Thyroid UK
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Under control then jumped


I have just joined the site following a jump back up in my TSH levels. I have been on Thyroxine for about 18 months with the doses being increased from 50 to 150 over that period. I had got my level down to about 3 and then had some voice issues a scan showed my thyroid as borderline enlarged and a camera check on my vocal cords was clear. The EN&T guy suggested I have another blood test and it had jumped back up to 5.7, which I would guess has something to do with these bouts of extreme tiredness that have been coming over me. I am speaking to my GP tomorrow so I guess I should be booking a blood test for three weeks time and he will up my dose. My T4 level seems to be very stable around 10 or 11. Any advice help would be welcome.

8 Replies

It would help members to comment more fully if you can post the results of the blood tests that you've had, including their reference ranges (usually to the right and might be in brackets). TSH, FT4, FT3 - vitamins and minerals such as vitamin B12, vitamin D, iron, folate, ferritin etc.

Lab equipment and the assays they use vary from one place to another so it's essential to know the reference ranges in order to interpret any numbers.

It would help if you could say whether or not your blood tests were taken at roughly the same time of day. Preferably, early in the morning, after an overnight fast, and 24hrs since your last dose of levo.


Ok latest test info was taken at midday following no fasting a dose of 150mg Levotyhroxine taken at 7am results were ;-

Serum TSH 5.7 miu/l

Serum 3T4 12pmol/l


Do you have the ranges (figures in brackets after each result)

Each lab has different ranges


No she read to me everything off the screen.


No but will get when at GP's today


Ask that they test vitamin D, flare, ferritin and B12. If these are too low they hinder uptake of thyroid hormones

Do you have autoimmune thyroid disease (Hashimoto's) If not ever been tested for thyroid antibodies ask that they do so

About 90% of all hypothyroidism in Uk is due to Hashimoto's (GP will call it autoimmune and ignore that aspect entirely )

According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

But don't be surprised that GP or endo never mention gut, gluten or low vitamins. Hashimoto's is very poorly understood

Changing to a strictly gluten free diet may help reduce symptoms, heal gut and lower antibodies

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



Dr Toft, past president of the British Thyroid Association and leading endocrinologist, 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 print it and highlight question 6 to show your doctor.

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Taken at midday and non-fasting, your TSH is actually higher than that. And your FT4 actually lower, because you took your levo that morning. You are pretty hypo, right now. You definately need an increase in levo. :)


Thanks for reply

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