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Thyroid UK
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Am sourcing some T3 so some queries.

I had a recent test done which showed I wasn’t receiving correct dose due to probably some lack of compliance by me but also a reduction in dose instruction by the Dr. That pesky TSH thing.

Latest labs on 150 dose levothyroxine only are:

TSH 41 (lab range .5-4). That’s forty one.

Free T4 16 (range 10-25)

Free T3 3.3 (range 3.1-5.4)

I’ve been hypothyroid for 30 years and on treatment all that time. TPO antibodies >1600 (lab range <100) so I was an easy case to diagnose in my twenties.

My thoughts are in line with the Rhuematologist (also have lupus/APS) as dosage of 150 alternate days with 200. She was quite shocked at both antibody and TSH levels.

But I also think I have a conversion issue so am thinking of supplementing with T3 (and probably not the 200 dosage)

Anyone care to contribute? :)

10 Replies

Hashimoto's very often affects the gut, leading to low stomach acid, low vitamin levels and leaky gut.

Poor gut function can lead to malabsorption issues of Levo as well as low vitamins

Low vitamins that affect thyroid are vitamin D, folate, ferritin and B12. Important to test these.

If they are too low they stop Thyroid hormones working.

Have these been tested, if not ask that they are. Always get actual results and ranges.

Post results here if you have them already, or on a new post once you get them

Essential to get these optimal before trying T3

As you have Hashimoto's then hidden food intolerances may be causing issues, most common by far is gluten. Changing to a strictly gluten free diet may help reduce symptoms. Very, very many of us here find it really helps and can slowly lower antibodies.

Just don't expect your GP (or endo) to be aware of gut and gluten connection






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


Always take Levo on empty stomach and then nothing apart from water for at least an hour after. Many take on waking, but it may be more convenient and possibly more effective taken at bedtime


Many people find Levothyroxine brands are not interchangeable. Once you find a brand that suits you, best to make sure to only get that one at each prescription.


Thank you. It’s really hard getting Drs to print the results. Unfortunately rheumatologists order multiple tests - which of course is good but they are a pain to get hold of. I take Vit D supplement now due to previous deficiency. It’s now 75 where minimum is 40 on our ranges. I get really bad heartburn as this is part of a dysmotility issue with the other auto immune stuff happening and am on a PPI. So that’s a complication. Do you think I have a conversion issue Slow Dragon. I do avoid breads and cakes but am not - yet - gluten free.


Have you recently started PPI's?

Or changed brand of Levo that TSH has shot up?

PPI's are notorious for messing up gut function and reducing absorption of Levo as well as vitamins

Most hypos actually have low stomach acid not high

There's is no such thing as almost gluten free. It has to be absolute as if you were Coeliac, even avoiding same toaster / butter

Every time we eat any gluten it takes weeks/months for antibodies to subside


PPI's lower magnesium and B12 especially

If your supplementing vitamin D it's good idea to take magnesium anyway, but more so if on PPI

No point testing magnesium by standard tests, it always comes back in range.




Are you sure you have high stomach acid not low ?

Suggest you put a post up specifically asking about this


I’ve read about the low stomach acid issues here. How does one tell the difference? I get a burning searing pain a few hours after eating. I’ve been on the PPI’s for around 12 months now. Levo - same brand so that’s covered. I do feel very hypo.

I’m planning on getting TPO retested privately.


I don't have low stomach acid myself, but there are lots posts about this


Low Stomach acid is probably misdiagnosed as high incorrectly even more that thyroid disease is mismanaged

Trouble then piles in as stomach acid lowers even further, leads to poor gut function due and low vitamins and then poor thyroid as result

Only a few lone medics prepared to think outside the box and realise the long term implications

Dr Myhill here in UK

Few functional medics too. The gut and thyroid are inexorably linked

Obviously more on the ball in USA

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I might try the bicarbonate test tomorrow.

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What do you mean by some lack of compliance?

Once you've tested positive for TPO there's really no point in retesting as antibodies fluctuate. Thyroid peroxidase antibodies are positive for autoimmune thyroid disease (Hashimoto's). There is no cure for Hashimoto's which causes 90% of hypothyroidism. Levothyroxine 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.




Sorry Clutter my reply ended up in the wrong spot - at the top of the thread.


Hi Clutter. By compliance I meant I went through a few weeks where I didn’t take the required thyroxine. I’m on so many treatments that I seemed to go through a funk phase. And it’s a kind of vicious circle - the more poorly I began to feel the less compliant I was! I’m on anticoagulant, lupus plaquemil, high blood pressure tablets, thyroxine and the PPI. It seems to overwhelm me sometimes. But I didn’t really associate feeling so poorly with not taking the thyroxine which is the only tablet I seemed to avoid. It started last year when the GP started reducing my dose based solely on at that time very low TSH. So I kind of gave up a little. It’s been 30 years since I started thyroxine and sometimes I just wonder if it makes any difference. I know now it does!



Try if you can to take Levothyroxine on an empty stomach one hour before food & drink or 2 hours after, and two hours away from most meds, longer if possible away from PPI. Levothyroxine can be taken at bedtime if that is easier to schedule around other meds or if you have to get up during the night to use the bathroom you can take Levothyroxine then.

You should have your thyroid levels checked 6-8 weeks after resuming Levothyroxine. Arrange the blood draw early in the morning and fast (water only) as TSH drops after eating and drinking. Take Levothyroxine after your blood draw. You'll be optimally dosed once TSH is between 0.5 - 1.0 with FT3 between 4.5 - 5.4.

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