I'm currently on 100mcg/75mcg alternating days. These are blood test results from this week:
TSH 1.7 (0.4 - 5.5)
T4 18.3 (11.0 - 26.0)
T3 3.8 (3.0 - 6.0)
8 weeks ago my results were:
TSH 2.2 (0.4 - 5.5)
T4 16.5 ( 11.0 - 26.0)
T3 3.9 ( 3.0 - 6.0 )
I was taking propranolol and weaned off the beginning of the year with advice from slowdragon, ( it was taken for headaches/migraines) as propranolol can affect T3 conversion. I have had very bad migraines every 2 weeks on the dot that last 3 to 4 days since January. I am 4 years post menopause and have been on tablet form HRT. Two weeks ago I changed to a patch (with a lower dose) could the T3 level be anything to do with oestrogen dominance. Any advice would be very much appreciated as the migraines are really getting me down. Thank you 😊
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Ladysmith53
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Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine
HRT will affect dose levothyroxine required
Do you always get same brand levothyroxine at each prescription
Headache and migraine are hypothyroid symptoms
When were vitamin D, folate, ferritin and B12 last tested
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.
How much do you weigh in kilo….can help persuade them to increase if your under dosed for weight
Ask for dose increase too 100mcg as “trial” increase.
Also take these results in (mark up next to Ft4 that it’s only 49% through range and next to Ft3 that it’s only 27% 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)."
(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
If you can’t get increase from GP …request referral to endocrinologist of your choice…or go private
Email Thyroid UK for list of recommend thyroid specialist endocrinologists
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Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Results on 2 grains compounded NDT and 60mcg T3...
How can TSH rise and T3 stay the same.
advice please 
Could I ask for some advice please? My FreeT4 and free t3 low but Gp only looking at my TSH which is below range. 
Still freezing cold on Levothyroxine will I need T3
