two options from endocrinologist: Please which is... - Thyroid UK

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two options from endocrinologist

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Please which is good dosage to get my TSH to normal My TSH is 5

One endocrinologist has said take 137 for the full week

Second endocrinologist has take 125mcg for 04days and 175mcg for 03days

I always take two options to see which one is better .Please advise which is better dosage from the two

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6 Replies
greygoose profile image
greygoose

Difficult to say without seeing results for FT4 and FT3. A TSH test on its own, once you are on thyroid hormone replacement, gives very little useful information.

Having said that, your TSH is much too high - should be 1 or under - so the higher dose would probably be the best. :)

Depends on your previous dose.The aim of treatment should ideally be to restore you health and get you to a place of being symptom free. There is a tendancy amoungst doctors to want to treat blood tests rather than people and in thyroid patients this often leads to poor treatment as what is a healthy TSH for one person can differ greatly from another.Thyroid medication should be raised slowly and allow six weeks before another raise.I would go for the lower dose option to facilitate this, too much thyroid medication can make hypo symptoms worse.I hope thisis not the first time you have been put on some levo, that neither of them are offering this as a starting dose.

in reply to

No need this is not first time I have used Levo before but this 137mcg is corrected dosage to bring the TSH to normal ranges according to the doctor

Angel_of_the_North profile image
Angel_of_the_North in reply to

It is impossible to tell what the "correct" dose would be for an individual before taking it as we all react differently. I'd take that opinion with a strong pinch of salt. The guidelines say that dose should be increased by 25mcg every 4-6 weeks until symptoms are gone and TSH is under 1. Anyway, it's not your TSH that you are trying to "normalise" but your actual thyroid hormones. It's much easier to take the same dose every day, but thyroxine just a storage hormone so it won't make any difference if you take varying doses as it doesn't really do anything until it's converted into T3. There's actually very little difference over a week in the two dosage plans.

helvella profile image
helvellaAdministrator

I personally feel better taking the same dose every day - rather than 100 one day, 125 the next I'd choose 112 every day.

This is not based on anything other than how I think I feel! :-) Have tried both and something just feels slightly wrong about alternating doses but others find them fine.

MaisieGray profile image
MaisieGray

What you need, can't be second guessed by anyone to be honest, including you; and the only way to find out is to try it. However I've never understood the logic or value of alternating doses, except that in the UK we don't tend to have the luxury of compounded meds as they do in the US, so can't have doses modified with the same ease. Thus it seems that alternating doses is simply to avoid splitting tablets to achieve the desired weekly dose, which is not good medicine. But in any case, having 50 mcg more on 3 days than the other 4 days seems equally poor medicine to me. Your second option totals 1025 mcg over the week, so if you want to take the higher dose why not try 150 mcg on 6 days plus 125 mcg on the seventh, which gives the same weekly total and avoids that (to me) ridiculous 50 mcg differential?

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