has anybody else been asked by their G.P to reduce their dose of Levothyroxine by 50mcg?

[Molly65]

Im very reluctant to do this as Ive been on 250 for about 10 years, and fed up of feeling ill, the GP reckons that its because my dose is too high, has anybody else been told this?

[HarryE]

Do you have your blood test results?

[helvella Administrator Thyroid UK]

We have seen lots of people have their doses changed by 50 - or more.

My view is that changes should almost always be made slowly and carefully.

It can be at least instructive to think about things based on the amount taken in a week (rather than a day). With a daily dose of 250, that is 1750 a week. Knocking that down to 200 a day gives in 1400 a week. So the reduction could be expressed as 350 a week. Which is considerably more than your dose for a whole day being removed from your regime. We see people who feel the difference made by taking 25 mcg more (or less) each week by simply changing their dose on one day a week is significant. So a change of 350 is simply enormous.

So, even if you do need a reduction, do it slowly. Take it steadily. Then, if you are feeling worse for it, you can all a halt, or reverse it before things have changed too drastically.

Make sure you have your test results before you even consider trying it. Maybe post them here.

Rod

[shaws Administrator]

If you can get a copy of your blood test results with the ranges from your surgery with the ranges and post for members to comment.

It is unusual to drop your dose only due to you feeling unwell. Usually they do it because of your TSH result.

I think they really do not know how best to treat patients. If he suggests dropping your dose by 50mcg of levo. Suggest to him that he prescribes 10mcg of T3 (liothyronine) as a replacement. This is what Dr Toft of the BTA suggests:-

This is an excerpt from Dr Toft who was President of the British Thyroid Association in a Pulse Online article:-

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.

*****

So you see he says that some need a suppressed TSH.

This is another excerpt from a scientist who treated people according to clinical symptoms. Read the answer to question dated January 25, 2002 re adjusting doses.

web.archive.org/web/2010103...

[Molly65]

Thanks for your comments ~ I shall get a copy of my blood results and post them on here and see what people think.

I'll also make another appointment to see a different G.P and see what they say before I start reducing my dose, there was no mention of reducing slowly just to do it. It does make you wonder about some of the medical profession!!