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Suggest Remedy For Weight Gain After Lower Dosage Of Synthroid
Question: Hi. I have hypothyroidism and was on Synthroid 125 mcg qd for many years. About 18 months ago, my doctor decreased my dose to 112 mcg due to lab results (T4). Then it was again reduced to 100 mcg a year ago due to T4. In December, my TSH dropped dramatically to 0.036 and my Free T4 was at 1.2. My Synthroid dose was decreased again to 88 mcg. In February, my TSH was 0.069 and my T4 0.9, Dose was dropped again to 75 mcg. I have put on about 15 pounds (I just had a gastric sleeve a year ago) and I am not happy about that. I do think the MD is missing the boat and should be looking for a pituitary tumor. What do you think?
XXXX, RN
XXXX, RN
Brief Answer:
Thyroid
Detailed Answer:
I understand what you are saying. TSH once suppressed can take several weeks to normalize. So when I see an individual like you, I do not lower the Synthroid dose based on a low TSH alone. I also go by the free T4 level. If this is in normal range then I generally do not lower Synthroid dose any further after a previous reduction. Then I order another TSH and Free T4 6-8 weeks later and make a decision as to whether a dose reduction is necessary. It is preferable to use the same laboratory as much as possible to run thyroid blood tests. Yes, pituitary problems are a possibility. But one needs a thorough physical examination to assess the need to test for this. Blood tests for prolactin and FSH will help screen for pituitary problems
Thyroid
Detailed Answer:
I understand what you are saying. TSH once suppressed can take several weeks to normalize. So when I see an individual like you, I do not lower the Synthroid dose based on a low TSH alone. I also go by the free T4 level. If this is in normal range then I generally do not lower Synthroid dose any further after a previous reduction. Then I order another TSH and Free T4 6-8 weeks later and make a decision as to whether a dose reduction is necessary. It is preferable to use the same laboratory as much as possible to run thyroid blood tests. Yes, pituitary problems are a possibility. But one needs a thorough physical examination to assess the need to test for this. Blood tests for prolactin and FSH will help screen for pituitary problems
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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