Changing Levo doses: Should it make a difference... - Thyroid UK

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Changing Levo doses

Jollypolly profile image
11 Replies

Should it make a difference to how you FEEL If you divide up your weekly dose, say , of Levo , into differing amounts,,,

Example…if I think that overall I need 40 mcg daily…and split up Into 3 days at 50 , 2@ 25 and 2@ 37,5…

I will get equivalent of 40 daily…but varying doses to get there,,,

Is it theoretically stupid to think it’s any different to actually taking 140 daily? I don’t quite understand how the t4 works….

I believe that its more important to keep the t3 dose stable,,,,which I do..at 2.5 mcg,..without it I’m sunk , but I still can’t get over the hyper/ hypo rotation of symptoms, whatever I do.

Any ideas,,? I dndeacour to keep my d3 and b12 levels up.

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Jollypolly profile image
Jollypolly
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11 Replies
helvella profile image
helvellaAdministrator

There are two opposing views:

T4 is "just" a storage hormone. Whatever you absorb is mostly bound to carrier proteins in the blood and T4 itself appears to have little or no activity. Therefore, you could take it in any regime even up to taking your entire weekly dose in one go.

VERSUS

T4 has effects that can be noticed within minutes - whether this is a direct effect of T4 or a deeper consequence. The maximum effect on T3 levels of taking T4 usually occur about 48 hours after taking the T4. If you vary the dose you are taking then, 48 hours later, the peak of T3 from that T4 dose will occur. If your T4 dose varies, so too will the T3 peak. Therefore the best approach is to have the same dose every day, or even multi-dose within a day - that more nearly approaches the pattern of T4 release that would occur in a healthy person.

My view? I have dosed alternate days, say 100 one day, 125 the next, to achieve 112.5. I prefer 112.5 every day. If it weren't for the difficulty in taking T4 away from food, etc., I think I would advocate at least trying multi-dosing but have never actually done it myself!

We are all individuals - what works fine for one might be intolerable to another.

radd profile image
radd

Jollypolly,

Great response from helvella.

I would add the difference may be how well you convert. If you don't convert well, then T4 becomes mainly a storage hormone and varying doses shouldn't in theory make any difference but if you converted well, then a steady dose taken the same time each day must be more beneficial because your body would become to rely upon that steady supply of converted T3. We do make a tiny bit of T3 but most of our supply comes from the conversion of T4 (unless we medicate T3 of course).

Jollypolly profile image
Jollypolly in reply toradd

This makes sense,,,THANKYOU

SlowDragon profile image
SlowDragonAdministrator

I currently take 112.5mcg per day I don’t find taking 100mcg and 125mcg alternate days is anywhere near as stable

I also (fairly) recently started splitting levothyroxine into 2 doses. 100mcg at 11pm and 12.5mcg at 5am.

Definitely find it an improvement

Considering trialing splitting into 67.5mcg at 11pm and 50mcg at 5am

Decades ago when I was struggling to increase levothyroxine dose I use to split into 4 doses a day

Jollypolly profile image
Jollypolly in reply toSlowDragon

Trials trials trials! That’s all I do ! But ok..thanks..I’ll consider this…

radd profile image
radd in reply toJollypolly

🤣 … thats what we do!

RoboTh profile image
RoboTh in reply toSlowDragon

This is really interesting. I'm struggling with each dose increase of 25mcg, now on 75mcg but the feelings of being wired and wiped at the same time for a week after each dose increase is hard to adjust to. Wondering whether to take 25mcg before bed and 50mcg at 4am (4am is my usual time of administration) until I get used to it and then go back to one dose a day ??

SlowDragon profile image
SlowDragonAdministrator in reply toRoboTh

Are you on same brand levothyroxine as before

Worth trying split dose

RoboTh profile image
RoboTh in reply toSlowDragon

No I'm now on Mercury pharma. I'm the same with every dose increase no matter what the brand. Was slightly better on accord to be fair. X

dizzy864 profile image
dizzy864

I had a lot of problems with Mercury Pharma. I felt different with every batch. Some were fine but many left me feeling ill. Every month for me was a new batch number. After a few months I switched to Atavis and have been much better. I yellow carded them a couple of times. I think the problem was that the strength of the pills varied so much with each batch. I m ultra sensitive and couldn’t cope with it.

Jollypolly profile image
Jollypolly in reply todizzy864

Thanks..it’s a minefield isn’t it !

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