does 12.5mcg levo make a difference ?

Does 12.5 mcg levo actually make much of a difference ? Has anyone increased or decreased by 12.5mcg and felt it actually did anything for them ?

thanks x

[Lalatoot]

Yes it does. There are many on odd doses. For example folks who take 75mcg one day and 100mcg the next day. That equates to an extra 12.5 mcg per day.When I tried to increase my levo by 12.5mcg thinking I might try an increase I certainly felt it and it was too much.

[Hidden in reply to Lalatoot]

Thank you.

[helvella Administrator]

Yes. Repeatedly.

If I take 100 a day then, in a few days, I start to feel under-medicated/hypothyroid.

If I take 125 a day then, in a few days I start to feel over-medicated.

If I take 112.5 a day then, over extended periods of weeks or months, I feel just about right.

Further, I prefer 112.5 every day to alternating 100 and 125.

If someone is on not quite enough, in my view, it makes far more sense to add 12.5 and see what happens, than to add 25 and possibly overshoot.

In naval gunnery, the standard approach is to fire and see where the shell falls. If it is short, they raise the barrel so they are certain to overshoot. That gives them two settings and two points where the shells fell. A bit of looking up in some tables and they can choose settings that should be almost certain to hit with the third shell.

But with levothyroxine doses, going too far isn't obvious. Sometimes it takes a while to realise it was too far. And you then have to wind back for TWO reasons - BOTH to allow the over-medicated level to drop AND to find a better dose. And those two requirements are inherently at odds with each other. The better dose would slow down the drop from over-medication. But a lower dose to attack the over-medication will certainly be less than is required in the longer term.

It is this sort of heavy-handed adjustment that causes so many to see their doses yoyo-ing. Sometimes for years.

[Hidden in reply to helvella]

Thank you so much. Will screenshot this info, it’s soooo helpful! Thanks

[HealthStarDust in reply to helvella]

Hi Helvella,

I am just curious as how you add the 12.5mcg as a daily dose? As I thought what you take (v-something?) came only in 100mcgs?

[helvella Administrator in reply to HealthStarDust]

I don't mention it purely to avoid confusion but I get Wockhardt 25 as well! I also have some non-UK tablets.

While I feel better on Aristo, the very small proportion of another make doesn't make a big difference to me. But not Teva!

[HealthStarDust in reply to helvella]

Ahhh! Thanks for clearing that up.

I am trying to learn as much as I can for when I finally hopefully get to the dose that suits me. So, thank you again.

[RMDG]

I take 112.5 daily and have done for 2 years, finally the right dose for me.

[SlowDragon Administrator]

I take 125mcg 3 days and 112.5mcg 4 days week (plus T3)

Always same brand levothyroxine

125mcg daily is too much

112.5mcg daily is too little

[Chouchou1234 in reply to SlowDragon]

Can you explain how you feel for too much and too little. I’m confused now if I am over medicated but my numbers are still low and stomaxh doesn’t work and tired with depression lethargy

[Hidden in reply to Chouchou1234]

Sometimes the symptoms can overlap a bit. When I’m under-medicated my heart races and i have anxiety, which could be symptoms of over medication too. Sounds like maybe you need to speak to your doctor about your blood test results if you’re still feeling tired and depressed.

[Singwell in reply to Hidden]

I have this. And depression follows it. What a cocktail! But I'm pretty sure it's underdose in my case as last test showed TSH still over. Not much, but I'm uploading to optimal so I guess that level fluctuates until stability is reached.

[Hidden in reply to SlowDragon]

I’m similar to you. 100 feels good but after a while it’s too much. 88 everyday is too little so I’ll have to find a pattern like you have. I do find alternating daily difficult though.

[RuthieRuth in reply to Hidden]

I added a recurring daily appointment to my diary and checked that each morning in order to keep track. Found I was on too much though so now I just take the different dose on Saturday and Wednesday - much easier to remember

[SlowDragon Administrator in reply to Hidden]

I just use a weekly pill dispenser. Then it’s easy

[Singwell]

In short yes! I'm having to upload slowly to my optimal because of a tendency to heart Arrythmia. I had to start on 12.5 because I couldn't tolerate 25. Then I moved up gradually- actually biting my half 25mcg into a rough 6mcg, then the 12.5 and making it - after 8 months - to 50mcg!! When I started to feel rough again (we knew my TSH was still over), I upped my dose by about 6mcg and am expecting to be up to 62.5mcg soon. Advice from this forum is I'll probably need 75-85 given age and weight.

I've also been flagged as highly sensitive to pharmacological products at my surgery. We're all different

[Hedgeree]

Hi Avarosie,

Yes it definitely makes a difference. I'm similar to Singwell. I struggled to tolerate levo when I was first prescribed it so had to start very slowly on approximately 4 or 5 mcg every other day. Once I started to tolerate it I started going up in 12.5mcg eventually after a year I'm up to the heady heights of 62.5mcg!

I seem to be very sensitive to it and so stick to the same amount each day but I split it, taking 25mcg during the night usually about 3 or 4am then the rest 37.5mcg about 12.30/1pm in the afternoon.

[Hidden in reply to Hedgeree]

hi Hedgeree,

I’m sensitive to it too, I can tell if the half I cut is just slightly bigger than the other half !

[Hedgeree in reply to Hidden]

Same here!

[Goldenbeads in reply to Hedgeree]

Me too ! Glad not the only one !

[Forestgarden]

I take 112.5mcg daily. Previously on 100mcg, but wasn't feeling good. Was very confused by symptoms though and couldn't work out if i was hyper or hypo - lots of overlap. Ended up getting bloods done privately (GP only tested tsh which was "normal"). My freeT3 was towards the lower end, so demanded a dose increase from GP! However, the 12.5mcg tablets are about 20 times the price of the 25mcg tablets (or they were when I was arguing my case) so I had to agree to having the 25mcg tablets, which I split each day to get my 12.5mcg (which I take together with 2x 50mcg tablets). My local pharmacist is not very co operative when I ask for the larger, splittable 25mcg tablets with a score line across the centre, so just now accept I'm going to get the tiny ones.

[Hidden in reply to Forestgarden]

I have to cut those tiny tablets too. I use a little knife from my partners tool box ! It works far better than a pill cutter, which sometimes just crushes them I find

[Forestgarden in reply to Hidden]

I have a craft knife specifically for these. However recently I've taken to just biting them in half!

[Hidden in reply to Forestgarden]

😂

[helvella Administrator in reply to Forestgarden]

On the basis that an uneven split is still closer than alternate day dosing, I don't worry too much about inaccuracy.

But I do worry about loss of crumbs/powder.

[paradime]

A lot of us find that TSH descends to next to nothing, when on levo, before our fT3 and fT4 levels get up to adequate levels for us to feel well. This is not at all well understood by doctors, even endocrinologists, who often rely on TSH tests only.

[arTistapple]

Whilst I totally think it does make a difference, it’s started a good number of answers, why’s and wherefores. Brilliant. Thank you for raising it.

[Gingernut44]

I halve my Wockhardt 25’s with a pill cutter. I find that, just letting the tablet slide into the cutting position rather than pushing it into position gets a much cleaner cut with no crumbs. Just using a gentle push down on the cutter is also more effective.

[Hidden in reply to Gingernut44]

I find a thin sharp blade directly to the top of the tablet chops it well for me. If i come in at an angle it mushes it. Maybe my pill cutter is blunt? Must admit my pill cutter looked nicer than the Stanley knife I now keep on my bedside table.

[Gingernut44 in reply to Hidden]

🤣🤣🤣 I wouldn’t trust myself with a Stanley knife 😱

[Otto11]

I’ve just been told to reduce my dose by 12.5 mcg as my TSH is below range. So following this post. I’m doing alternate days of 125 then 100. It may get confusing will wait & see I guess. X

[asidist]

Hi Avarosie, once on a dose that begins to approach /exceed what is needed, I find every mcg makes a difference. But, I’m a relatively small person, so that may be why small amounts have a bigger-than-typical impact on me. I also think I do better when my daily dose doesn’t have large variations so I split the pills to small pieces.

When I was taking levo tablets, in order to account inacccuracies in splitting I just wouldn’t throw anything away. So if I tried to split a pill into fourths or (I think I may have even attempted eighths for some time?), but ended up with uneven pieces, if I got a little less one day I would make up for it on the other days by getting more. That variation is still less than not splitting. And then I just assume my final dose was slightly less than what I was attempting due to any tiny crumbs that were lost. My T3 tablets were excessively crumbly so with those I would sometimes just give up and throw a tablet away if the cutting wasn’t going well. My prescription was more than what I needed so allowed me that luxury.

I find a high quality pill cutter to be best, and some tablets are most easily split in half just by hand.

Now on levo gelcaps I continue to split as I did tablets (despite official indication that should not be done), but because the loss is less visible and harder to account for (moisture that gets squeezed out), and they are apparently less stable than tablets, I’m get lower dose capsules and take several of those to allow for more accuracy in the splitting (up to fourths only). Hate the added work of splitting but if I feel better it’s worth it IMO.

[Hidden in reply to asidist]

Hi ! I agree , I think it’s worth the effort to have the same dose everyday. I’m quite a small person too, I hadn’t thought of that being a reason why I can feel every mcg. But as you mentioned, it could also be because I’m approaching or exceeding what is needed. I’m due a blood test pretty soon. I’m glad you’re feeling better on the gel caps. I didn’t even know those existed

[asidist]

Sorry for this delayed response. Hope you’ve found a way to dose that better suits you, or are on your way!

Didnt want to mislead about the gelcaps - I’m actually not feeling better on those at all after many months of trying, but I’m still figuring out the right dose on this formulation and the right split/timing. ( I’ve discovered how the split is done and the timing of the doses makes almost as much a difference as total dose - tho unfortunately that takes time and experimentation to sort through too.) Have only stuck with gelcaps this long, slowly increasing dose, because I’ve been able to tolerate higher doses without insomnia (in fact the opposite through most of the doses I’ve tried) and have therefore been able to raise my t4 blood levels slightly, and had hoped that at with a high enough dose I’d start to finally feel better than on tablets. But the journey hasn’t been that simple - haven’t achieved that goal yet - and not sure that I will, and its been hard to swallow the months of my life I’ve lost to feeling even crappier on these gelcaps. Still trying for now but very well may give up and go back to tablets (and trying new ways of splitting doses of tablets to tolerate an increased dose), or just settle on having low levels of t4.

I know gelcaps/liquid work much better than tablets for some people, so that’s just my experience. Unfortunately NOTHING related to thyroid hormone treatment seems to be simple

Hope your experience is going better than mine, best of luck