Levothyroxine dosage

[ali56]

Some advice please

I have Graves’ disease

TSH 0.01 range 0.30-5.50. March 2018. Over medicated on carbimazole

T4 9 range 11- 22

TSH 14.91. “ “ “. April. 2018. No medication

TSH 12.44 May 2018 put on 50mcg levothyroxine by gp

TSH 0.72 Blood results today

GP has told me to continue on 50mcg levothyroxine won’t that cause me to go hyper.

Am confused as TSH went from 14.91 to 12.44 with no medication.

Then took levothyroxine for 5 weeks and it came right down to 0.72

Hope this makes sense

Thank you for any replies

Ali 56

[helvella Administrator]

It sounds like you are being treated with some hotch-potch homebrew approach to treating.

There are two usual approaches to controlling hyperthyroidism - typically Graves.

First, take an anti-thyroid medicine such as carbimazole only. As thyroid hormone levels drop, reduce the dose. Try to keep the thyroid hormone levels at a good level.

Second, take an anti-thyroid medicine such as carbimazole in sufficient dose to fully suppress your thyroid making any thyroid hormone. Add in levothyroxine to supply all your thyroid hormone requirement. This is known as block and replace.

What you have described sounds like half way between the two. Trying to manage someone by adjusting both carbimazole (to allow some thyroid function) and also supply levothyroxine is quite likely an impossible job. Rather like driving by using both accelerator and brakes all the time.

[ali56 in reply to helvella]

Thanks for your reply what would you suggest I do as am struggling gp is managing it now as consultant discharged me last year.

Ali56

[bantam12 in reply to ali56]

You need to be referred back to the Endo because your GP is out of his depth.

[helvella Administrator in reply to bantam12]

Agreed, bantam12.

However, you might get some helpful pointers if you let us know exactly what medicines you have been taking - and dates.

[ali56 in reply to helvella]

Will do it is a long story

Thank you

[SlowDragon Administrator]

Ask GP to test vitamin D, folate, ferritin and B12

These are often too low and may need supplementing

Also look at gluten free diet as way of helping reduce autoimmune aspect

Ideally ask GP for coeliac blood test first

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