# Med Adjustment



## scottyg354 (Jun 13, 2011)

Ok guys, many of you know that there was a mistake a fews months ago and my meds got cut in half. form .05 to .025. Anwyas, I was in the process of adjusting, when this happened. Well when my meds got cut my TSH shot up to 9.6. Now I am up from .05 to .1 with a TSH of 6.1 . My questions is should it be taking this long to adjust, I am almost at a year since I was diagnosed (End of Novemeber 2010)?

Did it take anyone else this long to adjust? Is this normal? It's starting to get annoying. Doc works with me on this and i know its not his fault, he send me for my blood work every 2-3 months, I just think that the dosage mistake is what caused all this crap and I just really want to feel good already.

I am thinking about asking him about Armour this next visit.

I'm not sure how to go about it tho. I was thinking of asking him if he knows about it and if my levels don't start adjusting if he thinks it would be a good idea to possily give it a shot.


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## lainey (Aug 26, 2010)

Your TSH is still too high and you need an increase from the .1 mcg.

Your doctor could do your testing at shorter intervals--say 6 weeks--instead of making you wait 3 months, especially considering you had backsliding due to the dosage mix-up.

But in thyroid treatment, it is "slow and steady wins the race". As unfortunate as it sounds, there is no way to truly "hurry up" the titration process. You have to work through it until your labs are in normal range.

We had another poster here last summer who thought they could "hurry" things along by switching to Armour. The advice to her then, and also to you, is that changing medications basically puts you back at square one regarding titrating the medication. Later posts showed that she learned the truth to this the hard way. Are you ready to start over or would it be better to see this through? Only you can answer that.


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## SnoodMama (Jan 11, 2011)

I would see this whole thing through before switching. I also agree that you should get tested every 6 weeks instead. So basically I agree with everything Lainey says.


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## northernlite (Oct 28, 2010)

I agree also, you need blood work every 6-8 weeks with an increase in medication if required. 6.1 is too high for your TSH and it is coming down but you need to keep increasing the medication until it gets into range and you feel well. You are a big guy, 100 mcg is not a large dose.


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## scottyg354 (Jun 13, 2011)

northernlite said:


> I agree also, you need blood work every 6-8 weeks with an increase in medication if required. 6.1 is too high for your TSH and it is coming down but you need to keep increasing the medication until it gets into range and you feel well. You are a big guy, 100 mcg is not a large dose.


Hopefully, when I get on the right dose, I wont be that big of a guy anymore.


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## bigfoot (May 13, 2011)

It also seems like I have been taking forever to adjust, so don't feel bad. I can sympathize with being in a rush -- it's so hard to sit and wait to be feeling better. Especially when you couple that with the seemingly poor info. and non-consensus out there over thyroid issues, both for patients and doctors.

hugs6


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## scottyg354 (Jun 13, 2011)

Doc seems to understand. Had my dose increase today from .100 to .150 . Doc pretty much told me keep exercising and eating healthy because it will only benefit, but he also said don't expect to lose anything until my dose is right were it needs to be. At least he is honest.


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## Andros (Aug 26, 2009)

scottyg354 said:


> Doc seems to understand. Had my dose increase today from .100 to .150 . Doc pretty much told me keep exercising and eating healthy because it will only benefit, but he also said don't expect to lose anything until my dose is right were it needs to be. At least he is honest.


Yes; he is honest. But he knows this so that means he is going to get you there. You are so lucky to have this doctor.

When you are euthyroid, you will lose the weight. In the meantime, you can maintain and avoid futher gain by getting on a healthy diet now. Get used to it so when your body is ready, it will shed the pounds.


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## Marathon Man (Aug 31, 2011)

My doc suggested i ramp up to 300 mcg of Synthroid from 200 mcg. I managed two days before I went back down. I felt super hyper. The whole event threw me off for about a week and a half.


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## bigfoot (May 13, 2011)

My humble opinion: I think the docs that dose largely by weight are missing the big picture -- some of us still have partly-functioning thyroids! I believe the weight-dosage ratio is for people who need total and complete replacement of thyroid hormones (due to thyroid surgery or thyroid is totally shut down).

Here is an interesting research article on BMI/Weight and Dosage: http://jcem.endojournals.org/content/90/1/124.full

"Discussion

A stable dose of L-T4 in treatment of thyroid diseases is achieved when the amount of hormone entering the bloodstream equals the proportion that is metabolized, allowing constant serum concentrations of fT4, fT3, and TSH. When administered in the fasting state, about 80% of L-T4 contained in modern tablets is absorbed (23). After ingestion, serum T4 values peak at 2-4 h and return toward basal levels after about 6 h. The serum half-life of T4 approximates 7 d in the euthyroid state, and its clearance depends mainly on deiodination and to a lesser extent on other pathways, such as sulfation and glucuronidation (24). The daily replacement dose of L-T4 to normalize serum TSH in adult hypothyroid subjects is, on average, 1.6 μg/kg. The amount of hormone to be administered must be increased when suppressed values of serum TSH are desired. In both cases, however, individual adjustments are usually required to attain the optimal daily dose. Although the total daily requirements of L-T4 are related to body mass, unexplained difference can occur among individuals for the same age and body size, even in the absence of functioning thyroid tissue. In this regard, the role of obesity in affecting L-T4 disposal and therapy requirements has never been defined."


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## Andros (Aug 26, 2009)

bigfoot said:


> My humble opinion: I think the docs that dose largely by weight are missing the big picture -- some of us still have partly-functioning thyroids! I believe the weight-dosage ratio is for people who need total and complete replacement of thyroid hormones (due to thyroid surgery or thyroid is totally shut down).
> 
> Here is an interesting research article on BMI/Weight and Dosage: http://jcem.endojournals.org/content/90/1/124.full
> 
> ...


Totally awesome site; I have bookmarked it and thank you so much.


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