Alternate day doses of Thyroxine?

[Tortoise56]

I have been advised to take 100mcg one day then 125mcg the next, has anyone been given this advice?

[helvella Administrator]

It is not exactly unusual.

There are two reasonably sensible ways to get a dose between 100 and 125. Split the 25 tablet and take half each day. Or alternate day dose. Splitting always has the risk of losing small amounts.

People have talked of other patterns as well - like 125 Monday to Saturday and 100 on Sunday. Or the other way around.

[Tortoise56]

Thanks for your prompt reply. I'm being referred to an endocrinologist, I've been asking for a referral for years but have always been fobbed of by my GP. I had my dose reduced to 100mcg last year and felf dreadful so now they want to either reduce it again to 100mcg which I'm not happy to do or do the alternate day dose.

[helvella Administrator in reply to Tortoise56]

Have you got your actual test results? If not, get them , including reference ranges.

thyroiduk.org.uk/tuk/NHS_In...

I'd guess they are telling you to do something silly. If it were right to reduce your dose, one would expect you to feel better for doing so - not worse.

Rod

[Sam75 in reply to helvella]

I have just been diagnosed as being overdosed on 150 levo, and doc has suggested as with you...150 one day and 125 the next...guess its all trial & error

[Tortoise56 in reply to helvella]

Feb 2012. Dose 125mcg

TSH <0.1 (0.3 - 5.5)

Free Thyroxine 25.0 (10.0 - 19.8)

T3 4.7 (3.5 - 6.7)

GP said I was over treated so Reduced dose to 100mcg

April 2012

TSH 21 (0.3 - 5.5

Free Thyroxine 13.1 (10.0 - 19.8)

This was when I felt dreadful and even colleagues at work had noticed.

Told to increase dose back to 125mcg and repeat bloods

October 2012 and January 2013

TSH < 0.1 (0.3 - 5.5)

Free thyroxine 25 (10.0 - 19.8)

T3 4.1 (3.5 - 6.7)

In October GP said that 125mcg was obviously the correct dose for me, but that GP has now left and I've been seeing a locum GP as that's the only one who has any appointments free. The main GP who I am registered with is now a councillor and seems more interested in that than being a GP.

[helvella Administrator in reply to Tortoise56]

Well a quick read does suggest that 125 is too much and 100 too little. But that ignores any other factors such as time of year, other health, etc.

Or if you took your tablet(s) in the few hours before the blood tests? That can make FT4 look inappropriately high.

I would be tempted to try the alternate day dosing. Suggest that in time you might find two days of 125 and one of 100 or some other pattern might work better for you?

[Tortoise56 in reply to helvella]

Thanks for reply.

I always take my meds first thing in the morning and then have bloods done. Hadn't thought about having bloods done first and then taking meds as has been suggested on here.

[helvella Administrator in reply to Tortoise56]

That might explain the high FT4.

I always try to get blood draws at 08:00 and take tablet after (even though I usually take it at bed-time).