Hi, my husband is on 150mg PTU for his Graves. Is this a high dose? He needs to be on it for 4 weeks until his next visit at endo. We wouldn’t like him to go underactive. His current ranges are:
TSH 0.02 (0.30-3.05)
T4 25.7 (10-28.2)
T3 10.6 (4.3-8.1)
Did you not get a Patient Information Leaflet? You should have done. If you did not, ask for one.
The Summary of Product Characteristics (which is the prescriber's version of a PIL) says:
4.2 Posology and method of administration
Adults and elderly:
Initially 300 to 600mg daily, once daily or in divided doses until the patient becomes euthyroid.
When the condition is controlled (usually after 1-2 months), the dose is reduced to 50 to 150mg daily and continued for 1-2 years.
In renal impairment:
GFR 10 to 50ml/min, 75% dose
GFR < 10ml/min, 50% dose
In hepatic disease:
Reduced dose
medicines.org.uk/emc/produc...
So 150 milligrams is not a high dose. It is one half of the suggested initial dose.
We didn’t get the leaflet so thank you for this.
I recommend that you absolutely always ask for a PIL.
In my view, it is wrong to supply a medicine without the information necessary to understand everything you need to know about taking it. OK, so PILs are not perfect, but they are a good start.
The EMC site I linked to has documents for a huge range of UK medicines - but not all.
Looks like your husband’s thyroid levels are coming down quite well. It can be difficult to get the dose right, and endos tend to err on the side of avoiding the thyroid going hyper again, so it isn’t uncommon to dip slightly below range. This usually sorts itself out very quickly once medication levels are reduced, but if your husband is worried that he is experiencing hypo symptoms (eg, he begins to feel cold when everyone else is quite warm), he could always ask for his next blood test to be brought forward.
Thanks Valarian. We will monitor him but he is actually feeling very well - touch wood. Even his endo was quite surprised about his recent results especially that he had to stop Carbi for a week and start PTU. Within the past 2 months we have learned so much through this forum. He started looking after himself and I started driving (as was stuck when he couldn’t drive me to the town) so there are many good things which came out of his illness. We hope he continues to improve and goes into remission one day.
PTU causing liver problems.
Levo Dose 
