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Thyroid UK
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Help please

I think I am undermedicated on 50mcg levothyroxine. Diagnosed 2011. Please help.

TSH 6.2 (0.2 - 4.2)

Free T4 13.1 (12 - 22)

Free T3 3.4 (3.1 - 6.8)

I have these symptoms listed:





Leg weakness

Stumbling and losing balance

Dizzy spells

Blurred vision

Hair loss


Memory loss

Bladder infections and loss of control of bladder

Wounds taking forever to heal

Salt cravings

Sugar cravings



Pale skin

Tiredness, sleeping for more than 12 hours a day




Loss of appetite

Weight gain

Irritable bowel syndrome

Cracked corners of mouth

Cracked heels

Flaky nails

Eyebrow and eyelash loss


Thank you

6 Replies

Yes, I think you're undermedicated too. 50mcg is a starter dose but I don't think that's your primary problem. I think you may well have low vitamin levels as some of your symptoms may be attributed to lack of nutrients. Have you had them tested?



Vitamin D total 25.5 (25 - 50 deficient range) given 800iu D3

Folate 3.7 (4.6 - 18.7) given folic acid

Vitamin B12 194 (180 - 900)

Ferritin 15 (15 - 150)


Have you only ever been on 50mcg?

As Nanaedake says, this is only a starter dose

Bloods should be retested 6-8 weeks after any dose change and dose increased by 25mcgs. Waiting further 6-8 weeks before retesting

This repeats until TSH is around one and FT4 towards top of range

Your vitamins are far too low.

You need loading dose of vitamin D, then likely maintenance dose of 2000iu or possibly higher. 800iu is not enough for a mouse.

Ferritin so low you likely need iron infusion

B12 tested for Pernicious Anaemia before starting B12 injections

This is all due to incompetence on GP part, not increasing your Levo dose

Suspect you have high thyroid antibodies?

If not been tested ask that they are

If high this is Hashimoto's or autoimmune thyroid disease

Make urgent appointment with different GP. Ask for 25mcg dose increase in Levo and correct treatment for these vitamin deficiencies. With blood test form for retesting in 6 weeks. Likely to need further increase(s)

See SeasideSusie reply to similar low vitamin levels


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 louise.roberts@thyroiduk.org print it and highlight question 6 to show your doctor.

1 like

No I have been on more than this and I have antibody results below

Thyroglobulin 356.3 (<115)

Peroxidase 274 (<34)


So why are you only on 50 mcg if you were on more before? On what basis, what blood test results did you have to show you needed to lower your dose?


You need stepped increases, 25mcg at a time. Retesting after 6-8 weeks.

Until TSH is around one and FT4 towards top of range

You have Hashimoto's also called autoimmune thyroid disease- diagnosed by high antibodies

With Hashimoto's, until it's under control, our gut can be badly affected. Low stomach acid can lead to poor absorption of vitamins. Low vitamin levels stop thyroid hormones working.

Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten

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

You need to learn to manage this yourself. Most GP's and endo's are out of their depth

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




Importance of magnesium



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