Should I ask Endo for thyroxine?

[AB101]

Had half thyroid removed in 2008 but I’ve had no symptoms till now. Following advice I read in the forum I did thyroid blood panel last week. Nothing major stands out except low ferritin. I’ve been lacking stamina and feeling tired. I have arranged a private Endo appointment in a few weeks so need some advice if anyone can help please.

The surgeon said I would probably need thyroxine when I got older as I have nodules on remaining half of thyroid too so I’ve been half expecting problems now I’m 58.

Test results April 2025

Tsh. 1.86 (0.27-4.2)

FreeT3 4 (3.1-6.8)

FreeT4 15.3 (12-22)

Folate 22.7 (7-35)

B12 69.8 (37.5-187)

VitD. 81 (50-250)

Ferritin 40 (30-264)

So, do you lovely people think I would benefit from thyroxine? My cholesterol has also been rising problematically despite a good diet (was 7 in 2023 but has come down slightly)

[pennyannie]

Hello AB101 and welcome to the forum :

A euthyroid - ( well functioning thyroid on no medication ) -

would see a TSH at around 1.20/1.50 with a T4 at around 50% through its range with the T3 tracking just behind at around 45% through its range.

So - yes your TSH is too high and showing signs of struggling to cope -

with your T4 at around 33% and your T3 tracking at around 25% :

Your T3 is too low to function well on and likely also responsible for your cholesterol level which will automatically be resolved once you are on T4 thyroid hormone replacement and your body back to fully functioning.

T4 - Levothyroxine is the cheapest and most easily managed of all the thyroid hormone replacement options -

We generally feel best when the T4 is up at around 75/80% through its range with your T3 tracking just behind at around 70/75% through its range.

No thyroid hormone replacement works well until your core strength vitamins and minerals are up and maintained at optimal levels -

I now aim for a ferritin at around 100 - folate around 20 - active B12 125 ( serum B12 500++ )and vitamin D at around 125.

[AB101 in reply to pennyannie]

Thank you so much pennyannie for your detailed response. I will take this info with me to my appt and I feel more confident that I now know what to say 🤗

I have already started taking spray iron, vitD and and B vitamins so hope to get these levels higher to stand the best chance of feeling good again.

I really appreciate all the information I’ve gained from the knowledgeable people on this forum.

[pennyannie in reply to AB101]

Ok then - thank you - no problem :

Have you tried asking your primary care doctor about your situation, medical history and current symptoms being tolerated as this could and should be treated through the NHS ?

[AB101]

GPs response to my blood tests

‘These blood tests are normal

You are not hypothyroid and I would not suggest Levothyroxine or vitamin supplements.

Unfortunately there is often not a medical cause of fatigue in isolation. It is often post viral or unexplained.

Are you sleeping OK?

Generally we suggest trying to adapt to your fatigue and recognising this is how it is going to be for a while. It might be chronic fatigue syndrome see patient.info/signs-symptoms...

Happy to discuss but I don't think you are likely to find a correctable medical cause of this.’

So I don’t think I will get any help here…

[FancyPants54 in reply to AB101]

Good god! Useless! Worse than useless.

[pennyannie in reply to AB101]

Oh my goodness - is it a group surgery ? Can you see someone else ?

Once prescribed - you will need some level of monitoring and prescribing for the rest of your life - with a little help from here and other forum members we can guide you - but ideally you need a prescription -

and once with a prescription for hypothyroidism because it is a long term chronic health condition all prescriptions for everything become ' free ' - I know - and probably why the NHS don't like making the diagnosis and push us into the long grass for as long as possible.

I was going to suggest once prescribed ask the specialist if he will write and advise your primary care doctor to take over your care - so save you some time and money.