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Thyroid UK
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Bloods similar but feeling bad again?

Back in May TSH - 0.75 (0.55-4.78)

T4 - 16 (10-25) and results in today are TSH 0.90 and T4 - 16.

Last few weeks starting to feel rubbish again so was expecting change in results for the worse. Been supplementing for low Vit D and Iron so don't know why I feel so washed out.

I posted last week about symptoms being worse in winter, is this maybe why I'm feeling rubbish again despite results remaining stable?

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When did you last have your vitamin levels tested?

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About 6 months ago and ferritin and vit D were low. Tried supplementing but don't get on with the iron tablets. Got ferritin retested and got results today it's still at 24 (7.0-150.0) could that explain the tiredness etc.?


Low ferritin does cause tiredness. Low Vit D can cause joint/muscle pain. There are different options for iron if one type doesn't suit, try another or use food/diet to improve iron.

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TSH 0.9 is low-normal and FT4 16 is less than mid range. There is scope to increase dose to raise FT4 but it might suppress TSH which may alarm your GP. Read Treatment Options in thyroiduk.org.uk/tuk/about_... Email dionne.fulcher@thyroiduk.org if you would like a copy of the Pulse article to show your GP.

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There's no FT3 tested here

FT4 is low within that range

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, lowest FT4 and most consistent results

Is this how you did the test?

For full evaluation you ideally need TSH, FT4, FT3, TT4, TPO and TG antibodies, plus vitamin D, folate, ferritin and B12 tested

See if you can get FT3 and vitamin testing from GP.

Private tests are available


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.

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 articles from Thyroid UK email dionne.fulcher@thyroidUK.org. print it and highlight question 6 to show your doctor.

Prof Toft - brilliant article just published, it which he states he is now reluctant to do RAI or thyroidectomy as resulting hypothyroidism is currently so mismanaged in UK


You may need addition of small dose of T3, but essential to test current FT3, plus get vitamins very good first

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Thanks for the info. Yes have my Levo early hours of the morning then breakfast 2-3 hours later. Had my vitamins tested earlier in the year and ferritin and vit D were low. Ferritin has stayed the same just got results yesterday didn't get on with iron tablets. Wondering if it's the low iron making my struggle just now?


So how much did you supplement vitamin D and what level is it at now

We see 100's on here been supplementing for years with no improvement because dose was too low

Thyroid hormones can not work if any one of these four is too low

See SeasideSusie reply to very low levels here


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Getting fed up saying this but FT3 reading would be useful! Why they never test this I shall never understand. If you have a conversion problem them your FT3 could be very low but on what we know you would probably benefit from a dose increase.

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Did wonder about T3 but told the labs would refuse to test for it when I enquired. Maybe time to go for some private testing.

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