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Suggest Dosage For Synthroid
Question: HI, I am A Hashimoto patient who just cant get a comfortable dose for myself...I have had this disease since 1990 and never had this much trouble before..I was always on 1 dose every day and it worked great..Of course the doses always had to be adjusted up when I became hypo, but no problems until menopause..I was on .2 synthroid...Did great on it for 4 years..Then for the first time in 2000 I had to reduce tie dose..The endocrinologist had me doing .175 3 days, and .2 4 days..I became so dizzy and absolutely could not think ..Had to quit teaching, until another endocrinologist told me to go on .175 and stay on it..It took months, but finally I was able to teach again,,, Then she retired, and I have never been the same since..I am now on .175, and have been for 2 years..Now that has become too much , and as of this week, My tsh is .118 an and I feel terrible..My family doctor wants me to go down slowly, and has suggested trying .150 on Sunday for 8 weeks..She knows I like to keep the tsh a little below a 1.0.. My question is, how long until I feel evened out? I am afraid to be honest with you because when I go on different doses, I get dizzy and experience some wierd sweling feelings.. Will this go away over time? I am 64 years old, and I would really like to function again..Despite the face that I tried so hard to make my body work on the .175, it is clearly uncomfortable, hard to concentrate,etc.My doctor said she would work with me..I did try this back in 2115..My tsh went to 1.38 after 8 weeks..So I went back to the .175, but it is just a little too much.. Should I be scared, or should I just try to endure it and see..Does the body get used to doses over time?
Brief Answer:
Thyroid
Detailed Answer:
Sorry to learn about your bothersome symptoms.
I generally aim for a TSH goal of 1 to 2. I see you are targeting an even lower TSH. I do not typically encourage this. Aiming for a TSH in that range, especially as one gets older, is not a good idea.
However, you can discuss your individual goals with your endocrinologist.
Other potential medical causes of your symptoms need to be explored.
When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination:
CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
HbA1c (Glycosylated Hemoglobin = your last 3 months' glucose average). Also known by other names such as GlycoHemoglobin or Glycated Hemoglobin or A1c
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
TSH (checks your thyroid)
Free T4 (this too checks your thyroid) Thyroid autoantibodies : Anti Thyroid Peroxidase (TPO) antibodies and Anti Thyroglobulin antibodies
25 hydroxy Vitamin D levels (ideal range 40 to 60 ng/ml = 100 to 150 nmol/liter)
None of these tests require any fasting and can be done at any time of the day Correct diagnosis and treatment requires the opportunity to examine the patient so you must see an endocrinologist in-person.
Thyroid
Detailed Answer:
Sorry to learn about your bothersome symptoms.
I generally aim for a TSH goal of 1 to 2. I see you are targeting an even lower TSH. I do not typically encourage this. Aiming for a TSH in that range, especially as one gets older, is not a good idea.
However, you can discuss your individual goals with your endocrinologist.
Other potential medical causes of your symptoms need to be explored.
When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination:
CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
HbA1c (Glycosylated Hemoglobin = your last 3 months' glucose average). Also known by other names such as GlycoHemoglobin or Glycated Hemoglobin or A1c
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
TSH (checks your thyroid)
Free T4 (this too checks your thyroid) Thyroid autoantibodies : Anti Thyroid Peroxidase (TPO) antibodies and Anti Thyroglobulin antibodies
25 hydroxy Vitamin D levels (ideal range 40 to 60 ng/ml = 100 to 150 nmol/liter)
None of these tests require any fasting and can be done at any time of the day Correct diagnosis and treatment requires the opportunity to examine the patient so you must see an endocrinologist in-person.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you..I wondered if some people have to get used to the new dose..,or am I just more sensitive than others? It takes about how long to get used to a dose? Just so I don't freak out ..Then, you are supposed to wait at least 6 weeks to test again?Right? Have you ever heard of people who just cant handle different doses different days of the week?
Brief Answer:
Follow up
Detailed Answer:
1 It is appropriate to retest thyroid labs 6 weeks after a dose adjustment. This should continue till lab numbers are in the target range in a stable manner. This could take several months in many instances
2 My patients do just fine on different doses on different days of the week, although in general I try to prescribe a single fixed dose on each day for the sake of simplicity
Follow up
Detailed Answer:
1 It is appropriate to retest thyroid labs 6 weeks after a dose adjustment. This should continue till lab numbers are in the target range in a stable manner. This could take several months in many instances
2 My patients do just fine on different doses on different days of the week, although in general I try to prescribe a single fixed dose on each day for the sake of simplicity
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Well,.150 is too little,and .175 too much..there is no dose in between,regrettfully..one last thing..is it common to feel a little funny for the first few weeks,as I usually do..I have anxiety disorder and it scares me when I get sensations...What about the sensations I feel when I change my dose.?do I take my synth t old at exactly the same time each day, or could it be within the hour..then you wait a half hour before eating right ?
Brief Answer:
Second follow up
Detailed Answer:
As long as the dose is appropriate, there should be no side effects from synthroid. If the thyroid lab test are normal, you need to see your healthcare provider to consider other causes for your symptoms.
Synthroid must be taken 60 minutes before eating, on an empty stomach , with water only
Second follow up
Detailed Answer:
As long as the dose is appropriate, there should be no side effects from synthroid. If the thyroid lab test are normal, you need to see your healthcare provider to consider other causes for your symptoms.
Synthroid must be taken 60 minutes before eating, on an empty stomach , with water only
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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