good morning all. I was wondering, 1 or 2 individuals have told me on here that a dose of 50 does nothing more than has your thyroid get lazy or stops working and you need at least 75 to do anything. I know tons of people whom only take 50 though. My tsh was never super high so that is why i wonder whether more than 50 would be too high a dose. I crash though late afternoon. Waiting on dr but i am between jumping back up to 75 or asking to try a T3. Also, I have never heard of that with the 50 dose. Lastly, drs tell you to exercise every day or at least 4-5 days. I have been told on here that running and being very active is hurting me because it is draining my T3 that i do not have enough of to start. Very confused and need someone to shed light on all of this.

18 Replies

  • Hmm, I think it has more to do with how you feel and what your test results are like. Some people take 50mcg and feel fine. Obvs if you're left on 50 forever and no further tests are done you might end up feeling rough if it turns out that's not the right dose for you. I think 50 is often a starting dose and you might expect some tweaks after a blood test, but in six weeks if your test results look good and you're feeling well and you are monitored regularly then you wouldn't expect the dose to rise unless your symptoms and/or tests indicated you need more meds.

    Have I understood correctly that you were on 75 and your dose has been dropped to 50? If you're feeling less well than when it was 75 then perhaps 50 isn't quite enough for you.

    There is some concern here about certain kinds of vigorous exercise and t3 and/or adrenals but again, this is a personal matter. If you enjoy it and find it makes you feel good then Idk that there's anything to worry about. If you're struggling and exhausted you might want to try something a little more gentle until you feel back on form.

    What were your last test results? And is your afternoon crash your main problem?

  • I just had a look at some earlier posts of yours and some things stand out. Is it possible there have been a lot of changes in a short period of time? I read you went from 75 to 37.5 to 50mcg levo.

    Our own hormones can fluctuate and make us feel pretty awful, and if you're also changing meds quickly that can make you feel equally awful. Ideally (unless you're experiencing distressing or harmful symptoms like rapid hearbeat) it's good to stay on the same dose for a good chunk of time (it can take six weeks for your levels to stabilise) then have a blood test, then tweak the dose if necessary, and repeat until your levels are consistent.

    If your dose needs to be tweaked (as when you were a bit hyper on 75mcg) you can decrease gently every other day (alternating doses of 50 and 75) and see if that helps, and stay with it a while. Does that make sense?

    You seem to be coming at this from a lot of angles, looking at exercise, diet, supplements, meds etc all at once. It can be overwhelming to try to make and note the effects of many changes at once. You might want to limit your changes to just a couple at a time and stay there until you see results.

    I totally understand how urgent it feels to want to get better, but I'm just saying try not to tax your energies with a lot of different things, and be gentle with yourself. Then if after four to six months on the right (stable) dose of levo you still don't feel well, you might want to ask for a trial of t3 (cytomel).

    Good luck!

  • puncture bicycle you are understanding right. in december I was given 75 and within days started feeling a change, but then a few weeks in i felt hyper symptoms. Endo wanted me to stay on that but it was so bad (insomnia, diarrhea, sweating, heart racing I said NO!) I cut it into half and 4 days later felt normal and got blood drawn to find my TSh had dropped in a month to 1.01 on 75 levo (well after taking half of 75 for a few days I got tested) from Tsh 6. After a few wks hypo symptoms came back so I went up to 50 and was doing good, some symptoms but bearable and then I get my script filled and every day head aches, nausea and no energy. I couldn't understand. I stopped the pill a day and felt no head aches or nausea, popped the pill 4 hrs late and within an hr or 2 it was there again. I called my endo and he would not send me for tests and said i had to stay on meds. My family dr. agreed on tests and agreed on switching me to synthroid since i was super sick. Same dose 50. Guess what? No more head aches or sick!!!! then a few wks in I read about people taking it at night. So instead of having to wait to eat, watching the calcium and iron for hrs and having to wait with other meds and supplements for hrs....... I decided to try. I now take it at 10 or 11 before bed when my stomach is empty from dinner (usually at least 3 hrs after at the least) and in the morning i can take everything else i take and eat and not have to wait for food. It works great! Lots of studies show that is the best way. But now the last few wks I feel very little energy to spite the vitamins i take. So i know it is not my levels and it is the thyroid. Debating if i should give the 75 another go first or request cytomel for T3 for the afternoon crash. Last labs done in May after being medicated for 6 month and on the synthroid for awhile was Tsh 1.87 and the free T4 & free T3 were a tiny bit over the bottom "normal range" which i am aware they should be in the top 25% to feel optimal. They hardly moved :(

  • If you're going to give it a good try, you need to be on enough levo for long enough to know whether or not it suits you, so whatever you decide, best to stick to the same dose for six weeks and then get tested. Then with those results you'll know how to adjust your dose with confidence. If you make too many changes the test results are worthless and only add confusion.

    You can take your meds at night if it suits you. Idk that it is 'the best way' - that depends on what works for you - but it suits a lot of people and there's no reason why you shouldn't do it.

  • yes it is better for me. Since iron and calcium do mess with absorption, night is better than having to worry about that. And tea and coffee do as well which i drink tea every day (herbal.) Lastly i can eat without waiting and take other medication or vitamins so that i do not forget during the day or have to wait 4-5 hrs so they do not interfere. It is less stressful. A nd as i mentioned I take synthroid now not the levo any more because i had bad side effects. I have been on the synthroid for roughly 3 months now. Maybe a little longer so i think it is time to tweak the dose or add T3. I think maybe in the beginning the 75 dose was too much. It made me go hyper after a few wks because it was the first dose. I think for someone with a Tsh of 6 that was too much to start, plus i am a small person.

  • Some people find they sleep better when they take their meds at night. I take my supplements at night and my meds in the morning a couple of hours before I get up; I go back to sleep and can have a cup of tea as soon as I get up. I used to take meds at night but I went through a period of getting hungry before bed so swapped them to the morning instead. Whatever works.

    When raising your dose, if you feel like 75 every day might be too much you can always alternate 50/75. Currently I'm on 50/75 myself (plus 10 t3).

    Synthroid is a brand of levothyroxine. When I say levo I mean your Synthroid.

  • thank you I will make the suggestion of alternating doses to my Dr. I think it is worth a try. Yes i did the as soon as i woke up and then tried the 5 am go back to sleep an hr or 2 and then get up, but night works better in my situation. Yes I knew what you meant. I just think of Levo as generic which i was on first before the synthroid. It's all T4 anyway. Thanks for the info.

  • Well, the first thing you need to know is that doctors - in general - know absolutely nothing about hormones, nutrition, weight-loss, hypo symptoms, or anything like that. So, always take what your doctor says with a pinch of salt, and check it out on here before doing anything!

    The size of your dose has nothing to do with your TSH when diagnosed. The starter dose if 50 mcg. It is very rare that people don't need to increase that after six weeks. But, if your doctor is just looking at your TSH, and your TSH has gone down into range, he will think you don't need an increase. But were he to look at your FT3 - and understand it - he might think differently. It's the FT3 that is important, not the TSH. But doctors know nothing about hormones.

    If you have gained weight, which is a hypo symptom - but doctors know nothing about symptoms - your doctor will tell you to eat less and exercise more. Both are wrong. Low calorie will adversely affect your conversion, and exercising will use up your T3 - that's one of the things T3 is for. And, if you are just relying on 50 mcg T4 taken orally - and you probably have a conversion problem too because you're not eating enough calories - then you will not be able to easily replace that T3. You will become more hypo - because that's what hypo is, low T3 - and put on more weight. But, doctors know nothing about conversion or losing weight. In fact, they don't know very much about anything important, when it comes down to it. So, always better to check. :)

  • yes I definitely weight more. I know that you cannot eat a ton, but you also cannot go on a ver low caloric intake diet or yur body goes into survival mode. I read recently though that if you go and take too much T4 or a T3 and do not need it, your body not only burns the fat but a lot of muscle and muscle burns fat and gives you strength. I worry about that.

  • If you take too much T4 or T3 when you don't need it, you would make yourself very ill and stop taking it, long before you burnt any muscle! On 50 mcg levo, I really don't think you have to worry about taking too much.

    Do you think you were misdiagnosed, and that you don't need levo at all? I think that would be highly unlikely. It's so difficult to get diagnosed even when you're raging hypo. Do you have your labs from the time you were diagnosed? Do you have any recent labs? I should think they would tell you if you were taking it when you don't need it. Quite apart from how you feel.

  • Yes I believe I do have hashi's. I am showing all signs of hypo from symptoms to labs. I have high antibodies also. I was unfortunately misdiagnosed for many years before I pushed for the right tests and low and behold i was right and they were wrong. Turns out we know our bodies better than any dr :)

  • Well, of course we know our bodies better than any doctor. But, they've spent seven+ years studying, and they don't like admitting that anyone who hasn't studied can know what they know.

    If you have high anitbodies, then you have Hashi's. It's as simple as that. Although that's another think that doctors like to shroud in mystery. And, if you have Hashi's, your gland is going to completely fail at some point or other. But, it's advisable to take thyroid hormone replacement during that time, to support your gland during the attacks. It doesn't mean your taking it when you don't need it. You need it.

    So, be careful where you read. There is a lot of rubbish out there, and it's very easy to get sucked in. But, once you get the feel for it, it's easy to separate the wheat from the chaff! :)

  • thank you Greygoose. Yes I was getting thyroid storms for a long time unfortunately, but i think now i am starting to stay at the hypo end. I would not wish this condition disease or hashi's on my worst enemy.

  • Really? I'd wish it on all the miserable so-called doctors that mis-diagnosed me over fifty odd years! But, then, I'm vindictive.

  • Hashismom34,

    People need as much Levothyroxine as they need. Someone who is well taking 50mcg may feel over medicated taking 75mcg. Most people will be optimally medicated when TSH is 1.0 or lower with FT4 in the upper range.

    Strenuous exercise should be avoided while you are very symptomatic. Exercise depletes T3 so while T3 is low it is better to do gentle walking and swimming.

  • I gain weight if i do not run almost every day. I feel so lazy. I am wondering if adding a T3 in the afternoon would help the crash. Some have told me to try the 75 again first now that i have been on the synthroid awhile. My thought are to try some ashwagandha first to see if that increases my energy. I hate this disease.

  • Hashismom34,

    TSH 1.87 and FT4 and FT3 bottom of range indicate under medication. A dose increase will raise both. You could try 50mcg/75mcg alternate days for a couple of weeks before increasing to 75mcg. If FT3 remains low after a couple of months you could add some T3.

  • Thank you. I will see if dr will give this a try.

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