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Thyroid UK
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Viewpoint from across the pond

Hi, new here

I'm finding the posts very interesting. I was diagnosed with Hashimoto's spring 2016. It started almost immediately after finishing radiation treatment for breast cancer.

I've read a lot, and realize the radiation was probably the trigger. Or even the hormones involved in the cancer. Many books/articles talk about TSH, synthroid, etc etc. I watched a series of videos with doctors who talked about leaky gut, but it's hard to tell if that's real.

This morning I read the thread "New here help with thyroid results please" which I found very interesting! I haven't had vitamin tests, except vitamin D by my endocrinologist. It was very low and I'm now taking 2000iu/day.

I have a very good, attentive endocrinologist. But I've had continuing symptoms since the beginning...

nails are a mess. They started out splitting (my one thumbnail has been split for 18 months) and now they're starting to split the other way (peeling).

sore feet

tired & sore muscles, primarily legs, especially after walking up stairs

decreased stamina

hot flashes (can't tell what exactly is causing them. Should be in menopause, although bloodwork says no)


100mcg levothyroxine

2000iu vitamin D

25mg tamoxifen

Last blood work was in May. I'm overdue:

TSH .06

FT4 1.4

FT3 3.4

I've included a photo showing the history of my TSH.

Any insight would be most appreciated.

Thank you!

4 Replies

2000 iU per day of vitamin D is unlikely to make much dent in a vitamin D deficiency in someone who is hypothyroid. For many of us 2000 iU is our maintenance dose. And I hope you are taking vitamin D3, not vitamin D2.

Regarding leaky gut and hypothyroidism...

I think for most of us with poor gut function the triggering problem is low stomach acid. This may then lead to symptoms suggestive of leaky gut, indigestion, heartburn/acid reflux, gut pain and spasm, diarrhoea, constipation, flatulence, gastritis, increased risk of infection and inflammation in the gut, increased risk of parasites, ... Basically, almost anything that can go wrong with the gut is more likely when stomach acid is low.

Once the gut starts misbehaving, we end up less able to absorb nutrients and nourishment from our food, so vitamin and mineral deficiencies are common.

Regarding your results, I'm afraid without reference ranges we can't help. There is a very big difference between these two results :

Free T4 12 (ref range 12 - 22)


Free T4 12 (ref range 7 - 14)

Welcome to the forum. :)


Thank you for the welcome, response, and info! Sorry I left out ranges. Surely they're different between UK & US!

TSH .06 mIU/L (ref range 0.40-4.50)

TSH was 1.03 the month before. Now that I think about it, I had increased my levothyroxine on my own between the two tests because my dr was out of town and I felt awful. He determined that I was then hyperthyroid. Neither dose affected my other symptoms.

Free T4 1.4 ng/dL (ref range 0.8-1.8)

Free T3 3.4 pg/mL (ref range 2.3-4.2)


Ranges will be different between labs, between testing machines, between countries. But the biggest and most important difference between the US and the UK when interpreting results is that units of measurement are often different.

So, for example, an optimal level for vitamin D3 in the UK is 100 - 150 nmol/L.

In the US the same optimal level is usually given as 40 - 60 ng/mL.

To determine the dose of vitamin D3 you need to raise your level to optimal, and assuming your level is given in ng/mL, you can use this chart - but you will need to know what your level is currently :


The website that link comes from has some interesting articles on everything to do with vitamin D3 :


Bear in mind that vitamin D is stored in fat, and excess isn't lost in urine. Toxicity is possible as a result, so testing should be done regularly while raising level, and once you've got to an optimal level you'll need to find how much you need to take to keep it there. If you get a lot of sun exposure in the summer you may only need to supplement in the darkest 6 - 8 months of the year. It is just trial and error though.


Supplementing vitamin D raises the amount of calcium people absorb from their food. You want that calcium to go into your bones and teeth rather than into your soft tissues and arteries. To achieve this your body needs magnesium and vitamin K2 (not K1) both of which are easily sourced on Amazon and supplement sites. (That is true for vitamin D3 as well - prescriptions aren't required to buy it in quite high doses, if necessary.)

For magnesium supplements, pick one from these links :



For vitamin K2 I just buy one that is in my price range and gets good reviews. Read some replies written by SeasideSusie for better advice on K2, and other nutrient advice.



Free T4 1.4 ng/dL (ref range 0.8-1.8)

Free T3 3.4 pg/mL (ref range 2.3-4.2)


Your Free T4 is 60% of the way through the reference range.

Your Free T3 is 58% of the way through the reference range.

They are well balanced at the moment, which is good. No conversion problems have arisen yet. But they are both a bit low.

Patients have found that the thing which has least impact on symptoms and feelings of well-being is TSH. The thing which has greatest impact on symptoms is Free T3. These statements would be ignored by doctors because they usually think that TSH is the really important one.

For many patients taking Levothyroxine only, the optimal results (from the point of view of relieving symptoms) are

1) Both Free T4 and Free t3 should be in the upper half of the range.

2) Some patients need Free T4 and Free t3 to be in the top third or quarter of the range.

3) Some patients who have fairly poor conversion of T4 to T3 may need their Free T4 to be right at the top of the range or even a little bit over to get their levels of Free T3 high enough to feel well.

If you can feel well with situation (2) then that would be great.


Don't forget that there are loads of brands of Levothyroxine in the US. You can find out what they are and the ingredients they contain here :


Synthroid is popular in the US, mainly because it has a massive advertising budget. It doesn't mean Synthroid is "better" than any other brand or make of levothryoxine. The best levothyroxine is the one that works best for you. If you go through the list you may find tablets which are lactose free, and/or acacia free, or free of colours, or there may be other ingredients you want to avoid. Acacia is a common thing to find as a filler (excipient) in pills, but it upsets an awful lot of people.


As well as dealing with low vitamin D you should also find out what your iron and ferritin levels are. A full iron panel plus hemoglobin would be best if you can get it. You also need to find out your vitamin B12 and folate. These things all have optimal levels, and supplementing until you reach those levels will make you feel better.


Your hot flashes (US) or flushes (UK) might be caused by poor adrenal health or low sex hormones. For testing adrenal health adrenal saliva test is the best thing to get. For further info on getting tests you want done without involving a doctor or an insurance company, please see about half way down this page :


Good luck. :)


I don't have those leaky gut symptoms, but what I've heard about is that leaky gut triggers the immune system to kick in and is the cause of autoimmune disease.


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