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What Is The Right Dosage Of Levothyroxine To Be Taken For Thyroid?
I am currently talk f 88mcg of levothyroxine and I m experiencing my original symptoms again, tired all the time, very cold, Moody, fuzzy head forgetfulness etc. My endocrinologist says I need to increase my dosage to 100 mcg. I ve had this ongoing thyroid condition for 3yrs he also told me that my thyroid is on its way out and that eventually it will stop working altogether but before that happens he said I can go as high as 125mcg and in certain cases he would go as high as a 137mcg do you agree?
Thu, 8 Jan 2015
Hi,
Welcome to HCM. I have gone through your question and understand your concerns.
The dose of thyroid medication is adjusted based on thyroid function tests and not based on symptoms. The target TSH we usually keep is between 0.5 and 2.5 miu/ml. Your correct dose is one which can maintain the TSH in this level. The dose depends on your requirement and the absorption of the drug in your body.
In patients with absorptive problems or gastritis the dose can be as high as 600 mcg per day. This is because to get 100 mcg in body they have to take 600 mcg as the absorption from intestine is poor.
If your symptoms are persisting after correction of TSH then what I do in my practice is:
1. Check for other causes like increased sugars, cholesterol, vitamin D or B12 deficiency etc
2. Check T3 : T3 is active form of thyroid hormone. Normally the levothyroxine (T4) that you take will get converted to T3 adequately. If this conversion is inadequate, then you may have symptoms of hypothyroidism with normal TSH. This can be treated by adding T3 to your treatment. Please check with your doctor if T3 is available in your country.
Hope I have answered your query. If you have any further questions I will be happy to help
With warm regards,
Dr Ajish TP (MD,DM)
Consultant Endocrinologist.
Welcome to HCM. I have gone through your question and understand your concerns.
The dose of thyroid medication is adjusted based on thyroid function tests and not based on symptoms. The target TSH we usually keep is between 0.5 and 2.5 miu/ml. Your correct dose is one which can maintain the TSH in this level. The dose depends on your requirement and the absorption of the drug in your body.
In patients with absorptive problems or gastritis the dose can be as high as 600 mcg per day. This is because to get 100 mcg in body they have to take 600 mcg as the absorption from intestine is poor.
If your symptoms are persisting after correction of TSH then what I do in my practice is:
1. Check for other causes like increased sugars, cholesterol, vitamin D or B12 deficiency etc
2. Check T3 : T3 is active form of thyroid hormone. Normally the levothyroxine (T4) that you take will get converted to T3 adequately. If this conversion is inadequate, then you may have symptoms of hypothyroidism with normal TSH. This can be treated by adding T3 to your treatment. Please check with your doctor if T3 is available in your country.
Hope I have answered your query. If you have any further questions I will be happy to help
With warm regards,
Dr Ajish TP (MD,DM)
Consultant Endocrinologist.
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