High TSH, Normal FT4

[michael172]

Hi, Ive been on T4 on the NHS for about a decade now, I also self medicate with T3 since about 2 years. Before going on T3 I had private tests done and no issues with FT3 but suffered with what people on here describe as brain fog. I added T3 out of desperation and that provided me with a functioning brain again, quite literally change my life. I take 150mcg T4 and half a 25mcg tablet of T3 daily, any more T3 and I become quite aggressive although I do feel much better, ive had allsorts of doses while finding what feels right and settled with this combination for a while now, recently however ive started feeling quite tired (hypo tyred), could be because of a recent change in T4 brand or just the weather (doctors say the T4 is all the same though so what do we know).

I had a routine NHS checkup recently as they were threatening to withhold my prescription and 'FT4' levels were normal at 14.8, however TSH is at 8.5, normal ranges being 0.35 - 5. Obviously with it being NHS ive no more results of use, however I was not expecting to see a high TSH, do you think this could be time to check antibodies with a private test? Maybe even recheck reverse T3, FT3?

Thanks, Mike

[shaws Administrator]

You need an increase in levothyroxine due to your TSH being above range at 8.5.

You could try taking 125mcg T4 and 3/4 T3 to see if this is helpful for you.

(I am not medically qualified but I had undiagnosed hypothyroidism.)

You say your FT4 was 'normal' but I am assuming they didn't test your FT3 which is the more important one. We feel better when TSH is 1 or below with FT4 and FT3 towards the upper part of the range.

[Clutter]

Michael72,

You are undermedicated to have TSH 8.5. Ask your GP to increase Levothyroxine dose and have a follow up thyroid test 6-8 weeks later to ensure dose increase was sufficient.

The goal of Levothyroxine is to restore the patient to euthyroid status. For most patients that will be when TSH is 0.35 - 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 thyroiduk.org.uk/tuk/about_... Email [e-mail] if you would like a copy of the Pulse article to show your GP. Thyroid UK's office reopens 3rd January.

I would wait until TSH is around 1.0 before ordering a private thyroid test to check FT3 remains within range.

[Angel_of_the_North]

If you are taking levo and t3, you need to increase one or other of them. You need a free T3 test to work out which one. Your free T4 is about where you'd expect it for someone taking T4 and T3.

[michael172]

Thanks all,l had a slight increase in T4 today so ill keep an eye on it over the coming months.