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Advice on latest results

Hello, can someone give me some advice on my latest results? I was very unwell in September 2017 with TSH of 16 and T4 of 11. I started levo, initially 50mg then 75 for the last eight weeks. My symptoms have improved a great deal but still bit tired, little brain fog and muscle pain. My results this week were as follows.

Thyroid function scores 3 Jan 2018

TSH 1.1. Range 0.4 to 4.5

T4 14 range 12 to 24

T3 3.9 range 4 to 8.3

My question is whether I should ask for a dose increase as my TSH is now low but my T4 and T3 are at the bottom of the range. Thanks a million, I always get great advice from this forum.

3 Replies

I think you should ask for an increase, yes. Your FT3 is below range. However, if your doctor is one of those that only looks at the TSH, and doesn't understand the importance of T3, you might have a hard time getting one. :(


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?

your FT4 and FT3 are on low side

But your GP may be reluctant to increase due to low TSH

Did you get your vitamin D, folate, ferritin and B12 tested?

Have you ruled out gut infections, I see this started after trip abroad


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 print it and highlight question 6 to show your doctor

please email Dionne:

Prof Toft - article just published now saying T3 is likely essential for many



Brilliant, thanks for the article. The test was first thing following 24 hour fast and no levo day before

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