I have hypothyroidism and take 75 mcg of thyroxine.
I got bloods done my medichecks at 08:20am, before I took my thyroxine or ate anything.
TSH - 2.57 (0.27 - 4.2)
FREE T3 - 4.2 (3.1 - 6.8 )
FREE T4 - 17.8 (12 - 22)
THYROGLOBULIN ANTIBODIES - 10.1
THYROID PEROXIDASE ANTIBODIES - <9
You are undermedicated. Once we are on thyroxine tsh is best at 1 or below. Ft4 and Ft3 are best in the top third of their ranges.
Thanks - how do I approach this with a black and white medical system that believes if it's in range, it's fine?
You may have some success by showing your GP the following in support of your request for a dose increase:
Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine (the magazine for doctors):
"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).*"
*He recently confirmed, during a public meeting, that this applies to Free T3 as well as Total T3.
You can obtain a copy of the article by emailing Dionne at
tukadmin@thyroiduk.org
print it and highlight question 6 to show your doctor.
You can also refer to NHS Leeds Teaching Hospitals who say
pathology.leedsth.nhs.uk/pa...
Scroll down to the box
Thyroxine Replacement Therapy in Primary Hypothyroidism
TSH Level .................. This Indicates
0.2 - 2.0 miu/L .......... Sufficient Replacement
> 2.0 miu/L ............ Likely under Replacement
Thank you! I am seeing a private endo on tuesday about my adrenal glands, so I shall ask him about this then... I can then approach my GP. I have to be careful at the moment because I have low cortisol and increasing TSH can lead to a cortisol crisis. All fun and games! But this is really helpful.
Argue! Base your argument on the words normal and optimal. Ft4 would be considered normal at 12; it would be considered normal at 22. There is a big difference and that difference means symptoms until everybody finds their optimal level within the range. You still have symptoms at 17.9 so you would like to try a 25mcg increase. Your ft3 is low in the range. In the normal range it is expected that 50% of people will be around the mid point. You are not at the midpoint. If they mention tsh going too low - our thyroid is damaged and the we take hormones orally - the pituitary-thyroid link has been broken and does not function as normal.
Thanks! I'm so unwell recently... I have this weird hypothyroid, low cortisol combo going on. Which means I cannot gain weight, but I can't lose it either. My brain doesn't work and I'm tired all the time and I don't digest food very well. We want to have children soon, and I can barely keep myself functioning without a baby zapping all my nutrients. I'm also doing a PhD, and it's mainly stats based... as you can imagine, brain fog and stats = nightmare!
I can imagine. I gave up my small job as it was data handling and the brain just wouldn't! I went gluten free which has helped my gut function a lot. The brain and gut are the 2 biggest users of thyroid hormones.
My brain certainly needs something extra! I miss my brain functioning properly. People don't really understand either - they don't get why you're ill. I think that's one of the hardest things, the lack of understanding from people without invisible illness
You are correct about the 'invisible illness' as we might look fine to outsiders but our body/brain doesn't function as it should. This link from TUK might be helpful and show to your GP. You can also become a member (if you aren't already) which means the more members the stronger TUK will be:-
thyroiduk.org.uk/tuk/testin...
The aim is a TSH of 1 or lower - not above or 'in range' as the majority of doctors seem to think. Also if you can get a free T3 and Free T4 test (either through GP - rarely tested )or privately these two are more informative and I'll give you an excerpt:-
thyroiduk.org.uk/tuk/testin...
thyroiduk.org.uk/tuk/testin...
Hi - T3 and T4 results are both above 
See from your other post you also have PA
When were vitamin D, folate and ferritin last tested?
Can you add results and ranges if you have them
What vitamin supplements do you currently take (apart from B12 injections)
Your results suggest you need dose increase in Levothyroxine
FT4 is only 59% through range
FT3 and 29% through range
Useful calculator for working out % through range
Have you had ultrasound scan of thyroid?
One in five Hashimoto's patients never have raised Thyroid antibodies
healthunlocked.com/thyroidu...
Hello - I have never had any tests for my thyroid, aside from TSH and T4. The same with the PA, they put me on b12 tablets and my b12 didn't budge. So, I had to start injections. But, my b12 has been low since I was a teenager, they just didn't do anything about it, and I didn't know enough to realise it was a problem.
I have a complicated medical history... but I'm sure it all links in some way!
Ferritin was 20... last bloods it was up in the 40s, so the new iron tablets are working.
Folate was well in range but vit D wasn't done. I do take vit D tablets though, so that should be fine.
I take a multi-vitamin, high strength iron, folic acid, magnesium, vit D, calcium, omega 3.
For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12
Low vitamin levels are extremely common, especially if Thyroid antibodies are raised
Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water . This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)
Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose immediately after blood draw).
Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or all vitamins
thyroiduk.org.uk/tuk/testin...
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 special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random
If antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).
About 90% of all primary hypothyroidism in Uk is due to Hashimoto's.
Low vitamins are especially common with Hashimoto's. Food intolerances are very common too, especially gluten. So it's important to get TPO and TG thyroid antibodies tested at least once .
Link about thyroid blood tests
thyroiduk.org/tuk/testing/t...
Link about antibodies and Hashimoto's
thyroiduk.org.uk/tuk/about_...
thyroiduk.org.uk/tuk/about_...
List of hypothyroid symptoms
thyroiduk.org.uk/tuk/about_...
This link may be informative too.
If you are not a member of the P.A. group they will help/advise you how to get the best results you need.
Thanks - my PA isn’t a problem, I get b12 jabs and know how to self inject as well. Main problems are thyroid and adrenals. I had chemotherapy 6 years ago, and that exasperated everything
Blood tests 2008-2014
Dose changes advice please 
please could I have feedback on my private blood test results 
High T3
thyroid results
