Dose of t4 and t3 by your weight

[Evie7851]

I have read on here that you should calculate Levo at 1.6 per weight but how do you figure out how much when you are taking t4 and t3 the calculator says 108 kg is 176 for weight and I’m taking 125 alternating with 112 and 15 t3 Thanks

[SeasideSusie Remembering]

Evie7851

I have read on here that you should calculate Levo at 1.6 per weight

The NICE Guidance actually says:

Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.

So that is their guidance on a starter dose for newly diagnosed patients. They then go on to say:

Aim to maintain thyroid stimulating hormone (TSH) levels within the reference range when treating primary hypothyroidism with levothyroxine; if symptoms persist consider adjusting the dose of levothyroxine further to achieve optimal wellbeing, but avoid using doses that cause TSH suppression or thyrotoxicosis.

So nothing is set in stone, the new guidance suggests basing the starter dose on weight, then the dose is adjusted to what we need to make us feel well and is not necessarily weight dependent.

As you are on combination hormone replacement, as with Levo, we need what we need. You will know when you feel optimally medicated but it may take a lot of tweaking of doses to achieve that.

[Rapunzel in reply to SeasideSusie]

The NICE Guidance actually says:

Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.

Now that's interesting. There may be some GPs( of the year ) who therefore give this amount as a starting dose. In my case that would be almost 150mcg and all at once would doubtless have lead to me feeling like I'd just taken some Columbian marching powder...

NICE: legislate for muppets would be my advice...

[SeasideSusie Remembering in reply to Rapunzel]

I know. Personally I think it's ridiculous and some people have come a cropper starting on such a high dose. I'm within the "start low and increase gradually" camp, I have absolutely no idea why they changed it or who even thought it was a good idea. But I'm a mere mortal, an ordinary Joanna Bloggs who didn't get a medical degree or even go to Uni 'cos I'm not clever 🤣

[greygoose in reply to SeasideSusie]

Could it just be another ploy to be able to say: well, levo didn't work for you, so there's nothing wrong with your thyroid. And, take people off it completely?