Thyroid UK
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Advice Please???

Hi, 2009 I had RAI treatment for Graves. The treatment worked!!! and now I have no thyroid function at all. I have been taking thyroxine since then and have felt quite well on a dose of 125,150mg alternate days. I have had regular readings taken of TSH and FT4 and these have been ranging TSH 0.03-0.24, FT4 18-25. I have had no overactive side effects, my pulse rate is good, no anxiety problems etc. My doctor keeps telling me to reduce, I was quite worried about the effect these readings were having on my body, so I have been on 125mg every day now for 2 weeks. Over the past 4 days I dont sleep very well, having lots of anxiety and the dredding "dark Cloud" has started to appear. I dont know what to do??? shall I just go back to my original dose??? Does the TSH reading really matter if your thyroid is dead??

3 Replies

Go back to your original dose. Many GP's only prescribe according to the TSH which has no correlation at all and to reduce a dose when you were fine is ridiculous.

I hope this link will answer your question. Go to the question dated January 25, 2002

There are other topics at the top of the page.


This is also an excerpt of an article by Dr Toft ex of the British Thyroid Association

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.


Hi Thank you for the article from Dr Lowe, it makes interesting reading. I have printed it off and will be taking it to my GP the next time I see her.


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