Low TSH, High normal T4, normal T3 = bloody kna... - Thyroid UK

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Low TSH, High normal T4, normal T3 = bloody knackered

ozzy1000_0 profile image


I've been treated for hypothyroidism since my late 20's, I'm currently 41. the first couple of years my GP constantly changed my doses of T4 and I swung from anxiety to hypo symptoms again, eventually referring me to an endocrinologist. A bit of faffin around with them and eventually they put me on T4 and T3, sent me back to my GP with a letter saying, "keep replacing until symptoms are ok, as long as we can detect TSH I'm happy". So for the past 10 years of so I've been on 175mcg of levothyroxine and 20mcg of liothyronine (split into 10's x 2). This was initially better than just the Levo alone, I had enough energy to get back into cycling and get very fit again... however, it always felt like a fine line between being 'ok' and being burnt out and depressed, I can't say I've felt really consistently well for over 20years, more that I would have bits of feeling better and I was more able to function.. but it felt fragile... anyway the last couple of years have been aweful, I badly destroyed my knee in an accident last easter, then spent most of last year on crutches taking painkillers, this year I've had loads of work stress, personal stress, I have three kids and my knee still gives me pain. Prior to the knee injury the depressions and tiredness were already getting worse, but this past year or two has been ridiculous, I'm falling asleep at work I'm so tired,m, I forget things and my mood is so easily low. I've been back to my Dr, we've done blood tests and my thyroid results are as above TSH really low (I can't remember, but just detectable) and my T4 and T3 are in normal range but at the top end. I've taken antidepressants this year and they helped a bit, but caused other issues. I'm convinced that my thyroid could be further optimised, and that maybe I'm just stupidly fatigued with life and being slightly hyper/over replaced. last year I tried reducing my levo to 150, but was on my knees with fatigue after 4 or 5 weeks, so went back up. I've been thinking about armour?? any advice please??? many thanks, Owain

6 Replies

Have you considered using tirosint? A lot people say that it’s the best form of Levothyroxine.

Oh, please don't use the 'N' word. :( There's no such thing as 'normal' where thyroid is concerned. If you could give us the actual numbers - results and ranges - it would be far more comprehensible.

There could be several reasons why you feel the way you do. For example, have you had your nutrients tested? Vit D, vit B12, folate and ferritin? If they are low - and they very well could be because hypos often have low stomach acid and therefore difficulty digesting and absorbing nutrients - they will be cause lots of symptoms. And, your body will not be able to use thyroid hormone efficiently.

How about your adrenals? Have you investigated them?

Or, maybe you are someone that has difficulty absorbing thyroid hormone at a cellular level, and need very high levels of T3 to over-come it.

NDT might help, but there's no guarantee. It doesn't suit everyone. And, you wouldn't be able to replicate the dose you're on now exactly. One grain of NDT has 38 mcg T4 and only 9 mcg T3, so you would be starting again trying to find the right dose for you.

BUT before starting NDT, all your nutrients have to be optimal or it won't help you. So, there's your starting point: investigate your nutrients. :)

ozzy1000_0 profile image
ozzy1000_0 in reply to greygoose

I didn't get my T3 tested last time, my new GP is a bit old school... TSH was 0.02 and T4 was 22. My GP did a general MOT at my last test too, checked a bunch of stuff looking for anaemia and other fatigueing things. but probably not nutrients to a finer degree.. I'll ask about it, cheers, Owain

greygoose profile image
greygoose in reply to ozzy1000_0

Ask for a print-out of your results and ranges, not just your doctor's opinion. If you live in the UK, it is your legal right to have a copy.

Hi Ozzy

You have my best wishes, I'm still a little confused over my own thyroid levels which require further treatment to become optimal so I can't offer "technical advice".

I do know from personal experience of two bouts of surgery and long term pain in the last three years, that stress in the form of illness, work problems, financial etc plus heavy duty meds can seem to cause havoc with what seemed to be a relatively stable thyroid state, if there is such a thing !

Wishing you well and hope that you do feel better soon. We try to get fit and healthy but the exhaustion is the real killer....You begin to wonder " what exactly is the real you nowadays "? Things will improve....trial and error 😊

A pro-metabolic diet and substances that help metabolism / CO2 / conversion T4 to T3 like progesterone, aspirin / caffeine, caffeine, B's, etc. are a good start. Most antidepressants increase serotonin which worsens long-term depression and is anti-metabolic.

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