I've been on levothyroxine 75mcg for over a year now, still struggle with fatigue, brain fog, muscle aches etc. Not debilitating the whole time, but feel like I'm never really able to function to full capacity. Have other health issues going on, seem to be going through early menopause too (age 43) and many symptoms may cross over. Also developed wrist pains (possible carpal tunnel) which I have read can be relates to poorly managed thyroid.
Had bloods done this week with results as follows:
TSH 2.48 (0.27-4.2m/UL)
T4 17 (12-22pmol/L)
T3 3.8 (3.1-6.8 pmol/L)
My question is, should I be heading to the GP to see if I can get an increase in levo? Or should I consider a private doctor to see if T3 would help.... or both? Any advice gratefully received.
I haven't had my vitamins tested for a long time so know that needs looking at as well at some point soon.
A friend has offered to help financially with private costs if I do need to go private but don't want to incur unnecessary costs if an increase in levo will be beneficial.
Written by
Wrayofsunshine
To view profiles and participate in discussions please or .
First port of call is your GP to request a dose increase aim for 25mcg but I'd be inclined to take 12.5mcg extra and see how that goes... and get your vits and mins tested
Taking B vits, Vit D, selenium and zinc to try and help as well.
I haven't had my vitamins tested for a long time so know that needs looking at as well at some point soon.
How long since you tested
Test at least annually
How much vitamin D do you take
What are your most recent vitamin D, folate, B12 and ferritin results
Also did you remember to stop vitamin B complex before your tests
IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 5-7 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 if last test result serum B12 was below 500 or active B12 (private test) under 70:
Even if we frequently start on only 50mcg, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or somewhere near full replacement dose (typically 1.6mcg levothyroxine per kilo of your weight per day)
Adults usually start with a dose between 50 micrograms and 100 micrograms taken once a day. This may be increased gradually over a few weeks to between 100 micrograms and 200 micrograms taken once a day.
Some people need a bit less than guidelines, some a bit more
TSH should be under 2 as an absolute maximum when on levothyroxine
If symptoms of hypothyroidism persist despite normalisation of TSH, the dose of levothyroxine can be titrated further to place the TSH in the lower part of the reference range or even slightly below (i.e., TSH: 0.1–2.0 mU/L), but avoiding TSH < 0.1 mU/L. Use of alternate day dosing of different levothyroxine strengths may be needed to achieve this (e.g., 100 mcg for 4 days; 125 mcg for 3 days weekly).
Hi Wrayofsunshine . If your results are in range but you are symptomatic then a GP should consider an increase in your levo. There is still room for an increase given your latest results and most of us hypos feel better when TSH is closer to 1 and T4 a bit higher than it is at the moment. It's also a good idea to keep an eye on vitamin levels etc as it all contributes to overall health and helps the levo work more effectively.
Yes!!! DD you are Spot On. Being on my Thyroid Journey I would never believe the importance of nutrients . They are Great Components with our Thyroid meds. I wish Dr's would know more about this. That why patients always feel that their thyroid dosage is always off. Thank you for your Great Posts.
I would think seriously about trialing T3 liothyronine alongside your levothyroxine dose. Your T3 looks too low. You could increase your levothyroxine slightly but make sure you don’t go over the range as that could cause extra symptoms. If it was me and knowing how long these things can take through a GP I’d go private now and request a trial of T3 liothyronine combined with your usual levothyroxine medication. To go private you’ll need a GP referral letter and latest bloods. It’s quite simple really and you should be seen quite quickly. I see a private only endocrinologist who was suggested to me to see on here. He is brilliant and helped me straight away when the NHS did nothing. Private message me if you’d like his details.
Thanks for all the replies, life has been so hectic for the last year I've let things slide and not been looking after myself very well or been regular with taking vitamins etc. My aim is to really work on this in the next few months, see if I can get an increase in levo from the GP and see where things are in perhaps 3 months time. Could someone send me in the right direction for a post telling me when is best to take the various supplements, which can be taken together and how far from taking levo etc? I can't remember and need a clear plan! Thank you ever so much for all the advice, you are all so helpful steering me in the right direction again. 😀
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.
How much T3 increase
Whether to raise T3 or Levo
Levothyroxine increase 
Should I increase T4 or T3 or both?
Do I increase Levo or T3?
