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Thyroid UK
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Please advise

Diagnosed hypothyroid 2011, feel so unwell. Have high blood pressure, low heart rate, headaches, feeling low, swelling in neck.

Gp reduced from 175 to 25 based on

OCT 2017

TSH 1.60 (0.2 - 4.2)

FT4 18.8 (12 - 22)

FT3 3.9 (3.1 - 6.8)

He didn't like where FT4 was.

I have Hashimotos I think

TPO antibody 271 (<34)

TG antibody 335.3 (<115)

25mcg levo reduced from 175mcg

JAN 2018

TSH 4.88 (0.2 - 4.2) FT4 14.6 (12 - 22) FT3 3.3 (3.1 - 6.8)

Please advise do I need T3 thank you

3 Replies


You don't need T3, you need a decent dose of Levothyroxine and a different GP who has some understanding of hypothyroidism. FT4 18.8 was excellent. There was no reason for your GP to 'not like where it was'.

FT4 needs to be in the upper range to convert sufficient T3. 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.

Dose adjustments are supposed to be in 25mcg increments at six week intervals with follow up testing to check levels not swingeing reductions of 150mcg. Please see another doctor at your practice to increase Levothyroxine dose as you are now very undermedicated. You could also make a written complaint about your GP's treatment to the practice manager and your GP will hopefully receive some retraining.

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.




Geez ...these GPs are useless

T4 should be near 19 but importantly Freet3 should be 5.5

Hence you are not converting t4 into t3




Vits d3

All need testing and must be at least halfway in their ranges for the conversion of t4 into active t3 to occur


Yes, free T4 could easily be a bit higher (around 19.5), but I bet that wasn't what he meant. It's the free T3 that is the problem - much too low - needs to be around 5.5 at least. You are now severely undermedicated. I am amazed at how many of these doctors can't do percentages. We are looking for a level around 75% of range. The free T4 range spans 12 to 22 = 10 intervals. 75% of those 10 intervals is 7.5 (nice easy numbers) so the bottom of the range (12) plus the 75% = 19.5, so 18.8 was less than optimal, not more. You can do the same calc on free T3 with either 67% or 75% (depending on who you agree with) and you'll get a result of between 5.5 and 5.9.


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