Doubling of thyroxine dose - is this wise?

Hello, hoping for some advice!

About 8 weeks ago my TSH was over 100 and my free T4 was 3.0. My consultant put me on 50mcg of thyroxine and my results 8 weeks later were a TSH of 15.2 (range 0.25-5) and Free T4 of 14.6 (range 9-23).

My consultant has recommended doubling my TSH to 100mcg. I however think is too high a dose - the last time I was on this level my TSH became completely suppressed, and my Free T4 went to 33.5! I lost 4kgs in 2 weeks and became very jittery!

The background to this is that I need to get my levels stable before I start on a second round of IVF. I need to get my TSH to below 2 ideally and my free T4 in range.

I have therefore started taking 75mcg as opposed to the 100mcg he recommends (by splitting the pills), and am having no ill effects. However, I'm wondering should I just follow his advice to take the 100mcg and that perhaps it was the fact that I went straight from 100mcg from nothing last time that caused me this ill effects and my swing to overactive.

Be grateful for any thoughts.

6 Replies

  • 75 mcg seems appropriate based on the above numbers.

  • Sparkly, I think 75mcg is right too. If you feel symptomatic you could increase to 75/100 alternate days after 4 weeks. Better to do it gradually than overshoot and become hyper. I was over replaced and FT4 was >32 for 7 months. Not a good time at all.

  • I fully agree with above Sparkly.

    Only you know how you feel and increasing slowly can only have better long lasting consequences.

    I find recording my temperature every am & pm helps to monitor under or over medication and gives me confidence.

    Good luck


  • I think it's always better to increase gradually. I was diagnosed with around the same results as you but although I ended up on 150mcg levo, I had to go up very slowly as always feel hyper for about 2 weeks when I increase. You may end up needing the 100 but best to see how you get on with the 75 first. Good luck.

  • Thanks very much for this. Did you wait the standard 6 weeks before each increase, or did you go quicker than this?

  • Yes, I waited the standard 6 weeks each time. I found I had a pattern of - increase then feel hyper for a 1-2 weeks, better for a couple of weeks and then back to feeling hypo so I knew I needed to increase again.

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