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Suggest Dosage For L-Thyroxine
Question: I have hypothyroidism. I have had it for over 15 years. At times I have been on blended thyroxin in order to keep the readings 'normal'. This is a relatively common practice since the companies do not make thyroxin in smaller increments. For example, last year i was on 137 mcg one day and 150 mcg the next, alternating. When readings were below normal I was moved to 150 mcg daily.
However, when readings were again low, my doctor put me on blended 150 mcg one day and 175 mcg alternating. Notice that instead of resulting in a 6.5 mcg difference on average as before on blended, now the difference is 12.5 mcg difference on average. Since there is nothing between 150 mcg and 175 mcg AND my thyroid readings are likely too high for a 12.5 mcg average increase - WHAT WOULD BE THE ANOTHER OPTION IN TERMS OF MANAGING THYROXIN. I have thought that possibly I could take 150 mcg two days and 175 mcg a third day which would average out at around 8 mcg difference on blended.
However, when readings were again low, my doctor put me on blended 150 mcg one day and 175 mcg alternating. Notice that instead of resulting in a 6.5 mcg difference on average as before on blended, now the difference is 12.5 mcg difference on average. Since there is nothing between 150 mcg and 175 mcg AND my thyroid readings are likely too high for a 12.5 mcg average increase - WHAT WOULD BE THE ANOTHER OPTION IN TERMS OF MANAGING THYROXIN. I have thought that possibly I could take 150 mcg two days and 175 mcg a third day which would average out at around 8 mcg difference on blended.
Brief Answer:
Possible
Detailed Answer:
I follow what you are saying.
Such (levo-)thyroxine dosing schemes have been practised by endocrinologists for years now with good results.
So what you are considering is fair and it stands to reason because it is the weekly cumulative thyroxine dose that matters.
So you may wish to proceed with this but please stay under supervision of a qualified medical practitioner, preferably an endocrinologist.
You should recheck the TSH and Free T4 in 6 weeks after a change in dose to ensure you are achieving targets and staying in the goal range in a stable way.
Possible
Detailed Answer:
I follow what you are saying.
Such (levo-)thyroxine dosing schemes have been practised by endocrinologists for years now with good results.
So what you are considering is fair and it stands to reason because it is the weekly cumulative thyroxine dose that matters.
So you may wish to proceed with this but please stay under supervision of a qualified medical practitioner, preferably an endocrinologist.
You should recheck the TSH and Free T4 in 6 weeks after a change in dose to ensure you are achieving targets and staying in the goal range in a stable way.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
My new doctor, since my former doc retired, is good - with more experience he will be great. I don't think Sudbury XXXXXXX has an endocrinologist now.
I get regular TSH checking. However, WHAT IS 'FREE T4' ? WHAT DOES IT DO?
DOES FREE T4, LIKE TSH, ALSO INDICATE THE THYROXINE LEVEL?
I get regular TSH checking. However, WHAT IS 'FREE T4' ? WHAT DOES IT DO?
DOES FREE T4, LIKE TSH, ALSO INDICATE THE THYROXINE LEVEL?
Brief Answer:
Follow up
Detailed Answer:
Although checking TSH alone tends to suffice in many cases, it is preferable to keep an eye on Free T4 also.
Free T4 is the reflection of actual thyroxine hormone levels in the blood while TSH is an indirect but reliable marker of the pituitary gland's control over the thyroid status.
It is a complex subject
Follow up
Detailed Answer:
Although checking TSH alone tends to suffice in many cases, it is preferable to keep an eye on Free T4 also.
Free T4 is the reflection of actual thyroxine hormone levels in the blood while TSH is an indirect but reliable marker of the pituitary gland's control over the thyroid status.
It is a complex subject
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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