I am on 125mg levothyroxine. Struggling to lose weight so disappointed that these suggest to me I need to reduce my Levo. GPS are hopeless and refuse to do anythIng other than TSH. So I have to go private for blood tests.
Any advice. My BP is also elevated (165/100). Just had my ramipril increased to reduce but I am wondering if my elevated BP is over medication of Levo.
thank you in advance
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DylanA
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High blood pressure can be a symptom of hypo/under-medication. And as your FT3 is only 27.03% through the range, you are still hypo.
Your FT4 is much too high over-range. So, what you need to do is reduce your levo (probably as a matter of urgancy) and add in some T3 because you are a very poor converter.
Poor conversion can be - in part, at least - down to sub-optimal nutrients. Have you had vit D, vit B12, folate, ferritin tested? Or, having Hashi's - have you had your antibodies tested? And might even improve slightly just by bring your FT4 down to about 18. But, as your conversion is so very bad, you're probably going to need T3, anyway.
That's said, how long was the gap between your last dose of levo and the blood draw?
I had my Peroxidase antibodies tested 12 mths ago and with a range of 0 - 5.61 my result was 489.9 IU/ml. My Vitamin D was 58. Against a range of 50 - 200 so I have been taking vitamin D daily since, as the advice was that 58 was low for someone with hashimotos. The blood was taken 12 hrs after Levo dose.
I am going to drop my Levo from 125 back down to 100. Should I start T3 asap and at what dose. My GP is not good with thyroid issues and they refuse to even do the t3 test going merely on TSH results. So I’m on my own here!
A vit d of 58 is much too low for someone with hypo. But, are you also taking its cofactors: magnesium and vit K2-MK7?
Do not alter your levo dose at this point, because you did not do the test correctly! You have a false high, there, because you only left a gap of 12 hours instead of 24. So, you don't really know what your FT4 is. And you need to know that before considering taking T3.
Hi. In addition to vitamin D I am taking magnesium complex with zinc. My last b12 reading was 190pmol/l against a range 138 - 652. The only other result I have is foliage vit b9 of 8.7 range 7-46.4. These are 12 mths old
Unfortunately I increased my Levo off my own back as I was feeling so bad and getting nowhere with my GP so I have worried myself now after experiencing elevated BP and palpitations so do you think maybe I should go back to 100mg urgently or stay at 125 for now. I can redo the test after a 24 hr gap.
Sorry. I wish I had sought your advice sooner maybe T3 was my answer not more Levo. It’s all so confusing when you don’t have GP support.
In addition to vitamin D I am taking magnesium complex with zinc.
Not sure that's a good idea. From what I've read, taking magnesium with zinc blocks absorption. I think it's probably better to just take magnesium by itself.
My last b12 reading was 190pmol/l against a range 138 - 652.
That is dangerously low. Did you start supplementing B vits after that result? Your folate is too low, as well.
Unfortunately I increased my Levo off my own back as I was feeling so bad and getting nowhere with my GP
That's understandable.
so I have worried myself now after experiencing elevated BP and palpitations so do you think maybe I should go back to 100mg urgently or stay at 125 for now.
Difficult to say. But if you can beat to stay on 125 until the six week mark before retesting, I think you should do that. Keep changing dose is counter-productive.
maybe T3 was my answer not more Levo
And maybe it wasn't. We'll know after your next test. But, don't beat yourself up about it. These things happen - even when we do have a GP to 'guide' us. They often know less than we do!
Thank you so much. My thoughts are then to stay on 125 for now and do a retest seeings as I didn’t wait 24hr from Levo dose. I’ll retest now, change my magnesium to remove the zinc and do the other tests mentioned as my vitamin, b12 etc results are a year old now. Then I should have a more accurate picture for a plan ahead? Does that sound reasonable?
I have retested after waiting 24hrs from Levo dose. Results as follows:
TSH 0.08 mU/L (range 0.27-4.2)
FT3 = 4.1 pmol/L (3.1 - 6.8)
FT4 = 22.2 pmol/L (12-22)
Should I reduce my Levo back from 125 to 100. (Increased myself in desperation 6-8 months ago).
Very tired and struggling to lose weight
My Vit D has come back as ‘High’ at 113 nmol/L but I am taking Vit D supplements as I am under the impression thyroid patients should have higher D levels
Waiting for a new test to re-do my anemia tests as I messed them up!
What are your thoughts so far. I am worried that I may be over medicating on the Levo. My decision to increase the amount I am taking was due to lack of GP support. In my confusion I am wondering if it’s T3 I needed not more Levo.
Thank you so much for helping me make sense of all this
It is absolutely T3 you need more than levo. Levo is T4, which is basically a storage hormone that doesn't do much until it is converted into the active hormone, T3. Your T3 is very low and that's what's causing you to feel bad. You are a very bad converter. But, doctors know nothing about T3, they think it's unimportant!
I do think it would be a good idea to reduce the levo again. What was your FT3 when you were taking 100 mcg?
What is the range for the vit D? Hypos do need it around 100, usually.
Hi. Many thanks for your reply. My B12 and foliate have to be redone as I messed up my sample. I will let you know when I get the results. As for t3. It has always been in the low side. Last result (Prior to increasing Levo) was Nov 2022. T3 was 3.2 T4 was 17 & TSH was 0.7. There isn’t a range stated on Vit D. It just says High. Also recommends I stop taking Vit D supplements which I don’t think is wise. How long should I wait for retests after reducing back to 100mg Levo?
Ok thank you. I only have 100mg tablets. Shall I just start snapping them into 4? Again I am on 2000 IU of Vit D. I could break them in 2 and take 1000? How long do I need to be on the new dose of Levo before I retest?
Well, if you want it prescribed, you need to see an endo that is pro-T3 - not all of them are!
Or, if you want to buy it yourself, write another post asking people to PM you a link to their trusted on-line sources. But, beware of trolls! Never buy anything without checking with an admin first to make sure it's kosher:
A starter dose would be 5 mcg for at least two weeks. If all goes well then increase by another 5 mcg, and continue like that until you feel well. When/if you reach 20 mcg then hold for six weeks and retest.
Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
The blood was taken 12 hrs after Levo dose.
So ignore high Ft4 as test too soon after last dose levothyroxine
Recommend you stay on current dose levothyroxine
Do you always get same brand levothyroxine at each prescription
High thyroid antibodies confirms Hashimoto’s
ESSENTIAL to test folate, B12 and ferritin too
Vitamin D far too low
How much vitamin D are you currently taking
For good conversion of Ft4 (levothyroxine) to Ft3 (active hormone) we must have OPTIMAL Vitamin levels
hi. I take 2000iu per day. Started with 2 tablets per day for about a month then one per day. I always have same brand of Levo. I will have to get the others tested and will redo the thyroid test leaving 24 gap. I am worried about staying on 125mg Levo as I have developed elevated BP and having palpitations after 6 mths at new dose. Already on ramipril and have had dose increased by GP. GP will not test for T3 so increased from 100 to 125 as feeling so bad.
Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels
Low vitamin levels affect Thyroid hormone working
Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten. Dairy is second most common.
A trial of strictly gluten free diet is always worth doing
Only 5% of Hashimoto’s patients test positive for coeliac but a further 81% of Hashimoto’s patients who try gluten free diet find noticeable or significant improvement or find it’s essential
A strictly gluten free diet helps or is essential due to gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and may slowly lower TPO antibodies
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
The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported
In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned
Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.
Similarly few months later consider trying dairy free too. Approx 50-60% find dairy free beneficial
With loads of vegan dairy alternatives these days it’s not as difficult as in the past
With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a separate B12 supplement and a week later add a separate vitamin B Complex
Then once your serum B12 is over 500 (or Active B12 level has reached 70), you may be able to reduce then stop the B12 and just carry on with the B Complex.
If Vegetarian or vegan likely to need ongoing separate B12 few times a week
Igennus B complex popular option too. Nice small tablets. Most people only find they need one per day. But a few people find it’s not high enough dose
IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results
In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg) and continue separate B12 until B12 over 500
Post discussing how biotin can affect test results
presumably you are now taking levothyroxine at bedtime
No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.
Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away
(Time gap doesn't apply to Vitamin D mouth spray)
If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test
If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal
Here’s link for how to request Thyroid U.K.list of private Doctors emailed to you, but within the email a link to download list of recommended thyroid specialist endocrinologists who will prescribe T3
Ideally choose an endocrinologist to see privately initially and who also does NHS consultations
Thank you. I am waiting for iron, ferritin b12 results too. Vit D 112. will the anemia results affect the need or not to go on T3. Think I will struggle to get it.
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