I`ve just received my routine thyroid blood result TSH 5.3. (range 0.53-3.50). Because of COVID I wasn`t able to have the blood drawn early morning but instead at 2.30 pm, so I don`t know if this makes much of a difference? I was originally hyperthyroid, had RAI and have been ok for 6 years with TSH within range. Of course I wasn`t tested for T4 etc, I will order an online test to check full thyroid, but in the meantime would this level cause symptoms?
I`ve had a few like weight gain, dizziness and high BP that I didn`t connect to possible hypothyroid until today, after hearing my results.
I have been taking levothyroxine 100 mcg x 5 days and 75 mcg x 2 days per week and am now up dosing to 100 mcg per day. Am I adding enough?
Many thanks I would really appreciate hearing any opinions .
Written by
Joyliz
To view profiles and participate in discussions please or .
The TSH is at it's lowest at around 2 pm , and it's highest in the middle of the night. Once taking Levo , the difference in the high and low point may be less than it was naturally, but it's safe to assume there is still a difference between the result at 2 pm and how much higher it might have been at 9am.
TSH 5.3. (range 0.53-3.50).
This is definitely high enough to give symptoms of hypothyroidism, It 'is well over range, and taken on it's own would indicate the need for an increase in Levo dose.
Levo treatment guidelines say get TSH within range, and best practice is to aim for TSH around 1
However it would obviously be much better to see what the fT4 and fT3 are doing , rather than just TSH.
Thank you! I intend to order a full thyroid panel from Medichecks but first I`d like to wait a few weeks to see if adding extra levo is making me feel less sluggish. When you say TSH is lowest at pm, do you mean a higher number? I always get confused when people say high or low as I was hyperthyroid and was told my TSH was high ?? When it was off the charts as in minus.
As you say it seems safe to assume that even though I was tested at 2pm, that I have become underactive . The nurse suggested I increase my levo to 100 mcg per day from 100x 5 days and 75 x 2 days. Would you think this is enough?
Doctors get lazy with language , because they think we don't understand , (or sometimes because they don't understand it themselves!).So you will hear them say 'high' when they mean the levels of the actual thyroid hormones T4 /T3 are high . which is hyperthyroidism.
But you are right , TSH is very low in Hyperthyroidism eg 0.001 or less , i don't think you can get negative numbers , but you will see < 0.001, because they can't measure any lower .
It helped me to remember how it works by imagining TSH and fT4/3 on opposite ends of a see-saw. When one goes up the other goes down , and vice versa.
Hyperthyroid is very high fT4 & fT3 numbers ... with very low TSH number.
(TSH=Thyroid Stimulating Hormone) it is low because no stimulatio is needed , because there is already too much hormone in the blood.
Hypothyroid is low fT4 & fT3.... with high TSH . (TSH is now high because more thyroid stimulation is needed to produce more hormone, but if thyroid cannot manage to produce more as requested, that is when we end up taking Levo )
So if you had been tested at 9am , TSH would be higher, and that means you are really more underactive than the 5.3 result shows.
I don't know if raising to 100 mcg daily from 100x 5 and 75 x 2 will be enough , it's only a very tiny increase .
Currently your dose works out at 92.8 mcg /day
But maybe go with the 100/day suggestion for now and get tested after 6 weeks to see what 's what. You can always increase more later if it's not enough.
Thank you so much! At last I understand as that`s the best explanation I`ve heard since I started out with hyperthyroidism 6 years ago. I`ll increase the levo as the nurse suggested, test and go from there.
Unlikely to be high enough dose increase....but it’s a first step
Bloods should be retested 6-8 weeks after any dose change or brand change in levothyroxine
Do you always get same brand of levothyroxine?
What vitamin supplements are you currently taking
Essential to regularly retest vitamin D, folate, ferritin and B12. Likely these may be low as you are currently under medicated
Ask GP to test vitamin levels NOW
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)
Is this how you do your tests?
Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Tsh
Synthroid vs Cytomel's effect on TSH Suppression
Normalise the TSH to keep doctors happy?
High TSH and T4 in upper range?
low TSH higher cholesterol 
