My endo said my Tsh 7.9 is fine as t4 is in upper limits.... once again recommended I stop thyroxine, currently on 75mcg said stop for 8 weeks and see how I am.... then we will know if I have thyroid resistance but when I started thyroxine Tsh was in 30's and t4 was 13...... I'm going round in circles I have never particularly improved on thyroxine so she says stop it.... a scary thought as I had so many issues with tachycardia that's now settled a lot .... any help pls
Wondered if aswanga may help??? I do have raised cortisol but Drs ignore that
B12 vit d both at top end of normal
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richard123
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Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.
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
Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.
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
Very likely to have low vitamin levels and also be gluten intolerant
Are you on Gluten free diet? Or tried it ever?
Antibodies can completely mess up the gut, you don't need to have any obvious gut symptoms
Add your most recent vitamin test results too
In range is not the same as optimal
About 90% of all hypothyroidism in Uk is due to Hashimoto's
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
Ideally ask GP for coeliac blood test first plus retest vitamin D, folate, ferritin and B12
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 at
tukadmin@thyroiduk.org
Also request the list of recommended thyroid specialists
Suggest you find a new endo
With high TSH and very high TPO antibodies you almost certainly do not want to stop taking Levothyroxine
I would change your Endo. A TSH of 7.9 is fine!! Why then in other countries do we get diagnosed when TSH reaches 3+? We need T3 (converted from T4) and to tell someone to stop for four weeks, I believe, is reckless to say the least. Also as your heart was playing up before being diagnosed, I'd not like that experience again myself. Our brain and heart need the most T3.
At least it tells you that he/she is puzzled as some of us do not imrove on T4 and I assume she hasn't tested FT4 and FT3 to check whether or not you are converting to T3. You can read on the following link why these are important.
Some do not improve on levothyroxine - I didn't - but some need sufficient increases or the addition of T3. Unfortunately they have stopped prescribing T3.
They are so badly taught and I think it must have been a couple of hours minimum on Endocrinology as they seem never to have heard about liothyronine (T3) or that is the only Active thyroid hormone - levothyroxine being T4 only and inactive.
If you've had a recent blood test get a print-out with the ranges and post for comments.
You need TSH, fT3 and fT4 results before we can advise. Also endocrinologist should carry out a different TSH assay just to rule out assay interference.
Having read your history please ignore my previous reply. Has your iron levels ever been tested? Low iron could contribute to some of your symptoms. If you are taking lots of supplements I would discontinue them as they may be affecting your thyroid.
Really need free T3 as total T3 is of little use. Given your symptoms and your elevated TSH with high normal fT4 your endo should have tested TSH fT3 and fT4. They should also check your selenium level as low selenium can impair T4 to T3 conversion and presents with high fT4, high TSH. They are not on the ball, I'd suggest they pull their socks up.
With that TSH and freeT4 it's very likely your freeT3 is low. I've seen this exact pattern in a friend of mine.
Looks like you've had totalT3 and not freeT3 done, so we can't rule out very low freeT3.
T4 is the inactive, storage form of thyroid hormone. Your body needs to convert it to T3 in order to use it. When we're ill sometimes this conversion processes doesn't work well. The Levothyroxine you're taking contains only T4, so a lot of work being left to your body to convert it into a usable form.
Sounds like your doctor is clutching at straws and you are going to suffer as a result.
I think the most obvious first step is to get a freeT3 test done privately, so you can use that to back up your argument you don't want to drop your medication. If you go to BlueHorizon or Medichecks and get a mail order, finger prick test you can have the result in your hands by this time next week.
Take the test first thing in the morning, before you've eaten, and about 24hrs after your last dose of Levo. Then you can take your dose after you've done the test
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Doc says tsh doesn't matter not important !
