Starting dose of 125 mcg levo

[Riana87]

Hi all,

I have just gone through thyroidoctemy because of cancer and my thyroid surgeon prescribed me 125mcg because he wants surpressed TSH.

Would appreciate any advice on someone starting levo generally, particularly in such a high dose.

I should mention I am 35yrs old and 57kg weight. Diagnosed with Hashimoto’s in April this year and papillary thyroid cancer in August.

[PurpleNails Administrator]

welcome to forum

Were you previously taking levo when diagnosed Hashimoto’s?

Usually the decline in thyroid function is gradual so lower starting doses are given and increased over time.  

Replacement doses tops up levels but gradually a full replacement level is expected. Partly as thyroid declined partly as taking the hormones replaces the thyroid output.

With no thyroid you’ll be reliant entirely on dose taken, A rough guide is said to be 1.6 per 1kg body weight. 91.2.  

Doctor likely suggesting higher dose to keep TSH suppressed. 

Most manage -well - in fact better when FT4 is top of range.  

The FT3 levels will need to be converted entirely in your system with no natural T3 from your own thyroid or externally.  

So this will need to be checked to ensure not too low.  Doctors often go by TSH & FT4.

Most say FT3 is guide to hypo / hyper symptoms.  Some need both to be optimal. 

Did you have pre surgery levels checked to compare to post surgery levels. 

TSH, FT4 & FT3

TPO & TG antibodies 

Also important to test folate, ferritin, B12 & vitamin D.

Has a repeat blood test been arranged? 

[Regenallotment Ambassador]

hi, I have Hashi’s but I still have my thyroid so just sharing in the context of starting doses. I’ve spent months titrating up to my dose of 100mcg (currently weigh 67kg). Starting doses are usually 25 or 50mcg and it’s 6-8 weeks between increases. I’ve done 75mcg and just started on 100mcg. However as you need a replacement dose of hormones definitely look into how best/fast to make the increases. I found alternating doses each day in the early days helped me, as did splitting the daily dose morning and night. Also found one brand made me quite bilious etc. One thing is for sure you may feel overmedicated taking that dose from day 1. (My overmedication symptoms are palpitations, anxiety, sweats). Sending best wishes, 🦋💚🦋

[SlowDragon Administrator]

previous post from 2 months ago

healthunlocked.com/thyroidu...

Shows low ferritin levels

Request GP retest ferritin

[Litatamon]

I started on 112 mcg right out of a thyroidectomy. Felt fine, actually incredibly fine - like I had a drug dealer on my shoulder.

But my numbers were so off on the first check out of surgery my endocrinologist went against protocol and went from 112 to 200 in one go & then when it was still way off to 225 mcg not long afterwards. I never recovered from her initial choice (my surgeon did the 112 mcg).

I wish you all the best. I am sorry to hear about your cancer diagnosis.

I hope you feel like I did on 112 mcg. And that everything goes smoothly.

[Batty1]

I had Thyroidectomy for cancer 6 years ago and you probably will be changing doses a few times before your journey is done … I split my dose take 1/2 in AM and 1/2 in late afternoon because exhaustion is no joke when your meds feels like its lost it strength by mid afternoon…. Consistency is key.