TSH Result of B.Test Range .35 – 3.3
May 2012 4.18 (taking 25mcg)
Aug 2012 -1 ( Increase in July 75mcg)
Nov 2012 -1 (from 15th Dec 75/50 mcg alternate)
Jan 20 <0.1
FT3 Result of B.test Range 3 - 7
Aug 2012 5.9
FT4 Result of B.Test Range 10 - 25
May 2012 25
Aug 2012 25
Nov 2012 20
Jan 2013 21
from your bloods you seemed to be doing better in August 2012, however does that correspond to 'how you feel'?? 
Not my test but person they belong to doesn't feel too good at all. Thanks for reply
ok, my answer remains the same, ask them if they felt slightly better in August 2012, the bloods point to that...but bloods do not say the full story, hardly a small part of the story
I'm not too good at sums...but looking at the relationship of dosages and FT4 it seems to me that if your friend is taking 75mcg one day, 50mcg the next, then their average daily dose has dropped to 62.5mcg, whereas it was formerly 75mcg daily until 15 December '12.
It is not normal to have such a small dose, as 75mcg is, cut still further, by approx. 16% according to my calculator. This is a retrograde step and will have resulted in relative underdosing now, which could certainly explain why your friend is not doing well in the way he/she is feeling.
Starting at 25mcg was a very low dose anyway, but at least dosage upward titration was achieved to 75mcg and now it has gone backwards since 15 December. If this dosage of 62.5mcg daily is maintained then your friend's TSH will start rising, and the FT4 will continue its general downward trend. This dosage cut needs questioning. Perhaps the GP is even worse at sums than I am. But one thing is sure, treatment should take into account how the person is feeling.
For general background read the main site, thyroiduk.org
and buy Dr Anthony Toft's "Understanding Thyroid Disorders" only £5 at chemists/Amazon, and also read Dr Toft's article in Pulse magazine especially Q 6 to equip yourselves with knowledge.
Hope this helps - and my sums are right!
Thank you very much for that. Will pass the information on.
Having the following at optimal levels can certainly help maximise the body's utilisation of meds, your friend can ask for them to be tested.
Ferritin (storage iron) >90
Serum iron Well up in range, about 3/4 range
Vit B12 >500ng/L (at a minimum)
Folate About 10-12mcg/L
Vit D 125nmol/L - 175nmol/L
or if measured in ng/ml:
50ng/ml - 70ng/ml
DR Anthony Toft in his paper "Thyroid function Tests and Hypothyroidism" wrote:
"...most patients feel well only with a dose resulting in a high normal free T4 and low normal TSH concentration and those patients with continuing symptoms despite "adequate doses of thyroxine may be slightly under replaced. Some patients achieve a sense of wellbeing only if free T4 is slightly elevated and TSH low or undetectable. The evidence that this exogenous form of sub-clinical hyPERthyroidism is harmful is lacking in comparison to the endogenous variety associated with nodular goitre, and it is not unreasonable to allow these patients to take a higher dose if T3 is unequivocally normal."
and P 41 my edition of Dr Toft's "Understanding thyroid disorders" I quote this so you can better assess your friend's treatment, some of this quotation occurs also in Dr Toft's Pulse article, in 6, link given.
Treatment
"This is with thyroxine which is available in the UK as 25, 50, 100mcg tablets. Normally thyroxine treatment is begun slowly and you'll be prescribed a daily dose of 50mcg for 3-4 weeks, increasing to 100mcg daily for a further 3-4 weeks and then to 150mcg daily."
Of course, we do not know what other conditions your friend might have which might have dictated starting at 25mcg then titrating upwards more slowly than normal.
Supplementation info to help hypothyroidism is at:
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