Advice on blood test results, low TSH, low T4. - Thyroid UK

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Advice on blood test results, low TSH, low T4.


I have been struggling with excessive symptoms of debilitating fatigue, weight gain, burning sensation down my left side and generally feeling so bad I don't leave the house for the last two years. I have a diagnosis of Hashimoto disease, severe low growth hormone deficiency in two of the three tests, the third test showed above the cut off for treatment. My latest blood test results are as follows. TSH 0.69 ( 0.27 - 4.20) T4 12.8 ( 11.00 - 25.00) T3 test refused although I had it tested at hospital a few months ago and showed T3 4.1 ( 3.1 - 6.8) TSH 2.31 T4 13.5. I was then taking Levothyroxine 75mg and have had it increased to 100mg. My question is do I need to privately source T3? I have been taking a lot of recommended supplements but still don't feel well enough to get back to work which is putting pressure on my marriage. B12 is in the mid range, Ferritin 177 ( 15 - 300) Any advice would be greatly appreciated.

5 Replies

I don't think you need T3, you seem to be converting very well. It's just that you don't have enough T4 to convert. You need an increase in dose.

Busbod in reply to greygoose

Thank you

greygoose in reply to Busbod

You're welcome. :)


Are you on strictly gluten free diet or tried it? Many of us with Hashimoto's find it helps or is essential

Have you had vitamin D and folate tested

Low vitamin D strongly linked to autoimmune disease

Ferritin is ok

B12 needs to be towards top of range.

Get others tested too

For full Thyroid evaluation you need TSH, FT4, TT4, FT3 plus TPO and TG thyroid antibodies.

Plus very important to test vitamin D, folate, ferritin and B12

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or vitamins

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 ideally be done as early as possible in morning and fasting. If on Levothyroxine, don't take in the 24 hours prior to test, delay and take straight after.This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)

Your levels should have been retested 6-8 weeks after last dose increase. If not been done ask GP to test these plus vitamin D, folate and coeliac blood test too if not already gluten free

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

You have been so helpful thank you. My GP has agreed to increase Leno to 150mg fingers crossed I will get my life back!

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