These are my latest blood tests.... very long story short on Levo for secondary hypothyroidism. All pretty stable for 20 years and in the past year FT4 shot up to 31 (same ref range as below). Re-referred to Endo who said I was over medicated and reduce dose. I have been 250mcg, reduced to 225mcg, then 200mcg -225mcg alt days and now 200mcg.
I am concerned about FT3 being so low!! FT3 has got lower and lower whilst reducing Levo....
You need vitamin D, folate, ferritin and B12 tested. Low vitamin levels can be underlying issue
Getting vitamins optimal is first step. Post results and ranges if you have them
But also you may just need the addition of small dose of T3.
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 list of recommended thyroid specialists, some recognise patients need T3
Professor Toft recent article saying, T3 may be necessary for many otherwise we need high FT4 and suppressed TSH in order to have high enough FT3
Your B12 and folate were very low. You may also need sublingual B12 lozenges in addition to a good quality vitamin B complex, one with folate in, not folic acid
Vitamin D too low. Aiming to improve to around 100nmol
Vitamin D mouth spray by Better You is good as avoids poor gut function. It's trial and error what dose each person needs. Once you Improve level, very likely you will need on going maintenance dose to keep it there. Retesting twice yearly via vitamindtest.org.uk
Also read up on importance of magnesium and vitamin K2 Mk7 supplements when taking vitamin D
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Eyebrows have started growing again : )
Need Advice Please 
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I’m fine. Really?
