Hello everyone. Happy New Year! For the first time since my thyroidectomy 2 years ago, my doctor says my results are normal. Do you agree that they are?
TSH 1.35 - 0.32-4.00
T4 14 - 9-19
T3 3.3 - 2.6-5.8
I’m not sure what all this means and I’m just trusting my doctor. Any thoughts from my expert friends here would be very much appreciated!
Thanks 😊
It depends on how you feel. I would not be well with those results as the FT3 is too low.
How do you feel? What medication do you take?
Still have bloating and brittle hair. Not sleeping great and totally unmotivated. I take 112 Synthroid.
In that case I would say you need an increase. Once we are on medication we often feel best when the TSH is 1 or below. Your FT 4 is low in range and it is the same for your FT3 result. I think you are undermedicated.
I agree that you're under-medicated.
Your FT4 is only 50% through the range. Your FT3 a measly 21.87%. That would be much too low for most hypos. And, your TSH is slightly high - when on thyroid hormone replacement, it should come down to 1 or under.
When a doctor says that your results are 'normal', all he means is that they're 'in-range'. He has no idea whether that is actually 'normal' for you. But, he just doesn't know any better.
Results show you are under medicated
FT4 only 50% through range
FT3 only 21% through range
Helpful calculator for working out percentage through range
How much Levothyroxine are you currently taking?
Ask GP for 25mcg dose increase
Currently you have Poor conversion of FT4 to FT3.....
Good vitamin levels can improve conversion
EXTREMELY important to test vitamin D, folate, ferritin and B12
Low vitamin levels are extremely common, especially when under treated and/or Graves' disease
Ask GP to test vitamin levels
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 .
Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)
Is this how you did the test?
Aiming to improve FT3 to at least 60% through range
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
Come back with new post once you get vitamin test results
Thank you SlowDragon. Lot’s of good information. I have read your responses to other posts and am doing my testing per above now.
Yes that’s how I do my tests. My dosage is 112. My vitamins were tested and are good. They won’t test vit d though. My doctor says everyone is low in vit d. 🤷♀️
Then you need to test yourself
£29 NHS postal kit
On Levothyroxine we need GOOD vitamin D, at least around 80nmol
Guidelines on dose by weight is
1.6mcg per kilo of your weight
This may help in persuading GP to increase dose
New NICE guidelines
nice.org.uk/guidance/ng145/...
1.3.6
Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.
HRT frequently means need higher dose of Levothyroxine
Hi can't believe gp won't test vitamin d, I had years of being deficient, saw specialist research consultant who links to vitamin d Council website for advice. It can cause all sorts of symptoms of poor health. I supplement now and levels deemed sufficient. Don't take no for a answer we need it for all sorts of body functions for optimum health and the expert I saw said to me GPS don't know enough about it. He is a retired lecturer with vitamin d scientists on teaching exactly what this vitamin is and its functions. Hope this helps 🙏👍
Thanks Thor63. I’m taking Vit d anyway along with magnesium and vit k2/k7. B complex.
Hello Thissucks37
I totally agree with everything that has already been written.
You do currently appear under medicated and am sure an increase in Levothyroxine is appropriate. Our bodies need to convert the Levothyroxine - T4 - into T3 which is the active hormone that the body " runs on " and your conversion of the T4 into T3 can be compromised if your vitamins and minerals are not optimal within the ranges.
A fully functioning working thyroid would be supporting you on a daily basis with approximately 100 T4 + 10 T3.
Some people can get by on T4 alone, some people simply stop converting the T4 into T3 and some people simply need both these essential hormones dosed and monitored independently to bring then into balance and to a level of well being acceptable to the patient.
Personally, I just believe that if there has been a medical intervention and the thyroid surgically removed or ablated with RAI both these vital hormones need to be on the patients prescription for if, and probably when, needed.
T3 is said to be about 4 times more potent than T4 with the average person needing about 50 T3 to function on a daily basis. So you will see from this that you have " lost " your own natural ability to produce T3 and that equates with about 20% of your overall wellbeing.
In the first instance you need to get your T4 - Levothyroxine - up to the top of the range :
Your T3 should then increase and you will may feel the relief of symptoms experienced :
If your T4 goes slightly over range it doesn't matter too much, as it's your T3 that needs to be higher and you need the T4 increased proportionately in order to do this.
In order to be prescribed T3 your doctor can refer you to endocrinology - but in the first instance you need an increase in Levothyroxine and optimise your vitamins and minerals to give yourself the best chance of better health.
The thyroid is a major gland responsible for full body synchronisation, your mental, physical, emotional, psychological and spiritual well being including your inner central heating system and your metabolism.
Your Thyroid and How To Keep It Healthy is a very good, easily read book, written by a doctor who has hypothyroidism : Barry Durrant - Peatfield.
It may sound a little late, as now neither of us have this amazing little gland, but this book, along with learning from this amazing website has equipped me better to get my life back.
I'm with Graves disease, post RAI and now manage hypothyroidism, thyroid eye disease and lingering Graves symptoms. I am now self medicating and getting back to being " me " .
Thanks Pennyannie. Last year my dosage was 150 but I felt I wanted to jump out of my skin. I was taking HRT then so I know the dosage needed to be higher. I have some 125 tabs so I’ll start those and see how I feel. Of course not taking HRT I am having the hot flashes again.
I can't really comment on HRT, as my Graves raised it's ugly head well past menopause for me, in fact, I got off very lightly when my periods stopped in my mid/late 40's.
However when Levothyroxine wasn't helping me, after RAI, my doctor put me on anti depressants and then suggested HRT - I took it for a month, but looking back, the doctor was at a loss as to what to say or offer me.
I think it's worth trying an increase as you are " looking " under medicated and have typical symptoms, why not try 125 mcg rather than jumping back up to 150 mcg ?
I found my cognitive functions severely compromised whilst on Levothyroxine.
I found no help within the NHS system and eventually trialled both T3 synthetic hormone along with my T4 Levothyroxine and then tried Natural Desiccated Thyroid.
They both worked and I've settled on NDT which is pig's thyroid, dried and ground down into tablet form with each grain/tablet containing T1, T2, T3, T4 and calcitonin, the same known hormones as those found in the human thyroid gland.
NDT was the successful treatment of choice for over 100 years prior to the introduction of Levothyroxine, blood tests and ranges of the 1950's. You dose to the relief of symptoms and if patients were not feeling better, they were believed, and their portion of NDT would be slowly be increased until their symptoms subsided.
Yes I’m having cognitive issues. Even started worrying about dementia. I’ll try the increase first before starting something else. I had to quit my job because I could not cope. I’d been there 13 years.
I know that feeling - and have the T shirt.
The brain needs a large proportion of T3 to function.
It's commonly called " brainfog " on here -
It used to take me hours just reading simple things, and then I couldn't remember any of it, ten minutes later.
I actually took flash cards with me when I visited the doctor -
She'd seen me go from a vibrant, talkative, somewhat " funny " person to someone unable to answer simple questions ???
I was given anti depressants as a sort of consolation prize, as in the UK getting a prescription for T3 is very difficult, unless you go private, and then to the appropriate endocrinologist who is understanding and sympathetic to thyroid sufferers.
Am I right in thinking you are in Canada ?
How's is T3 perceived over there ?
There have been some very interesting articles posted here from Canadian Thyroid UK arm written by a Tania S Smith.
Yes I actually have some T3 and I took it for 2 weeks last year and developed acne so I stopped. I took some the last couple of days but I’m feeling terrible. Yes I’m also on antidepressants for years now. Also have an eye problem where everything looks foggy. The worst symptom is lack of energy and motivation. I am from Canada. 😁
Well, maybe you need some help on how to dose T3 alongside your T4 - some people drop some T4 to accommodate the T3 ?
The acne maybe have been transient or simply a coincidence ?
Your vitamins and minerals will need to be optimal for any thyroid hormones to work effectively ?
Anti depressants, I think, can have a negative effect on thyroid hormone conversion.
Is your eye condition thyroid related ?
Energy and motivation go hand in hand and suggest lack of T3 could be the culprit.
You'll need to get your ducks in a row -
Deal with the eye issue first :
Supplement ferritin, folate, B12 and vitamin D if necessary :
Introduce a little T3 with your T4 - and see how things go - slowly, slowly,
Monitor temperature and blood pressure daily -
And so it goes on -
Have a think, things need to change, otherwise you wouldn't have posted your message and found me here this afternoon !!
Good advice. I appreciate and will start to make some changes. I did have surgery 6 weeks ago so I’m possibly still recovering from that as well.
Well yes, of course, any surgery is going to have a knock on effect - sorry, I didn't know this piece of the jigsaw.
Be kind to yourself, and when you feel ready you'll start to build back your health.
The other thought I had was to ask if there a different doctor you could try and work with ?
I have also had a thyroidectomy from graves disease. Generally on this website I was told that the TSH should be in the low range, T4 should be mid-range, and free T3 should be near the top of range. After three years I have pretty much reached this level but lately I just went over. T3 range at 6. I have had high pulse rate from that. I have recently been put on 15 mcgs of T3. Most of my other symptoms are gone and I feel much better than I have ever have since I started taking T3. This is just how my system has worked and I have learned so much from this website.
Glad you’re feeling better 😁
Graves' disease patients frequently find strictly gluten free diet helps or is essential
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal
While still eating high gluten diet ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first
Assuming test is negative you can immediately go on strictly gluten free diet
(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially)
Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse
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