You need what you need! And a TSH of 4.75 is far too high. Typically, on treatment it is likely close to 1 or quite possibly a bit below. But dosing by TSH alone is poor practice.
(Can't really comment on the FT4 result because you have not quoted a reference interval, a range. They vary from lab to lab across the country.)
Many of us lament the fact that doctors almost invariably adjust doses by 25 micrograms - which they do simply because that is the next dosage of tablet available.
You could take 87.5 a day by alternating 75 and 100. And much finer dose adjustment can readily be achieved.
Or you could split tablets (depending what exact tablets you get).
Also, do you get a different make of tablet when you switch between 75 and 100?
Hi thanks for the reply yes the 75 /100/25 all different brandsI have discussed this with doctor many times but they are insist and that diff brands do not make a different, but they we know that
If I insist will the doctors ensure same brand? I was on 100 now reduced to 75 these blood tests where when I was on 75
Thinking to alternative 75 one day and 100 the next as I have always felt better on 100
Well, they are right that there is only one formulation of 75 micrograms. Teva.
But Teva also supply 12.5, 25, 50 and 100!
I know many (including me) do not like Teva as it causes side effects (e.g. stomach discomfort).
Maybe try pointing out that 75 to 100 is a 33% increase. (And 100 to 75 is a 25% reduction.) Which, for a medicine which is well known to require accurate and consistent dosing, is extremely heavy-handed.
Add that absorption of a given dose does vary by formulation. You could absorb, say, 80% of one formulation, but 70% (or less) of another formulation.
helvella's medicines documents (UK and Rest of the World) can be found here:
helvella - Thyroid Hormone Medicines
helvella has created, and tries to maintain, documents containing details of all thyroid hormone medicines in the UK and, in less detail, many others around the world.
This link takes you to a page which has direct links to the documents from Dropbox and Google Drive, and QR codes to make it easy to access from phones.
The UK document contains up-to-date versions of the Summary Matrix for tablets, oral solutions and liothyronine available in the UK.
To be honest I don't know when I was on 100 mg I was OK then 12 months later started to feel anxious ache joints worried dry skin then reduced to 75mg then when on 75 I feel the same then they up the dose to 100. So I am unsure, and the fact I have inflammatory arthritis for which I am on dmards and started hrt 2 yrs ago so could be a combo of all as they hv similar/same symptomsHence the doctor started with the thyrpid test first, they won't re do a hormone test just up the dose and arthritis is now stable after a very very long road
TSH ( thyroid stimulating hormone ) should ideally be under 2/ 2.5 ish and many people on levothyroxine feel best when it is lower than 1.
When Levo is adjusted upwards (to get the T4 higher) , this will make the TSH to go lower. When T4 is lower the TSH goes higher.
So if those results are from when taking 75mcg , then it looks like your dose should be increased .
if GP's have been lowering your dose when on 100mcg this suggests 100mcg was sending the TSH below the lab range.. this is the main reason GP's lower dose. ( the other reason dose is lowered is if T4 is over range ~ what is the lab range given with your fT4 test ? , they vary , so you always need to know the range used for fT4 results .. TSH ranges don't vary so much , so we can confidently say anything over 3/4 is too high)
So it may be that you would be more stable on a dose in between 75mcg and 100mcg .
This can be prescribed as 75mcg one day/ 100mcg the next etc. (alternate day dosing) .. or if people prefer to take the same each day then 25mcg tablets can be cut in half to get 87.5mcg / day.
The main thing is how you feel though ... do you feel better on 100mcg or on 75mcg ?
This post may help to explain why TSH 'in range' is not the same as optimal for the individual:
And this post had several references recommending GP's keep TSH in the lower part of the range: healthunlocked.com/thyroidu.... list-of-references-recommending-gps-keep-tsh-lower-in-range-
you need to do your blood test under consistent conditions to get results that can be compared properly to the previous ones . Ideally you should test early a.m 9 am ish and wait until after the test to take that days dose of levo.
( TSH has a circadian rhythm and is naturally highest middle of the night, falling to it's lowest around 1-3pm , then slowly rising again ~ the difference isn't massive , but if TSH is already very near the top/ or bottom end of the range ,it can be the difference between GP changing dose, or leaving it alone)
This post explains the reasons for testing timings , and why levo dose should not be taken on the morning of the test. but taken after the test : healthunlocked.com/thyroidu... suggested-thyroid-hormone-test-timing-protocols
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