Feel Awful with Inconsistent Dosing: I increased... - Thyroid UK

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Feel Awful with Inconsistent Dosing

Trina64 profile image
21 Replies

I increased my dose of Synthroid levothyroxine) about 10 days ago, so still very early on this dose. For the last few days, I had felt a little improvement. I was out living life even though I still have a ways to go. After my last bloodwork, I requested my dose to be raised from 50mcg to 75mcg. My endo agreed, but he wanted me to cut my dose in half (37.5mcg) one day a week. Maybe this is his way of telling me he is in charge. This morning I took the half dose at 4:30 a.m. A few hours later, I could feel this decline in mood and then by early afternoon I was anxious and emotional. One of my hypothyroidism symptoms is jaw pain and I can feel that more as well.

I thought that sinceT4 is a storage hormone that I wouldn't even notice, but that is the only change I have made so don't know what else it could be. I think when it comes to thyroid, I need consistency....same dose, same time, empty stomach, full glass of water every day. I left work early, came home and took the other half. I don't expect much since it isn't on an empty stomach.

Does this resonate with anyone else? I hope so, because I feel like I took a huge step backwards after seeing some improvements. I am hoping like crazy I get back on track tomorrow when back on my 75mcg. I am refusing to take half a dose again. My GP has referred me to another endo.

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Trina64 profile image
Trina64
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21 Replies
Lalatoot profile image
Lalatoot

Trina My body likes the same doses at around the same time each day. I have to cut tablets to have a consistent dose. I feel up and down if I do different dosing on different days .

Trina64 profile image
Trina64 in reply to Lalatoot

It is good to know that I am not the only one who feels the fluctuations. I am even careful how I take my estrogen (same dose, same time of day) and make sure I don't take it too close to my thyroid as well.

Mccrae profile image
Mccrae in reply to Trina64

may I ask what form of estrogen you are on and how far apart you take from thyroid meds

jrbarnes profile image
jrbarnes

I don't like those alternating doses. Perhaps I'd feel differently if T4 alone was enough.

Trina64 profile image
Trina64 in reply to jrbarnes

I forgot to mention that I am also on 5mcg of T3.

jrbarnes profile image
jrbarnes in reply to Trina64

I've been doing as SlowDragon mentioned. Split my Levo once at bed and the other half in the morning plus the T3 I'm taking.

Trina64 profile image
Trina64 in reply to jrbarnes

I think I am fine taking it all at once. I just need a consistent dose everyday. Maybe I would be fine alternating doses if I had some in reserve, but my T4 was not nearly high enough when it was tested 10 says ago.

SlowDragon profile image
SlowDragonAdministrator

Many members find it important to take same dose Levothyroxine everyday

Same brand at each prescription

Smaller number find it better/smoother to split levothyroxine as 2 smaller doses per day. Half dose waking and half dose at bedtime

Important to regularly test vitamin D, folate, ferritin and B12

What vitamin supplements are you currently taking

Do you have Hashimoto’s

Trina64 profile image
Trina64

I take Vitamin D and no Hashi's. B12 and Ferritin are high in the range.

I switched to name brand, Synthroid, for consistency and most people seen to have more success with it. I switched to Synthroid 3 days into the increase.

I think dropping down to 37.5mcg is insanely too low, especially since I don't know if 75mcg is enough yet.

jrbarnes profile image
jrbarnes in reply to Trina64

It's supposed to be dosed based upon how much you weigh in kilograms but also other factors like age. The bioavailability of these tablets is also not 100% so found myself taking a higher dose than calculated for my weight. I was on 88mcg for 10 years. Even a 12.5 mcg increase in Levo could raise your T4 from the lower end of the range to the higher end. Of course, they don't make smaller doses like 5mcg of Levo to add on so I guess they get creative with dosing. He increased it from 50mcg to 75mcg but wants you to decrease by 37.5 one day which divided by 7 days is around 5mcg less per day. I suppose it depends on where your FT4 levels are. 5mcg per day change for me is very noticeable. I can even feel the difference between generics and brand names. Personally, when one dose is too high for me I'm not going to feel well taking it more than one day consecutively. I like to take daily what I need.

helvella profile image
helvellaAdministratorThyroid UK in reply to jrbarnes

I'm very wary of dose by weight!

helvella's calculation document and spreadsheet can be can be found by following this link:

helvella - Estimation of Levothyroxine Dosing in Adults

A discussion about the use of formulas to estimate levothyroxine dosing. Includes link to a downloadable spreadsheet which calculates several of these.

helvella.blogspot.com/p/hel...

Noelnoel profile image
Noelnoel in reply to helvella

Excellent document. My brain doesn’t currently allow such ordered thinking so I’ve never considered any of your assertions in it. They make complete sense and have given much food for thought. I hope one to day to have at least some of the charity that you have

Thank you

helvella profile image
helvellaAdministratorThyroid UK in reply to Noelnoel

It's an issue that has been annoying me from the first time I heard of it!

helvella profile image
helvellaAdministratorThyroid UK

The population of levothyroxine takers seems split in two.

One lot seem to take it any how they like - up and down - without feeling any impact.

The other lot seem to want to keep to variations of no more than 12.5 micrograms a day. I'm one of these! Despite repeated attempts to cut corners and make life easy (e.g. 100/125 alternating rather than 112.5 every day) - it doesn't work for me.

(Obviously, total taken must be consistent - it is just day by day changes I'm referring to.)

Trina64 profile image
Trina64 in reply to helvella

I am probably in the same camp as you. I don't know why my doctor had me cut it in half (37.5mcg) one day a week. I am just staying at 75mcg everyday and retest in 6 weeks. I am no where close to being over medicated.

jrbarnes profile image
jrbarnes in reply to Trina64

I take Levoxl and they're easy to split by hand by snapping in half. Sometimes if I find myself just needing a little bit of an increase I'll split two doses to get somewhere in between. Most of the time I just need an extra 5mcg in Levo daily. I don't like alternating these big dose differences not even 12.5mcg. Just like to get the same amount daily.

Trina64 profile image
Trina64 in reply to jrbarnes

It is quite a process, isn't it? I just hope my happy, upbeat, positive self returns one day.

Gingernut44 profile image
Gingernut44

I think to drop you by 37.5 mcg for one day is stupid, I felt the difference of 25 mcg when on 75/100 alternating. What goes on in these doctors brain, it’s equivalent to 5.3 mcg per day ! I think your instinct to take 75 mcg per day is right. See what your levels are in 6/8 weeks. You don’t have to tell him you’ve ignored his instruction until you know what your results are.

Trina64 profile image
Trina64 in reply to Gingernut44

That's what I thought. It may now take a few days to make up the difference. We already feel like we are all over the place trying to get level and then they do something stupid luke this.

arTistapple profile image
arTistapple

Dr Broda Barnes back in the day said that doctors are very careless (not an exact quote) in their prescriptions of thyroid meds. They don’t understand them. He was pretty exasperated. No change I think. I could not be bothered with that up and down way of taking meds. I’d rather cut them up so I take the same dose each day. Why make it more complicated?

Trina64 profile image
Trina64

Exactly! I am still trying to get optimal and feel better and then add another variable in the mix makes no sense. I will probably be off kilter some today as well. Hopefully it gets better and I will just remain on a stable dose from here on out.

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