Alternating thyroxine dose

[Jenbot78]

Hiya, my GP has recommended alternating my dose from 125 one day to 100 the other day. This is because 125 makes my hyper and 100 makes me hypo. Anyone have experiences of this and did it level you out?

[SlowDragon Administrator]

Your FT3 was already low. It's likely to drop further if you reduce dose, even by 12.6mcg

You look like poor converter, many with Hashimoto's are

With Hashimoto's, vitamin problems/deficiencies and already supplementing and strictly gluten free diet, you are doing all you realistically can

You may need addition of small dose of T3

GP will be very reluctant to acknowledge that, but you could ask for referral to endo (of your choice - don't take pot luck)

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,

"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)."

You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor

 please email Dionne at

[e-mail]

Also request list of recommended thyroid specialists, some are T3 friendly

Professor Toft recent article saying, T3 may be necessary for many otherwise we need high FT4 and suppressed TSH in order to have high enough FT3

rcpe.ac.uk/sites/default/fi...

Or leave Levothyroxine dose as is

[Jenbot78 in reply to SlowDragon]

Thanks a lot, really helpful advice. I never really paid attention to FT3 so I will have a read and get myself clued up!

[SlowDragon Administrator in reply to Jenbot78]

FT3 is the important one. Most need it at least half way in regards, ideally around or just over 5, if not a bit higher.

[Aurealis]

Yes it worked for me for several years. The tests have never been much help to me, I have to adjust to where I feel well.

[helvella Administrator]

Very similar to me.

I found I didn't like switching between 100 and 125 - despite the theory being it should be perfectly acceptable. Difficult to explain, I just was always aware of the dose. (Mind, it was better than either 100 every day, or 125 every day.)

So I take 112.5 every day - by taking a 100 microgram tablet and splitting a 25 microgram tablet.

The odd day, I take a full 25 microgram tablet - but only rarely. Again, I am not at all sure that I am right, but I feel as if I am very slowly falling away from my optimum.

[Northie]

Yes, this is the exact dose I’m on at the moment, and for the same reason. It did help me and I’m being monitored by my gp. I have felt better since starting this level. Still have the usual issues but yes, much better than I was. Good luck with yours.