Do ladies with a higher BMI need higher dose of meds

[Kiwiq2019]

Hi just curious if this was a thing as the title asks really? I am on the bigger side. I've been started on 25mcg levothyroxine but so far have only spoke to gp on phone and want to make a face 2 face appt next week to discuss everything I can

Thanks in advance

[greygoose]

The normal starter dose is 50 mcg unless you are very young, very old or have a heart condition. You should then have retests and increases of 25 mcg every six weeks until you feel well. It doesn't have much to do with weight. You need what you need and should continue increasing until you find what you need. But, very few doctors understand that.

[Kiwiq2019 in reply to greygoose]

Yeah I plan on asking them for 50 instead of 25 and have printed out the bnf/ nice guidelines on what the initial startingn dose should be. I've been feeling shit for too long now and sick of getting fobbed off. I'm only 27 and I just feel so crappy all the time. It causes issues with me and my husband too because I just cba doing anything most days. I've known for a while it was cause of my thyroid just had a gut feeling. I wanna be as clued up as I can so doctors listen to me .need my levels to be safe for me ttc again..

My gp practice only book appts on the day so I'm hoping one day next week I will get one. Sick of all the telephone calls. The doctor who rang me yday thought I hadn't been compliant with my thyroid meds. He obvs hadn't even checked my notes. Just annoys me how some GPS just cant be bothered to do their jobs.

Eurgh rant over lol

[greygoose in reply to Kiwiq2019]

I think it annoys us all. Lord knows they get paid enough for it!

[MaisieGray]

Since gaining weight I am very definitely fat, yet take a lower total amount of thyroid hormones than my friend who weighs a lot less than I. As greygoose says, we need what we need, and we also need to start at the correct dose otherwise can feel worse than we did without it - assuming you have some thyroid functionality, if the dose is too low, it can be just sufficient to cause the thyroid to reduce its own production in response, and you can end up with less rather than more thyroid hormone in your blood.

[diogenes Remembering]

BMI is a factor in dose decisions. One usually starts at 1.6-1.8 mcg T4/Kg body weight. Then one finds out the best level of T4 therapy by future trial and error. It's fairly clear that if you weighed 60 kg, then your requirement would be much less than someone of 85kg. The latter is nearly 40% bigger than the former, and the appropriate T4 dose reflects this.