Thyroid UK
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Found out recently I have hashi's

Hi! For 6 years I was under the impression I was just hypo but now told I have hashimoto's thyroiditis. Despite this diagnosis I remain on exactly the same medical regime - 75mcg levo daily. Is this right? Just had an horrendous night - got a cold but symptoms were extreme - difficulty breathing, pounding headache, hugely swollen neck glands and sore throat but the worst symptom was shooting pains throughout my whole body. I'm shattered this morning. How should I approach my doctor next week. Don't want to put her back up like the last time I questionedher on my thyroid health. Only ever been given results of t4 and tsh.


TSH. 0.74 (0.35-5.5)

FT4. 19.2 (11-24)

Any advice or insights would be gratefully received. Thank you

1 Reply

This is a quote from Dr Toft ex of the British thyroid Association and if you need a copy of the Pulse article, email

6 What is the correct dose of thyroxine and is there any rationale for adding in tri-iodothyronine?

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).

Even while taking the slightly higher dose of levothyroxine a handful of patients continue to complain that a sense of wellbeing has not been restored. A trial of levothyroxine and tri-iodothyronine is not unreasonable. The dose of levothyroxine should be reduced by 50µg daily and tri iodothyronine in a dose of 10µg (half a tablet) daily added.


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