Thyroid UK
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Hypothyroidism or not?

Hi everyone, I am writing because I am at a complete loss as to what to do about my health. I am quite a slim girl, but my nails are brittle, ulcers on lips, constipated despite drinking more water and eating more fibre, tired, periods are heavy, hair falling out, feeling cold all the time.

Ultrasound on the thyroid confirmed it was enlarged,swollen with coarse patches through it.

Is it possibly a thyroid issue?

Thank you for reading!

10 Replies


A healthy thyroid gland has a smooth texture. Have you had a thyroid function test and thyroid antibody blood tests?



TSH 60.8 (0.2 - 4.2)

FT4 10.1 (12 - 22)

FT3 2.2 (3.1 - 6.8)

Thyroid peroxidase antibodies 376 (<34)

Thyroglobulin antibodies 1700 (<115)


What did your doctor say about these results?


Normal no action


You need a new doctor. That is malpractice.

1 like


High TSH and low FT4 and FT3 confirm that you have overt primary hypothyroidism. How much Levothyroxine have you been prescribed?

Thyroid peroxidase and thyroglobulin antibodies are positive for autoimmune thyroid disease (Hashimoto's). Typical Hashi's damage is coarsened texture of enlarged or atrophied thyroid gland.

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.


No Levothyroxine has been prescribed yet



How long have you had the results?


2 weeks



I would make a formal complaint to the practice manager that no-one from the practice has advised you need treatment for overt primary hypothyroidism.

You should make an appointment with your GP as soon as possible for a prescription. NICE recommends intiating 50mcg - 100mcg

The goal of Levothyroxine is to restore the patient to euthyroid status. For most patients that will be when TSH is 0.3 - 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

For maximum absorption Levothyroxine should be taken with water 1 hour before, or 2 hours after, food and drink, 2 hours away from other medication and supplements, and 4 hours away from calcium, iron, vitamin D supplements, magnesium and oestrogen.

It takes 7-10 days for Levothyroxine to be absorbed before it starts working and it will take up to six weeks to feel the full impact of the dose. Symptoms may lag behind good biochemistry by several months.

You should have a follow up thyroid test 6-8 weeks after starting Levothyroxine. Arrange an early morning and fasting (water only) blood draw when TSH is highest, and take Levothyroxine after your blood draw.


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