Thyroid UK

Thyroid results - Hashimotos, looking to try T3 again

Hi I am a new member. I was diagnosed Hashimotos 2014 and I am currently looking to try T3 again since it helped me feel and look better. I still have some left from my previous endo's prescription and they are still within date but is this not the right thing to do? Symptoms are not improving on recent dose adjustment to 175mcg Levothyroxine from 150mcg Levothyroxine.

Thanks in advance.


TSH 5.3 mIU/L (0.2 - 4.2)

Free T4 12.9 pmol/L (12.0 - 22.0)

Free T3 3.5 pmol/L (3.10 - 6.80)

TPO antibody 604.3 IU/mL (<34)

TG antibody 356.3 IU/mL (<115)

8 Replies


How long is it since dose was increased to 175mcg?


6 weeks ago



You should have a thyroid function test to check levels 6-8 weeks after dose was increased to 175mcg. Most people are optimally dosed on Levothroxine when TSH is 0.3 - 1.0 with FT4 in the upper range. FT4 needs to be in the upper range in order that sufficient T3 is converted. Read Treatment Options in Email if you would like a copy of the Pulse article to show your GP.

FT3 3.5 is low in range and unless it has increased substantially on the dose increase you may benefit from adding some T3.

Have you had ferritin, vitamin D, B12 and folate tested? Low/deficient levels are common in thyroid patients and symptoms can be similar to hypothyroid symptoms.

Thyroid peroxidase and thyroglobulin 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.

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Thanks, my T3 just gets even lower the more my Levothyroxine dose is raised. I have had vitamins and minerals checked and I supplement but they are not improving



FT3 normally rises when Levothyroxine dose is increased. If your vitamin and mineral levels are not improving you are not taking sufficient doses of supplements. If you post your vit/min results and ranges and say how what and how much you are supplementing I can help advise.


Ferritin 22 ng/L (30 - 400)

MCV 77.2 fL (80 - 98)

MCHC 384 (310 - 350)

MCH 28.2 (28 - 32)

Haemoglobin estimation 113 (115 - 150)

Haematocrit 0.41 (0.37 - 0.47)

Platelets 252 (150 - 400)

RBC count 4.44 (3.80 - 5.80)

WBC count 7.12 (4.00 - 11.00)

Iron 5.3 umol/L (6.0 - 26.0)

Transferrin saturation 12 % (12 - 45)

Taking 3x ferrous fumarate a day since 2013

Folate 2.3 ng/L (2.5 - 19.5)

Taking folic acid 5mg since 2016

Total 25 OH vitamin D 24.8 (25 - 50 deficient)

Taking 800iu D3 since 2013

Vitamin B12 241 (190 - 900)

Results done August 2017



Ferritin, MCV, Haemoglobin, Iron & transferrin indicate iron deficiency anaemia. If 3 x 210mg since 2013 hasn't improved iron levels your GP should be arranging an iron infusion.

Folate is deficient. Perhaps GP could increase folic acid dose or refer you to a haematologist.

B12 is low in range. If you have symptoms in go to for advice on B12 and folate.

Vitamin D is severely deficient and 800iu is a maintenance dose totally insufficient to treat deficiency. Your GP should refer to local guidelines or the NICE CKS recommendations for treating vitamin D deficient adults My GP prescribed 40,000iu D3 daily x 14 followed by 2,000iu daily x 8 weeks which raised vitD from <10 to 107. Vitamin D should be taken 4 hours away from Levothyroxine and T3.

Alternatively you can buy vitamin D3 without prescription from Amazon. If you buy on Amazon please use the affiliate link

It would be sensible for your GP to checking whether you have malabsorption preventing you absorbing nutrients. Coeliac disease is a common cause of malabsorption in hypothyroid patients. Ask your GP to check tissue transglutaminase.

1 like

Why was T3 stopped? Presumably endo didn't like suppressed TSH

You need to get vitamins much better first before looking at adding T3 back, ask that they are retested with thyroid

All thyroid tests should be done as early as possible in morning and fasting and don't take Levo in the 24 hours prior to test, delay and take straight after. This gives highest TSH and most consistent results

See SeasideSusie detailed reply on vitamins here

Your TSH needs to be around one and FT4 towards top of range and FT3 at least half way in range

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

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

Once gluten free, vitamins at good levels and TSH at around one if FT3 remains low then adding small dose T3 may be needed

You might consider DIO2 gene test


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