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Suggest Treatment For Hypothyroidism
Question: This is for my wife who is 35 yrs old.
she is hypothyroid from last 10 years. Started with thyronorm 50 mcg dose.
She is currently on 112.5 mcg daily dose from almost 1.5 years.
I got a repeat test done yesterday and here're the numbers
TSH 0.08
FT4 3.2
FT3 1.15
does she need any dose adjustment?
she is hypothyroid from last 10 years. Started with thyronorm 50 mcg dose.
She is currently on 112.5 mcg daily dose from almost 1.5 years.
I got a repeat test done yesterday and here're the numbers
TSH 0.08
FT4 3.2
FT3 1.15
does she need any dose adjustment?
Brief Answer:
She has to decrease the dose
Detailed Answer:
Hi XXXXXXX
Welcome to HCM. I have gone through the question and understand your concerns.
Currently her TSH is below normal and thyroid hormones ( T3 and T4) are elevated. This means she is over treated with thyroxine. Once on treatment your TSH should be between 0.5 and 3.5 miu/ml.
Please check with her if she was taking medications properly. Most common cause of fluctuations in thyroid function is irregularities in medicine intake. Probably she was not taking medications regularly before - and her doctor has increased the dose leading to over dose.
In a similar case I would decrease the thyroxine dose to 100 mcg and follow up after 2 months with thyroid function tests.
Hope I have answered your questions. If you have any further queries I will be happy to help you.
Regards,
Dr Ajish TP [MD,DM]
Consultant Endocrinologist
She has to decrease the dose
Detailed Answer:
Hi XXXXXXX
Welcome to HCM. I have gone through the question and understand your concerns.
Currently her TSH is below normal and thyroid hormones ( T3 and T4) are elevated. This means she is over treated with thyroxine. Once on treatment your TSH should be between 0.5 and 3.5 miu/ml.
Please check with her if she was taking medications properly. Most common cause of fluctuations in thyroid function is irregularities in medicine intake. Probably she was not taking medications regularly before - and her doctor has increased the dose leading to over dose.
In a similar case I would decrease the thyroxine dose to 100 mcg and follow up after 2 months with thyroid function tests.
Hope I have answered your questions. If you have any further queries I will be happy to help you.
Regards,
Dr Ajish TP [MD,DM]
Consultant Endocrinologist
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
thank you doctor. I can confirm that she has been extremely regular in taking thyroid medicine in last 10 years day in and day out. She never miss even a single dose.
Given above, Is it normal for someone to be on 112.5 mcg from almost 2 years and now suddenly that dosage seems more than required. is it possible that thyroid gland has started somewhat functioning ?
TSH was within range 6 months back when we last visited endocronologist which is when dosage of 112.5 was suggested to be continued.
Given above, Is it normal for someone to be on 112.5 mcg from almost 2 years and now suddenly that dosage seems more than required. is it possible that thyroid gland has started somewhat functioning ?
TSH was within range 6 months back when we last visited endocronologist which is when dosage of 112.5 was suggested to be continued.
Brief Answer:
There are many cause for fluctuations
Detailed Answer:
Hi XXXXXXX
Welcome back
There are many causes for fluctuation in TSH like:
1. Irregular drug intake
2. Thyroxine not taken in empty stomach. Taking tea / coffee / food within half an hour of thyroxine intake
3. Taking other medicines like calcium with thyroxine that decrease thyroxine absorption
4. Presence of gastritis which decrease thyroxine absorption
5. Thyroid is not totally destroyed in hypothyroidism. Some amount of thyroxine is still produced in thyroid. Their levels vary
In the end of the day, whatever be the reason, we go by the TSH values and adjust thyroxine dose. If TSH is low we decrease the dose. If TSH is high, we look for all the above factors, if there are no modifiable causes, we increase the dose
Hope I have answered your question. If you have any further queries I will be happy to help you.
Regards,
Dr Ajish TP [MD,DM]
Consultant Endocrinologist
There are many cause for fluctuations
Detailed Answer:
Hi XXXXXXX
Welcome back
There are many causes for fluctuation in TSH like:
1. Irregular drug intake
2. Thyroxine not taken in empty stomach. Taking tea / coffee / food within half an hour of thyroxine intake
3. Taking other medicines like calcium with thyroxine that decrease thyroxine absorption
4. Presence of gastritis which decrease thyroxine absorption
5. Thyroid is not totally destroyed in hypothyroidism. Some amount of thyroxine is still produced in thyroid. Their levels vary
In the end of the day, whatever be the reason, we go by the TSH values and adjust thyroxine dose. If TSH is low we decrease the dose. If TSH is high, we look for all the above factors, if there are no modifiable causes, we increase the dose
Hope I have answered your question. If you have any further queries I will be happy to help you.
Regards,
Dr Ajish TP [MD,DM]
Consultant Endocrinologist
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Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Answered by
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