Thyroxine dose change

[SovietSong]

Hi, I posted a few days ago about joint pain relating to thyroxine(neck,shoulders,hips,small joints in hands etc).Doc tested me last week and results showed my tsh levels very high.He has reduced my dose from 150mcg to 100mcg with another blood test in 6 weeks.I was wondering how long it takes to level itself out as I am still getting the joint pain etc..I had the feeling the test would show me to me under medicated as thats how I was feeling prior to it.Any advice would be very welcome thanks.

[SlowDragon Administrator]

If your TSH was high levothyroxine dose should have been INCREASED

Can you double check your results

Just testing TSH is completely inadequate

ALWAYS test as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

Is this how you do your tests

If you had LOW TSH and high Ft4 ………you might need small dose reduction…..but dose should never be reduced by more than 25mcg at any one time

More likely to only need to reduce by 12.5mcg daily or alternate days

But if TSH was high ……you definitely needed dose INCREASE not reduced

Do you always get same brand levothyroxine at each prescription

When were vitamin D, folate, ferritin and B12 last tested

What vitamin supplements are you currently taking

[SovietSong in reply to SlowDragon]

Thanks for the replys guys, much appreciated. I'm sorry I didn't word my post very well, my ft4 was very high and my tsh was low. Very sorry for the error. I did think myself that dropping from 150 to 100 was quite a drop. Is it possible these symptoms will subside in next few days/weeks? I thought the joint pain that I have was symptom of undermedicating but I guess not.

[SlowDragon Administrator in reply to SovietSong]

Looking at previous posts you were experimenting with increasing dose levothyroxine to 200mcg (likely far to big an increase)

How long before test had you been on constant unchanging 150mcg dose and unchanging brand levothyroxine

ESSENTIAL to regularly retest vitamin D, folate, ferritin and B12

When were vitamin levels last tested

What vitamin supplements are you currently taking

Suggest you get FULL thyroid and vitamin testing done after 6-8 weeks on unchanging dose and brand of levothyroxine

Wether that’s 125mcg or 100mcg is your decision

How long have you been on 100mcg now

How much do you weigh in kilo approx

[SlowDragon Administrator in reply to SovietSong]

Please add actual results and ranges

Was test done as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

Obviously essential to test TSH, Ft4 and Ft3 plus vitamins all together

[tattybogle]

If TSH is HIGH then Levo dose should be increased not reduced . Are you sure they didn't say fT4 was high ? ( that might explain a dose reduction )

Or a very LOW TSH would also explain a dose reduction.

[tattybogle in reply to tattybogle]

Also .. even of it was correct to reduce dose .. going from 150mcg to 100mcg is likely to be far too much of a reduction . It's very heavy handed. Usually dose should be adjusted by only 25mcg at a time , (at most.).. quite often when we are already on a stable dose , we only need an adjustment of 12.5mcg . ( For example taking 125 one day and 150 the next, alternating, gives 137.5mcg )

[SeasideSusie Remembering]

SovietSong

Doc tested me last week and results showed my tsh levels very high.He has reduced my dose from 150mcg to 100mcg with another blood test in 6 weeks.

Are you sure that it was the TSH that was very high, and not the FT4?

Do you have a print out of your results, or online access to them? If not then please get your results, with their reference ranges, because there is some mistake here.

I had the feeling the test would show me to me under medicated as thats how I was feeling prior to it.

If your TSH was high then your doctor is an idiot to reduce your dose and needs reporting. High TSH = hypothyroidism/under medicated.

By the way, dose changes should be 25mcg increments, so your GP was also wrong to reduce by 50mcg.

[Buddy195 Administrator]

I always ask for a print out of any blood tests from my GP, as it’s easy to get mixed up with results. You can phone your GP surgery and request a copy. It’s helpful to post these results (with ranges in brackets) on the forum, so members can best advise.

[Marz]

I have read your 3 previous posts/threads and can see you are always asked about FULL testing TSH FT4 & FT3. Still cannot see you have posted these results which help members make good suggestions. Also tests for B12 - Folate - Ferritin - VitD have been requested. All these details complete the picture - or some of the picture at least. For example you can be over medicated if your T3 is over range. Optimal nutrients help with the conversion of T4 into T3 - inactive hormone into ACTIVE.