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Had levo reduced to 50mcg, been getting upset stomach and headache, just wondering if this is an under medication or over medication issue? Diagnosed 2011 with hypo.


50mcg levo Oct 2017

TSH 8.2 range 0.2 - 4.2

Free T4 12.9 range 12 - 22

Free T3 4.1 range 3.9 - 6.8

150mcg levo Aug 2017

TSH 0.01 range 0.2 - 4.2

Free T4 20.8 range 12 - 22)

Free T3 3.8 range 3.9 - 6.8

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17 Replies

  • Beth33 - if you post your results, with their reference ranges, members will be able to comment. No-one can say if you are under or over medicated without seeing your results.

    Why was your Levo reduced to 50mcg? What dose were you on before?

    Have you had other dose changes in the past? Do you have results from then, if so please post them and say why your dose was changed.

    Do you have high antibodies - Hashimoto's?

    Have you had vitamins and minerals tested -

    Vit D




    If so please post the results with their reference ranges for comment, and say if you are supplementing and what dose.

  • Done thanks

  • Beth, so you were on 150mcg and had these results

    150mcg levo

    TSH 0.01 range 0.2 - 4.2

    Free T4 20.8 range 12 - 22)

    Free T3 3.8 range 3.9 - 6.8

    your doctor reduced your dose to 50mcg and now you have these results

    50mcg levo

    TSH 8.2 range 0.2 - 4.2

    Free T4 12.9 range 12 - 22

    Free T3 4.1 range 3.9 - 6.8

    1) What was the reason for reducing your dose from 150mcg? There is nothing wrong with those results, FT4 is in range and FT3 is below range. Your doctor is a flipping idiot. Did he see the suppressed TSH and panic?

    2) On 50mcg your TSH is way over range, your FT4 is at the very bottom of the range, and it's a miracle that your body is actually making a little it of T3. What has your doctor said about these new results? Does he realise that you are grossly undermedicated?

    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'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 print it and highlight question 6 to show your doctor and ask that you have an immediate increase of 25mcg, retest and another increase by 25mcg in 6-8 weeks, repeat retesting and increasing until your results are where they need to be for you to feel well.

    Dose changes should be in increments of 25mcg so he was very wrong to reduce your reduce from 150mcg to 50mcg anyway.


    Also, do you have high antibodies - Hashimoto's? That might go some way to explaining this.

    Have you had vitamins and minerals tested -

    Vit D




    If so please post the results with their reference ranges for comment, and say if you are supplementing and what dose.

  • Thanks the GP saw suppressed TSH and panicked

  • Also TPO antibodies 87 range below 34

    TG antibodies 285 range below 115

  • Previous results

    175mcg levo Nov 2016

    TSH 2.63 range 0.2 - 4.2

    Free T4 15.2 range 12 - 22

    Free T3 4.0 range 3.9 - 6.8

    150mcg levo Jun 2016

    TSH 3.85 range 0.2 - 4.2

    Free T4 16.8 range 12 - 22

    Free T3 4.1 range 3.9 - 6.8

    125mcg Levo May 2016

    TSH 2.74 range 0.2 - 4.2

    Free T4 13.8 range 12 - 22

    Free T3 4.2 range 3.9 - 6.8

  • Ferritin 51 range 30 - 400

    Folate 2.4 range 4.6 - 18.7

    Vitamin B12 203 range 190 - 900

    Vitamin D 40.6 range 25 - 50 deficient

    Haematologist wants ferritin above 50

    Taking 5mg folic acid

    Taking 800iu vit D3

  • Beth33

    Ferritin 51 range 30 - 400

    Haematologist wants ferritin above 50

    As you are under a haematologist, am I right in thinking you have iron deficiency anaemia?

    What are you taking?

    For thyroid hormone to work ferritin needs to be at least 70, preferably half way through range. You must raise your ferritin, either with iron supplements, in which case take each iron tablet with 1000mg Vitamin C to aid absorption and help prevent constipaton. Always take iron 4 hours away from thyroid meds and two hours away from other medication and supplements as it will affect absorption.

    You can also help raise your level by eating liver regularly, maximum 200g per week due to it's high Vit A content, and including lots of iron rich foods in your diet


    Folate 2.4 range 4.6 - 18.7

    Vitamin B12 203 range 190 - 900

    You are folate deficient with very low B12. Do you have any signs of B12 deficiency Bear in mind that taking folic acid masks signs of B12 deficiency so think back to before you were taking it. You need to go and post on the Pernicious Anaemia Society forum for further advice quoting your folate, B12 and ferritin levels, your iron information, and any signs of B12 deficiency you may have had or are currently experiencing. You may need testing for Pernicious Anaemia, you may need B12 injections.

    If you have been taking folic acid for a while and your folate result is since you started supplementing, you need to ask your GP why you are still deficient.


    Vitamin D 40.6 range 25 - 50 deficientTaking 800iu vit D3

    800iu D3 isn't going to raise your level. It is hardly a maintenance dose for someone with a reasonable level.

    Your GP can't prescribe more so I suggest you buy your own D3 softgels like these and take 5000iu daily for 3 months then retest.

    When you've reached the level recommended by the Vit D Council - which is 100-150nmol/L - and then you'll need a maintenance dose which may be 2000iu daily, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. You can do this with a private fingerprick blood spot test with City Assays

    There are important cofactors needed when taking D3

    D3 aids absorption of calcium from food and K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems.

    D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds.

    Magnesium comes in different forms, check to see which would suit you best and as it's calming it's best taken in the evening, four hours away from thyroid meds

    Check out the other cofactors too.

  • Thanks for reply I don't take ferrous fumarate at the moment, I am sure I should be and I do have iron deficiency anaemia as shown by complete blood count results and iron panel results

  • Beth, if you still have iron deficiency anaemia then it should be treated. Why aren't you taking FF at the moment? Did your haematologist or GP stop it? If your results show the deficiency then you need treatment, ask for it.

  • Hi my GP stopped it in 2016 after seeing my ferritin was back in range 187 (15 - 150) and since then haven't been back on it.

  • But if you are still testing positive for iron deficiency anaemia you need treatment. You need to sort this out with either your haematologist or your GP.

  • Your GP freaked out at low TSH and didn't even look at the other results - FT3 was UNDER range

    Is there another GP you can see

    You are now significantly under medicated and as result have very low vitamin levels

    See SeasideSusie vitamin advice to others in similar situation

    You have Hashimoto's, you need to read and learn as much as possible about it. Medics ignore it and only treat the ever changing TSH - which will never get us well

    Changing to a strictly gluten free diet may help reduce 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



    Great film definitely shows why just dosing by TSH is inadequate

    Your upset stomach likely due to low stomach acid

  • Thanks the endo was dosing but when the GP accessed the suppressed TSH result ordered by endo she decided to adjust, not sure if GP is someone I should trust if she is going behind endo's back and messing about with my dose

  • GP should not meddle, they obviously don't have the experience

    If dose had needed reducing (which it didn't) then a tiny dose adjustment of 12.5mcg or 25mcg maximum.

    To cut by 100mcg was ignorant or negligent, either way unacceptable

  • Thanks I think my endo has written to them and to me saying what my dose should be and hopefully the GP will leave things the way they are

  • I would hope GP would apologise, if not see another in future.

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