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