Reducing Tirosint Dose One Day/Week - Feeling Bad

[KarmaMaya]

Hi,

I've been on 88mcg of Tirosint for a year and felt better than I have in years. My recent labs were:

TSH - .029 (range .4 - 4.5)

Free T4 - 1.34 (range .8 - 1.80)

My endocrinologist wants to lower my dose from 88 mcg of Tirosint to 75 mcg/day. I was resistant since I finally feel good, so he said we would move down slowly. I take one 50 mcg of Tirosint one day per week, and the 88 mcg/day the other 6 days.

The issue is that I feel depressed on the 50 mcg day - and just don't like anybody, including my husband.

My endo says that since there is a 7 day half life, I shouldn't notice the drop. But, I do. Does anyone else alternate or use different doses different days, and feel emotional or physical symptoms? What is a better way to reduce my dose? Or do I really need to mess with something that was working?

Thanks for your help.

[SlowDragon Administrator]

Just testing TSH and Ft4 is completely inadequate

Most important result is Ft3

Ft4 isn’t over range

You need TSH, Ft4 and Ft3 tested together, plus vitamin D, folate, ferritin and B12

Always test thyroid levels early morning ideally just before 9am and last dose levothyroxine 24 hours before test

What vitamin supplements are you currently taking

What were most recent vitamin results and ranges

[KarmaMaya in reply to SlowDragon]

I will ask for FT3 - he is a traditional TSH only endo. But I agree, can understand why he wouldn’t want the whole picture.

[SlowDragon Administrator in reply to KarmaMaya]

Many people need to take as near as possible same dose every day

[helvella Administrator Thyroid UK]

Some of us notice even relatively small changes.

I prefer taking 112.5 every day to alternating 100 and 125. I'll happily admit I might not notice for several days, but if I change back to 112.5 every day, something changes for the better.

There seems no logic to 50 one day a week. Especially if the endo thinks you should drop to 75. Why not 75 one day a week (or every so many days - whatever you can agree) and see how that goes? If it goes well, increase the number of days you take 75. Two days a week? Or every six days? Then every five days. And so on.

If the pan on the stove is boiling (rather than simmering), you probably want to turn the burner down a tiny bit - not halfway to off!

[KarmaMaya in reply to helvella]

Yes, I agree and I actually asked him for a 75mcg prescription and suggested I take it every other day. Not sure why he insisted on this approach. I will go back and ask again. Thanks