Thyroid meds every other day (different doses)

[bmcentire]

Has anyone ever taken 2 different doses of thyroid meds....every other day (so 1 dose M, W, F, Sun...and the other tue, thur etc). Or anything like that????? Ive been going thru problems for 3 years now (after radioactive iodine). I feel really stuck (& sick right now). Had started doing this...but not sure how it will be longer tern.

[SeasideSusie Remembering]

I have alternated dose of Levo to give an average daily dose when I don't have the correct tablets, eg if I have 100mcg and 50mcg tablets, and my dose is 125mcg, then I alternate 100mcg and 150mcg.

Is this what you mean? If not, can you explain further please.

[bmcentire in reply to SeasideSusie]

It is. Would u normally feel ok if u took the same dose everyday? Or is this something u do otherwise? I feel stuck..I go up to 75mcgs & I get really sick. So Im trying to alternate 63mcg and 75mcg. This is after 3 years of trying different things. Im on Tirosint..which is levo..just a gel cap w/o fillers

[SeasideSusie Remembering in reply to bmcentire]

I have no problem at all alternating doses to give an average, I don't feel any different on the 150mcg day to the 100mcg day. However, there is at least one member of the forum that tried this and felt better for splitting the tablet and taking the exact same dose every day.

So you're trying to altenate 63/75. I understand that Tirosint is a gel capsule and it's not possible to split it. I also understand that the dose strength of them is 13-25-50-75-100-125-150

What dose strength is your capsule - 75mcg? How do you propose arriving at 63mcg?

[bmcentire in reply to SeasideSusie]

Thx for replying. Theres a 13mcg...so I take that with the 50. Then my blood test says I supposed to be on 75. Ive had a hard time going past 63. Ive been so sick for so long...so I was going to try those doses every other day. Im having a specific problem to taking over a certain dose of anything (the tirosint has been better tho). I go into the doctor on Feb 8 to talk to him. Hes at one of the best hospitals (Cedars sinai) but knows nothing. But I havnt found an endo specialist that can help me in any way. (sorry this is so long)

[SeasideSusie Remembering in reply to bmcentire]

As you have the different dose strengths then I would give it a try. It's a relatively small increase, averaging 69mcg daily, and you might find that works. Some people have to make very small and gradual increases. I hope it works for you.

[bmcentire in reply to SeasideSusie]

Thank You

[MMaud]

I have done the same as SeasideSusie. The prospect of halving 25mcgr pills just didn't appeal.

I didn't notice it (in terms of how I felt), and provided I didn't let my 7-day pill box het totally empty, I had no issues working out which does I needed to take, as soon as I opened my eyes.

[bantam12]

I do 125 then 150 twice a week.

[anonymous45]

Because T4 has such a long half-life, taking it alternating days is usually absolutely fine, and for almost everyone will not be noticeably different from taking the same dose every day.*

The totally weekly dose is therefore useful for maintaining consistent T4 intake. E.g. I take 75mcg per day. When the tablets are not in stock, they will sometimes give me 25+50 to take every day, or just the 50mcgs to take 2, 1, 2, 1 on alternating days. This results in 500-525mcg per week; and I've noticed no difference from this pattern.

This means that within reason (i.e. not taking all of it one day a week), you can create a dosing schedule that works best for you. As bantam12 pointed out above, you could even do 5 days of one dose, and 2 days of another if that hits the sweet spot.

*An example exception to this is where your body is short on fT4 (which is like a reservoir of thyroid hormone), e.g. being undermedicated. As a result of this, even a slight drop in fT4 can worsen symptoms as the conversion from T4 to T3 might actually be limited by the amount of T4 available in the blood.

[bmcentire in reply to anonymous45]

Thank u so much..this is a huge help. The way u explained that was so clear..and good...it was really helpful.

[SlowDragon Administrator]

A common problem preventing dose increase is low vitamin levels

Have you had vitamin D, folate, ferritin and B12 tested?

Ask GP to test if not been done or test privately

Always get actual results and ranges on all tests

For full Thyroid evaluation you need TSH, FT4 and FT3. Also extremely important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. Do not take Levothyroxine dose in the 24 hours prior to test, delay and take immediately after blood draw. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Is this how you do your tests?

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or vitamins

thyroiduk.org.uk/tuk/testin...

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random

Did you have Graves before RAI?

[bmcentire in reply to SlowDragon]

Thank you. I really needed to know this. I take D and B12...but the others I need to have checked. Those are great to tell my Dr to check. My endo dosnt check for T4..but Im going to ask him to start. I dont know if I had graves...I was hit in the throat so hard I couldnt talk for a couple weeks & whatnot..right after that I started dropping weight and had my thyroid checked. After a year of nothing working...this Dr told me to do the radioactive iodine. But after 3 years Im still having alot of problems,..,only when I adjust to the medicine,,and Im on the right dose...is when I have the problems, Its been really really bad. Im wonder if being hit in the throat mess up something that effects my thyroid. Or it could be one of the things you said.

[LAHs]

Yes, you can alternate your dose to produce an average as explained above. I am just writing to point out that this will not work with T3 because T3 has a short half life of about 8 hours. If you attempt this averaging down with T3 you will have one good day then one lousy day. Same thing with NDT since it is probably the T3 in the NDT which is making you feel good. But yes you can take any combination of T4 which makes the average dose that you require.

Btw, you can even do this over a 3 day spread, let's say day 1 you take 100, day 2 you take 120 then day 3 you take 50 do the same the next 3 days and so on and so forth then effectively you will be taking a dose of 90. I am not sure if you can do this with a 4 day spread because two repeats will exceed the half life of the T4, I'll have to think about that.

[bmcentire in reply to LAHs]

Thank you..that helped so much. I appreciate it.