I need a slight dose reduction and was going to trial 75/100 instead of 100 a day. I only get on with Accord. Can I split this to 87.5 per day? Or do I risk loosing parts of it to do this?
I have taken 75 today to start the trial but feel really tired and this happened before recently. It was suggested I take 75 for one day to start the reduction by helpful advice on here, but the 75 seems too low on any one day for me.
I am also thinking of night time dosing but am I right in that I need the dose reduction period first or I will get confused doing both?
I have had many problems with 50 mcg Accord (being substandard) so these aren’t an option due to this and the issues they have already caused.
Thank you again for any possible advice.
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Sailing14
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I would use a pill cutter to reduce your 100mcg tablet to 87.5mcg, as this slight reduction may be enough to get FT4 within range. Try this reduction first, before trialling a change in time of day (as I’ve found it’s best just to make one change at once).
Your last bloods showed
Free T4 (fT4) 22.2 pmol/L (12 - 22)
Free T3 (fT3) 5 pmol/L (3.1 - 6.8)
TSH 0.35 mu/L TSH (0.27 - 4.2 )
You are clearly a poor converter, as FT3 only half way through the range.
Has your GP agreed to retest 6-8 weeks on your slightly reduced dose?
Sorry I was not sure where to put this question but it relates to this conversation. I have a viral infection at present and feel quite low and run down with it. Do I wait for this to clear before I consider this reduction and could this be why I am so tired when I try?
Also, I am not sure if I have symptoms of overactive thyroid (not the usual like palpitations, increased hunger and anxiety). Could I continue on 100 or is the T4 quite high and is the virus not helping?
Over range FT4 may adversely affect heart health, plus there are thoughts it could be a cancer risk.
FT4 may not be as affective when you exceed your ‘sweet-spot’- as T3 conversion reduces the higher you go. radd may be able to provide more information (as she has posted about this previously). I’ve certainly found I achieve better FT3 levels with my FT4 slightly lower.
Sailing14, I needed to increase my levo from 100 to 112.5 mcgm and can only tolerate Vencamil, so I cut a 100mcgm tablet into quarters and keep the quarters in a small pill box including any crumbs. I then take a quarter on alternate days (25 mcgm every 2 days ) This has worked quite well for me. I believe Accord have 50mcgm tablet, can you get them to cut into quarters? Then you could take a quarter every day.
I will consider this option but would this be more difficult when reducing? Also, I can’t use 50s as I had problems with substandard issues in the past.
Sailing14, re issues with Accord, I had issues with how much T4 was being delivered. So moved to Vencamil last year. They only do 100 mcgm but helvella has mentioned they have 50 and 25 mcgm waiting for MHRA approval🤞it will be soon
Thank you for this information. I do have vencamil but when I tried them I got indigestion and stomach issues within a few hours. I am lactose intolerant so would have liked to have changed to these.
Can you advise if I can introduce these gradually and whether this may help due to them being too strong possibly for me?
I do think that the absorption profile (how much your blood levels rise over time), and total absorbed, have been largely ignored by the pharmaceutical people. They do test in the lab and, to a very limited extent, in volunteers. But we'd probably find that in real world patients - such as members here - the reality can be up or down from that is thought.
Maybe try only taking a half and a quarter (yes - first break is easy, next is more difficult)? Or half in the morning and half in the evening? Not necessarily to switch to a different approach but to see if it makes any difference.
If I try the half and then a quarter together as suggested, when would I take the other quarter? I am not sure on a night time dose at the moment so could it be taken early evening as long as on an empty stomach? Maybe I could take the whole tablet in one go after a week or so as hopefully my body may get more adapted to it.
Thank you for any advice you may be able to recommend.
If you are being prescribed but only taking a half and a quarter, I think I would simply throw away the quarter.
Many of us have felt the need to make small changes. Sometimes we confirm that. Sometimes we revert to the previous dose. Very difficult to predict but entirely possible that you could 'get used' to it - but maintain awareness and act if needed!
Thank you for letting me know as you do wonder if it is just you making these assumptions. I dropped from 100 to 75 at Endocrinologist’s advice using the 50 mcg tablets. I found out the hard way as I went seriously underactive and have not been the same since with trying to work things out with Covid in between.
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