Wow radd. Pretty wise as always. Well, I decided to add some T3 since I "thought" I am not a good converter. I am not sure how to figure out that. I like your dosage formula. Even though I read yesterday that a good way to calculate the right dosage:
"For those of us who must take thyroid hormone because we do not have a thyroid gland due to thyroidectomy, radioactive iodine (RAI), etc., is there a mathematical way to determine our replacement dose? I recently found the article below and found the formula correlated well with people I know. A person’s weight in kilograms is multiplied by 1.5 to calculate the T4 dose in micrograms. This is expressed as 1.5 μg/kg.
Levothyroxine replacement dosage determination after thyroidectomy.
Four hundred four patients were included; 85% were women. The mean initial levothyroxine dosage was 1.4 μg/kg, which resulted in thyroid-stimulating hormone normalization in 59%, suppression in 23%, and elevation in 18% of patients. After dose adjustments, the mean therapeutic levothyroxine doses after total thyroidectomy and lobectomy were 1.5 and 1.3 μg/kg, respectively. A regression model incorporating other patient factors [age, sex, ideal body weight, body mass index, and body surface area] did not produce a more reliable dosing regimen. CONCLUSION: A 1.5- and 1.3-μg/kg dosage calculation based on actual weight is currently the best estimation for levothyroxine replacement therapy after thyroidectomy.
To apply this formula to yourself, you need your current weight in kilograms.
1 Pound = 0.45359237 Kilograms
I weigh 135 pounds, which is equal to 61.2 kg.
61.2 kg multiplied by 1.5 mcg = 92 mcg.
The closest prescription dose would be 88 mcg of levothyroxine, which just happens to be a dose I lived on for years after my RAI treatment! I believe that some amount of T3 is necessary to replicate normal thyroid gland output, and studies state that thyroid glands secrete T4 and T3 in a 10:1 ratio. To attain this theoretical ratio, I would need to add 10% of 88 mcg, or 8.8 mcg of T3. A dose of 1 grain of desiccated thyroid + 50 mcg levothyroxine equals 88 mcg T4 + 9 mcg T3, which is what I’m currently taking. While others may think this dose is far too low (only time will tell), other lab markers were telling me that higher doses were too much for me (the various types of medications and the problems I’ve encountered are covered in my book).
I know others who are also taking 1 grain of desiccated thyroid, but combining it with different amounts of levothyroxine, which happens to correlate with their weight. Here’s another example:
Male, 185 pounds = 84 kg
84 x 1.5 = 126 mcg T4
His current dose is 1 grain + 88 mcg T4, which is 125 mcg T4 + 9 mcg T3. This makes his T4:T3 ratio about 14:1 instead of 10:1, but I don’t know if all men have a higher ratio, or if everyone only needs about 1 grain as a base, and levothyroxine is what increases or decreases based on weight.
I am well aware that this formula will not work for everyone, but I thought it was an interesting way to calculate a reasonable dose for some people. We can’t dose by TSH, and reference ranges are so broad that widely different doses will give “normal” results. Of course, this formula doesn’t address any nutrient deficiencies such as low iron, cortisol, Vitamin D, etc. either, but at least it can be used as a base guideline by those who are undermedicated and on a dose that is far too low for them to function simply because their TSH is suppressed.
so my weight is 78 kg x 1.5 = 117 mg of T4 ... I am still undecided if taking NDT +t4 or only NDT. I'v e read T4 combination could be tremendously beneficial to mimic the right human thyroid production.