Why You Still Feel Awful (Despite "Normal" Thyroid Labs)



Hey there,

I wanted to talk about something I see ALL the time in my community...

You're taking your Levothyroxine faithfully. Your doctor says your TSH is "perfectly normal." Yet you still feel absolutely terrible.

Sound familiar?

Let me tell you why this is happening - and more importantly, what you can do about it.

The Problem with Levothyroxine Monotherapy

Here's the truth I've come to after years of working with thyroid patients (and being one myself):

T4 monotherapy just doesn't work.

Not for most people. Honestly? I don't think it works properly for ANYONE long-term.

Your thyroid naturally produces two main hormones:

  • T4 (about 90% of production) - this is the storage form
  • T3 (about 9-10%) - this is the ACTIVE form your cells actually use

When you take Levothyroxine, you're only getting T4. Your body is supposed to convert that T4 into T3. But here's the kicker - many of us simply CAN'T convert enough. This conversion happens primarily in the liver and gut, and for countless reasons, this process fails us.

The result? Your cells are literally starving for thyroid hormone, even though you're taking your medication exactly as prescribed.

My Personal Nightmare

My own doctor kept cranking up my T4 dose when I complained about fatigue. My TSH looked "perfect" on paper. But I ended up with such severe muscle pain I could barely walk!

When I finally ordered my own private blood test, I discovered my free T3 was in my boots while my T4 was sky-high. My body simply wasn't converting properly.

The Testing Problem

Most doctors only test TSH. If you're lucky, they might check T4 levels.

But almost NONE of them test T3 - the active hormone your cells actually need!

Without knowing your T3 levels, you're missing the most crucial piece of the puzzle. You could be severely deficient in the active hormone while your doctor keeps telling you everything looks fine.

What Actually Works

I believe everyone with hypothyroidism needs combination therapy:

  • T4 (Levothyroxine) PLUS
  • T3 (Liothyronine) or
  • Natural Desiccated Thyroid (NDT) which contains both hormones

My personal preference is the synthetic combination (Levothyroxine + Liothyronine) because it allows you to dial in the perfect dose of each hormone for YOUR unique body.

NDT comes in a fixed ratio, which makes it harder to customize, but it works beautifully for many people.

Key Action Steps

  1. Get your Free T3 tested! If your doctor won't order it, consider a home testing kit
  2. Track your symptoms even when your doctor says your labs are "normal"
  3. Research combination therapy options so you can have an informed conversation with your healthcare provider
  4. Consider switching doctors to find one who understands the importance of T3
  5. Join our free community where we share strategies for optimizing thyroid treatment


The Truth No One Tells You

You might feel okay on T4 alone for a while - I managed 2-3 years before things fell apart. But eventually, for most of us, our health starts declining.

It might take 2 years, 5 years, or 10 years, but if your cells are chronically deprived of the active hormone they need, things will go south.

There is credible research linking the development of fibromyalgia and other diseases with long term lack of T3

We weren't designed to live on T4 alone. Our bodies naturally produce both hormones for a reason.

I will die on this hill: monotherapy is insufficient for proper thyroid health. You deserve better treatment that addresses ALL of your thyroid hormone needs.

Until next time, remember - your symptoms are valid, even when your lab work says otherwise. Trust your body, seek comprehensive testing, and never stop advocating for the treatment you deserve.

With care,


ORDER YOUR HOME TEST HERE


Join our private and supportive Facebook group:

The Hypothyroid & Hashimoto's Thrivers Recovery Community.

Connect with women who truly understand your journey.


💜 JOIN US HERE 💜​

PLEASE NOTE - I am NOT a Doctor or Medical Professional of any kind.
The content on this website is strictly for informational and educational purposes only. It is not intended to provide medical advice or to take the place of medical advice or treatment from a personal physician.
All recipients of this content are advised to consult their doctors or qualified health professionals regarding specific health questions


This email may contain affiliate links. This means I make a small commission from any sale at no cost to you. This allows me to be able to give you discounts on products and also supports my work and mission.
I only recommend products I use and love.

HypoThrive With Helen

Join 3000+ Hashimoto's & Hypothyroid Warriors learning to live again with topics including eating for thyroid health, medication optimisation, weight loss with hypothyroidism, getting support from your doctor and lots lots more ...

Read more from HypoThrive With Helen

Hey lovely, You know when something just doesn’t sit right? You’re dragging yourself through the day, completely wiped out...You’ve gained weight, your brain’s in a fog, you can’t warm up, and your energy’s on the floor…But your doctor says everything’s “fine.” But deep down, you know it’s not. And you’re right. WATCH - Still Exhausted with Hypothyroidism or Hashimoto’s? This Could Be the Missing Piece In Your Recovery I’ve just been working with a client recently who’s been treated for...

Hey beautiful, I've been thinking a lot about something lately, and I just had to share it with you because I know it's going to resonate deeply. 😔 You know that feeling when you're sitting in a meeting, and someone suggests something you completely disagree with, but instead of speaking up, you just... nod along? 😔 Or when your partner asks what you want for dinner for the third time this week, and you say "whatever you want" even though you're craving something specific? If you're nodding...

Hi beautiful. I had an experience this week that I just had to share with you. I took my daughter (she's 21) to the doctor's appointment I'd spent nearly 3 weeks trying to book. On the drive there, I asked her if she was prepared. Did she have a plan? A list of symptoms? Anything written down? Her response? "No." 🤦 Despite me asking her for the past week to prepare (and being the typical 21-year-old who doesn't want to listen to her mum), she was just rocking up half-asleep with absolutely no...