Just had my bloods back from Medichecks. Had NHS test done at the same time so I assume NHS result (TSH only) will be the same/similar...
I have been on 75mg Levo now for 6/7 weeks after a titrate from 25mg start in November. Have my GP phone consultation on Monday. When I last spoke to her she said she would be unhappy to increase my dose to 100 because 'it's a very big jump from 75 to 100'. Obviously it's less of a jump from 50 to 75??? So, I'm preparing for battle.
My TSH has gone down a bit but my Free T4 has also gone down and my Free T3 is up a bit:
TSH 3.64 mIU/L (Range: 0.27 - 4.2)
Free T3 4.23 pmol/L (Range: 3.1 - 6.8)
Free Thyroxine 12.700 pmol/L (Range: 12 - 22)
Previous blood results on 50mg (increased reluctantly to 75mg after a real push from me):
TSH 4.11 mIU/L (Range: 0.27 - 4.2)
Free T3 3.99 pmol/L (Range: 3.1 - 6.8)
Free Thyroxine 13.500 pmol/L (Range: 12 - 22)
Thank you - any thoughts please because I'm feeling really rubbish at the moment!
Jo x
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Josephineinamachine
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Once on levo the aim is for TSH to be less than 2 and prob less than 1 and for your "frees" to be nice and high - at least 2.3 through range. Your free T4 is an utterly feeble 7% through range (and previously was not much better at 15%). Free T3 is better at 30% through range - but even that's a long way off what you want it to be.
Thank you fuchsia-pink I’m so hoping the GP ups the dose on Monday. My Medichecks test in January showed all nutrients good to excellent (I only take vit D, selenium and magnesium) so I think I’m okay there. Thank you 😊
Replacement therapy with levothyroxine should be initiated in all patients to achieve a TSH level of 0.5-2.0pmol/L.
New NHS England Liothyronine guidelines July 2019 clearly state on page 13 that TSH should be between 0.4-1.5 when OPTIMALLY treated with just Levothyroxine
Note that it says test should be in morning BEFORE taking levothyroxine
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)."
(That’s Ft3 at 58% minimum through range)
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
guidelines on dose levothyroxine by weight
Even if we frequently don’t start on full replacement dose, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or near full replacement dose
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.
Traditionally we have tended to start patients on a low dose of levothyroxine and titrate it up over a period of months. RCT evidence suggests that for the majority of patients this is not necessary and may waste resources.
For patients aged >60y or with ischaemic heart disease, start levothyroxine at 25–50μg daily and titrate up every 3 to 6 weeks as tolerated.
For ALL other patients start at full replacement dose. For most this will equate to 1.6 μg/kg/day (approximately 100μg for a 60kg woman and 125μg for a 75kg man).
If you are starting treatment for subclinical hypothyroidism, this article advises starting at a dose close to the full treatment dose on the basis that it is difficult to assess symptom response unless a therapeutic dose has been trialled.
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Would T3 help me
How do you work out your percentage through the range please? 
T3 Above Limit: Ok or not?
Does this TSH mean I am over-medicated? 
Need help with results, private test said increase, thyroxine by 25% NOW seems maybe too much? 
