Hello. So 6 weeks ago my levo was increased from 75 to 100. Up to that point I had been getting 50mg tablets, however the later prescriptions I have only just realised were 100mg. It's come about as I was using up my remaining 50s and didn't realise the new ones were double. So basically for the last 5 weeks I have been taking 200 instead of 100!
So my question is before I speak to my GP I am wondering if anyone has an opinion on reducing the dose as I am sure just going back to 100 isn't the idea, so at least I can have an informed discussion.
Thank you as ever
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StanleyThyroid
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Thank you - now 90kg. Some of the symptoms associated with exceeding the dose are similar to the stimulant medication I have recently started taking for ADHD so it is difficult to say (weight loss, raise pulse etc). The one thing I have noticed recently is that my voice is becoming hoarse and I have tightness in my neck and tenderness around the thyroid. I have just had my latest NHS TSH test yesterday as should get that result tomorrow. Planning on doing full panel in the summer
I was thinking 150 as well, appreciate your feedback
Might need need slight further reduction after next test
But guidelines on dose by weight suggests around 144mcg per day
guidelines on dose levothyroxine by weight
Even if we frequently don’t start on full replacement dose, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or near full replacement dose
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.
In the majority of patients 50-100 μg thyroxine can be used as the starting dose. Alterations in dose are achieved by using 25-50 μg increments and adequacy of the new dose can be confirmed by repeat measurement of TSH after 2-3 months.
The majority of patients will be clinically euthyroid with a ‘normal’ TSH and having thyroxine replacement in the range 75-150 μg/day (1.6ug/Kg on average).
The recommended approach is to titrate thyroxine therapy against the TSH concentration whilst assessing clinical well-being. The target is a serum TSH within the reference range.
……The primary target of thyroxine replacement therapy is to make the patient feel well and to achieve a serum TSH that is within the reference range. The corresponding FT4 will be within or slightly above its reference range.
The minimum period to achieve stable concentrations after a change in dose of thyroxine is two months and thyroid function tests should not normally be requested before this period has elapsed.
Hi StanleyThyroid, As you have been taking a double dose for 5 weeks it will certainly have an effect on your TSH and T4 results, they will probably check yout T4 due to the shift in the TSH. Best to tell your GP when results are in so they can record it and advise a dose change with the information at hand.
If anyone is curious my results at the wrong dose are as below. Given the level I expected to feel quite unwell but actually feeling better on 200 than on 75. As has been suggested I have dropped down to 150 and am waiting to see what my GP is going to say next week.
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