Do you think I need an increase in my T4 dose???

[Gigihadad]

Hi all,

I have hashimoto and hypo since many years. I take T4 medication ( 100 mg) every morning. The brand name is Euthyrox ( the version which has mannitol and citric acid instead of lactose). This is my thyroid test results after 14 months of no tests at all due to lack of medical insurance. I was fasting and did not take my morning dose before the test. Do you think I need an increase in my dose? My doc believes that as long as my TSH is fine, I do not need an increase but Free T4 is at its lowest range and this concerns me. Perhaps if I raise my dose, Free T4 and Free T3 will become better. If this is right how much increase per mg do I need? and if I raised my dose to become 125 mg instead of 100 can this be considered a big increase and made me hyper????

Thanks a lot

[SlowDragon Administrator]

Free T4 (fT4) 0.92 pmol/L (0.8 - 1.9) 10.9%

Free T3 (fT3) 2.4 pmol/L (1.5 - 4.5) 30.0%

Shows you definitely need 25mcg dose increase per day

You might initially increase by 12.5mcg per day

Wait 6-8 weeks before increasing again up to 125mcg

Retest in 6-8 weeks

Many people on levothyroxine find they need Ft4 (levothyroxine) at least 60-70% through range

Meanwhile test vitamin D, folate, B12 and ferritin

What vitamin supplements are you taking

[Gigihadad in reply to SlowDragon]

Thanks for reply. I can not find 25 mg of Euthyrox. Can I take 100 mg one day and 150 the following day? I will test these vitamins the next month. Right now I take B12 injections and I will purchase iron supplements. I am vegetarian but I eat a lot of plant based protein each day.

[SlowDragon Administrator in reply to Gigihadad]

Cut 50mcg in half to get 25mcg

And into 1/4 to get 12.5mcg

[Gigihadad in reply to SlowDragon]

The pill is too small to be cut in even half. Right now I can not find 25 dose. There is a shortage in medication and I barely can secure 100 and 50 so as a start and to take 112.5 dose can I take 100 mg for two days and the third day take 150 mg so the total will be 350 mg every three days??

[SlowDragon Administrator in reply to Gigihadad]

Here in U.K. we have to cut pills regularly

Either with sharp craft scalpel or pill cutter

I cut my 20mcg T3 into 4 using craft scalpel

And take 112.5mcg 3 days and 125mcg four days per week……so also cut 25mcg Levo in half

Store spares in weekly pill dispenser

[SlowDragon Administrator in reply to Gigihadad]

as vegetarian it’s extremely difficult to maintain iron/ferritin

[Gigihadad in reply to SlowDragon]

I am gluten intolerant and also can not absorb animal based protein. Meat gives me constipation. My hair starts to grow and my period becomes much lighter after becoming vegetarian and eating lentils every day.

[Bluecarnation]

I am on same medication. They usually go by the TSH reading so as long as that is in range you should be OK. At my last blood results that was what my GP went by only the TSH.

[tattybogle in reply to Bluecarnation]

Gigihadad GP should be willing to increase dose slightly based on this list of recommendations that they keep TSH towards the lower end of the range in all patients on levo

( Bluecarnation 'TSH anywhere in range' might be ok for some thyroid patients , but not all .. for details see the following list of references advising GP's that for optimal treatment they should try to keep TSH at lower end of range ie. 0.4/0.5 - 2/2.5 ish)

healthunlocked.com/thyroidu.... -list-of-references-recommending-gps-keep-tsh-lower-in-range

[Bluecarnation in reply to tattybogle]

Thank you for info x