Please can someone advise me: I posted a short... - Thyroid UK

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Please can someone advise me


I posted a short time ago the results of GP blood tests that were TSH level is 4.91 (range 0.35-5.50) T4 is 9.2 (range 7.86-14.41). My GP put me on 25mg thyroxine to see if it'd help my symptoms even though he think it's depression causing it, and I've since paid for private tests to get a clearer picture.

I've just got the results back but I'm really not sure what to make of them. The results are in range, just, and I'm guessing I don't have an autoimmune reason for elevated levels?? I've had other tests done for vitamins d, b's, ferritin etc and they're all either high or above range. If anyone can help shed some light I'd really appreciate it. Is it likely my thyroid causing me these symptoms?

These are the private results:

TOTAL THYROXINE(T4) 63nmol/L (59 - 154)


FREE THYROXINE 13.8pmol/l (12.0 - 22.0)

FREE T3 3.4pmol/L (3.1 - 6.8)

Thyroglobulin Antibody<10.0IU/mL 0-115

Thyroid Peroxidase Antibodies<9.0IU/mL 0 - 34

6 Replies

You need a 25mcg increase in levo. You are aiming for TSH under 1 and free t4 and free t3 in top quarter of range (So FT4 > 19 and FT3 >5.5). 25mcg is a starter dose for a child or frail elderly person. The NHS guidelines say that 50mcg is the normal starter dose for adults. Can be physical damage to thyroid or pituitary or nodules. Apparently some people can have autoimmune thyroiditis but not show antibodies every time tested. No scientific evidence to point to depression as a cause, but low T3 causes low mood. Anti-depressants make money for GP and mean your symptoms will be ignored, so don't allow GP to diagnose depression.


Ask GP to increase dose up to 50mcg. Bloods will need retesting 6-8 weeks after

Dose in increased in 25mcg steps until TSH is around one and FT4 towards top of range and FT3 at least half way in range

Most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine

NHS guidelines saying standard starter dose is 50mcgs

Can you add the results and ranges of vitamins

What supplements do you take?

If ferritin is above range without supplementing, that can be a problem

in reply to SlowDragon

Thanks slowdragon. I'm seeing the GP again in a few weeks and hoping he'll agree to up the levo I'm taking. Unfortunately he alreayd diagnosed depression a year ago. I still maintain it's not that that causes these symptoms.

Anyway, here are my vitamin levels. They look fine to me but if you have any advise of improvements that might ease my symptoms that'd be much appreciated :) I currently take vit D, B complex, multi-vit, and calcium supplements.

Serum folate 20.7 (>4.0)

B12 537 (150-750)

Ferritin 111 (22-322)

Vit D 68.4 (>50)

calcium 2.36 (2.10-2.70)

celiac test 0.3 (0-7)

in reply to katmell

Your vitamin D is too low, best at least up to 80nmol.

Many find getting level up around 100nmol is better

Vitamin D mouth spray by Better You is good as avoids poor gut function. Suggest you increase your supplement for 2-3 months and retest. 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

Also read up on importance of magnesium and vitamin K2 Mk7 supplements when taking vitamin D

You probably don't need calcium supplements. Improving vitamin D naturally improves calcium levels

Ferritin, B12 and folate look ok. Though folate and B12 are not very high considering you are supplementing

But increase in Levothyroxine will help

Depression is common symptom of being hypothyroid

On Levothyroxine TSH should not be higher than 2. And many patients need it much lower in order to have high enough FT4 and FT3

Official NHS guidelines saying TSH should be between 0.2 and 2.0 when on Levothyroxine

(Many of us need TSH nearer 0.2 than 2.0 to feel well)

See box

Thyroxine replacement in primary hypothyroidism

Most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine (increased slowly in 25mcg steps over many months/years)

in reply to SlowDragon

Many thanks slowdragon for all the info. Very handy and I’ve just ordered some of the spray.

I found an article recently that suggested levothyroxine dosage should be proportionate to body weight. I think it was 1.6mcg per kg of weight which would put my does at around 85 (I’ve been prescribed 25). I’ll bring this up with the gp when I go for a check-up


GP's get substantial financial incentive for "diagnosing" depression.

Your results clearly show you are under medicated for Levothyroxine

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