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Thyroid UK
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Hhhmmm... i'm not so sure

Hello everyone

Just had a letter through the post. A copy from the endo.

All is states is my results are normal and my TSH is 3.9 and my FT4 is 14.6 and i'm to stay on the 125mcg levo and now have my TSH checked annually..

so is that it now??

I mean i feel so shite a lot of the time but apparently 'I am normal'. haha!!

Thanks for listening x

6 Replies

Your Endocrinologist may be correct and that, yes, your results may be in the normal range (you haven't given the ranges) but the fact is that if we have been diagnosed as hypo, the aim is a TSH of 1 or lower or even suppressed otherwise we will not feel 'normal' health with relief of all symptoms.

Email louise.roberts@thyroiduk.org.uk and ask for a copy of Dr Toft's Online Pulse article and highlight question 6 and send to your Endo. Dr Toft was President of the British Thyroid Association and we don't want to go backwards as suggested by your Endo. She will send it next week.

You will appreciate the following video from STTM - I think all Endos should watch it.



Demitria Oh dear, I think your endo is a diabetes specialist (most of them are) and as usual thinks that just because the TSH is somewhere within the range then everything is hunky dory! You haven't given reference ranges (please do so when quoting test results, it helps us to interpret them :) ) but I imagine your FT4 is low in range.

No, that's not it now. The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it needs to be for FT4 and FT3 to be in the upper part of their respective reference ranges when on Levo. You now have to persuade your endo, or your GP, that you still have symptoms, you are not optimally medicated and that you'd like an increase in your Levo in line with the following:

From thyroiduk.org.uk/tuk/about_... > 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's published by the British Medical Association for patients. Avalable on Amazon and from pharmacies for £4.95 and might be worth buying to highlight the appropriate part and show your doctor.

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 obtain a copy of the article by emailing louise.roberts@thyroiduk.org print it and highlight question 6 to show your doctor in support of your request for an increase.


TSH looks much too high, but as others have said, we need to see the ranges

Do you also have high antibodies diagnosed as autoimmune thyroid disease also called Hashimoto's

If so highly likely you have low vitamin D, folate, ferritin and B12

Have these been tested? If not ask GP to do so

Also was your thyroid test done as early as possible in morning and fasting and no Levo in the 24 hours prior to test, delay and take straight after. This gives highest TSH

If not then consider getting retested

If you can't get full thyroid and vitamin testing from GP


Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers. DIY finger prick test or option to pay extra for private blood draw


Thank you for all your replies. Unfortunately no ranges given. Very basic. How do i go about obtaining these? Thank you for all the references for me to look into further. I really appreciate it. And yes i did have confirmation a little while back that ferritin was a little low and vit d.

Thank you so much everyone x


Contact the endo's secretary, ask for the reference ranges to go with your test results. Also ask for the results for the ferritin and Vit D tests, again with appropriate ranges.

If your surgery used the same lab for tests as the hospital you attend, they may be able to give you the information, but it would be best to get it from the endo/secretary to be absolutely sure.

1 like

A TSH is always a TSH. You don't need a reference range for it - unlike the other readings. And a TSH of 3.9 is not 'normal', it is hypo. It should be one or under.


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