Changing thyroid doses over the week

[Freddyjo]

My GP has recently started me on 100mg levothyroxine Monday to Friday with 50mg at the weekends. I feel that this is not good for me but are there any facts out there that will help my case when i speak to him next month? Thanks

[Hidden]

What is the reason your doctor put you on this dose?

It sounds strange to me.

Some people take alternate doses such as 100 mcg every other day and 75 mcg every other day if they feel best on 87.5 mcg daily, but I don't see the reason for your doctor to put you on 50 mcg on weekends only.

[helvella Administrator Thyroid UK]

Freddyjo,

I think it has been argued (sorry - no links) that having a larger, or a smaller, dose for ONE day a week might have some benefits.

My personal experience has been that I was better taking 112 micrograms every day than alternating 100 and 125 micrograms day by day. Others seem fine on alternate day dosing. We are all different.

In some countries, they tend to prescribe a dose per week - e.g. 875 micrograms a week. (Or 600 micrograms a week in your case.) With the patient left to distribute the dose through the week as best they can. It does make it easy for the prescriber to adjust the dose by just 25 micrograms a week.

(I am now on 125 micrograms every day so there is less reason to consider alternate day dosing.)

My view is that dropping for two consecutive days is bonkers and I doubt you'll find any evidence to support it. Seems to be based on arithmetic rather than optimum treatment.

[greygoose]

I think your doctor is totally out of his depth, and just trying to prove he's doing something, rather than nothing. Try asking him his justification for dosing in that way? Have you actually tried taking 100 mcg every day? What happened? Do you have copies of your blood test results? Is he even doing the right tests? Or is he trying to dose by the TSH? In which case, his little 'adjustments' would be laughable, because they're not likely to make much difference to the TSH.

[humanbean]

I would suggest taking 50mcg on

Monday and Thursday or

Tuesday and Friday or

Wednesday and Saturday or ...

You get the idea... Try to spread your Levo dose as evenly through the week as you can. Taking a small dose two days on the trot only at weekends doesn't sound very logical to me.

You will almost certainly need a weekly pill box to allow you to do this spreading of dose sensibly, unless you have a phenomenal memory and will remember which days you are taking what.

You should find this document written by helvella to be helpful :

dropbox.com/s/sllu21khbeyth...

[Freddyjo]

Thanks everyone, I will continue with the reduced dose and simply spread them out in the week. I have been on 100mg daily for around three years and i think my GP was saying that he thought my dosage was suppressing the natural working of my thyroid so he wanted to reduce the dose but after reading the comments in reply to my question i'm thinking he was not aware of the importance of spacing the doses out.

[Lora7again in reply to Freddyjo]

What does he mean by suppressing the natural working of your thyroid? It sounds like he is going by just your TSH to me and he should be testing your T4 and T3 as well not just the TSH. This man has no idea about how the thyroid works imho. I would find another doctor who has some knowledge of thyroid disease if I was you.

[Wetsuiter]

sounds like he s dosing by TSH (and as others have said, trying to make it work mathematically)

how did you feel on 100 per day?