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Thyroid UK
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Hi 👋 I am new and I have been really suffering of late. I have dry eyes, sluggish bowels, tiredness, ears ringing every day, periods more heavy, losing hair, puffy and dark eyes, sweats when walking, weight gain. I take 100mcg levo. How long to feel benefit? I felt better on 175mcg levo once but GP didn't like where my TSH was (0.03 range 0.2 - 4.2) FT4 20.9 (12 - 22) FT3 4.5 (3.1 - 6.8)

Recent results on 100mcg below. Thanks!

Dec 2017

TSH 5.66 (0.2 - 4.2)

FT4 14.8 (12 - 22)

FT3 3.5 (3.1 - 6.8)

TPO antibodies 374 (<34)

6 Replies

You are extremely under medicated. You are very likely to have low vitamin levels as result and these cause symptoms

Even on 175mcg your FT3 was too low. Poor conversion to FT3 is often linked to low vitamins and low vitamins are common with Hashimoto's

you have Hashimoto's also called autoimmune thyroid disease, diagnosed by high thyroid antibodies

Essential to test vitamin D, folate, ferritin and B12.

Always get actual results and ranges.

Post results when you have them, members can advise

Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels

Low vitamin levels affect Thyroid hormone 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

Ask GP for coeliac blood test first







You need a 25mcg dose increase and then bloods retested after 6-8 weeks. Dose increase repeated until TSH is around one and FT4 towards top of range and FT3 at least half way in range

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


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

Link about antibodies


Link about thyroid blood tests


Print this list of symptoms off, tick all that apply and take to GP


See Box 1. Towards end of article

Some possible causes of persistent symptoms in euthyroid patients on L-T4

You will see low vitamin D, folate, ferritin and B12 listed


Post with detailed advice on supplements for Low vitamins due to under medication



** retesting after vitamins are optimal, Levo dose increased so TSH is around one (or slightly less) and FT4 towards top of range. Plus strictly gluten free. If after all this FT3 remains low then, like many of us with Hashimoto's, you may need addition of small dose of T3

But other steps must be taken first


Your GP was wrong to reduce your results so drastically - especially as you were not overmedicated as your FT3 is well in range. The T3 is the active hormone needed in every cell of your body and by reducing your dose you can see what has happened - it is now on the floor 😊

Please read up on this forum about the TSH. It is a meaningless test once on treatment.

I would increase your dose by 25mcg and re-test in six weeks.

Have you tested B12 - Folate - Ferritin - VitD ? All need to be optimal for you to feel well and for thyroid hormones to work in the body.

As you have Hashimotos have you considered being gluten free to reduce anti-bodies ?

1 like

Hi I have had vits and mins tested 3 weeks ago but I don't know what to supplement. Not yet gluten free as doing coeliac test. Can I post results for ferritin etc for advice? Thanks


Please post your results with ranges for the vitamins and minerals that were tested ....


Does that mean if I supplement anything I will likely need lower dose of levo in order for it work? Sorry not sure how it all works :(


You need a dose increase. Your vitamins and minerals when optimal is a bonus as your thyroid hormones will work better in the body when they are ....


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