# Does anyone make seasonal adjustments to their synthroid dose?



## joplin1975 (Jul 21, 2011)

Does anyone make seasonal adjustments to their synthroid dose? If so, can you tell me how you go about doing that? When you decide to go up (or down)? Do you base things 100% on lab results or are there other factors you consider? How much of an increase (or decrease)?

****

I'm asking because I'm thinking I'll need a slight increase for a few months in the summer and wanted to talk to my doctor about it, but wanted a little bit of information on how common this is and how people manage the process.

In May, my TSH was 0.54 and in August it was 0.78. My crazy conservative endo thinks these values are "PERFECT!" while my surgeon (who I adore) said he was willing to accept the 0.54 level, provided it didn't go any higher. His stated preference was to see me somewhere around 0.1-0.3. And, then, of course, it went up to 0.78 in August. At which point, he and my endo entered into an ongoing, protracted debate about if I should or should not bump up to 175mcgs.

I'm currently on 150 and like 150. Me and 150 get along just fine. I don't want to set myself up for a reoccurrence however I feel like I'm just on the edge of being hyper. It's a little hard to articulate, but whereas I used to be very, very laid back, I'm now quick to get anxious...sometimes feel just slightly jittery...it's nothing earth shattering, but it's there and its so unlike me and my laid back self that I admit I've been rather hesitant to bump up to 175.

During my endo and surgeon's battle, I got established with a new GP and inquired about how comfortable she was prescribing synthroid. She's happy to do so for more mild cases, but she's clearly not ready to jump into the fray. She offered to refer me to another endo for a third opinion. I asked her, instead, to re-run my labs just so we could check.

I just got those labs back and my TSH is now 0.38 (range 0.3-1.8) so surgeon is now happy and everyone has stopped arguing. Top end of the range for free t4 was 1.69 and mine was at 1.68. I asked for free t3 and she ran total (GRUMP). I don't have that with me because when I saw total, I disregarded it, but it was a three tenths of a point below the top end of the range, too...

Anyway, in retrospect, it seems totally reasonable that my TSH went up in August because that's smack dab in the middle of hay season. We buy our hay from a local farmer and I usually get about 1,000 bales a year. Which means during most of July, August, and the beginning of September, after work I'm driving to the farm, unloading the bales off his hay wagon, loading them onto my trailer, and then unloading and re-stacking them at my house. Each of those bales is about 40-50 pounds. I also work out during my lunch hour (part of my normal routine).

So, then short story is I want to stick with 150 for most of the year, but bump up to 175(ish?) for three months (or so) of the year...I don't know if that's possible or reasonable or how one does this? Next endo appointment is in March, but I'd love to get any advice now, in advance of that appointment.


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## Andros (Aug 26, 2009)

joplin1975 said:


> Does anyone make seasonal adjustments to their synthroid dose? If so, can you tell me how you go about doing that? When you decide to go up (or down)? Do you base things 100% on lab results or are there other factors you consider? How much of an increase (or decrease)?
> 
> ****
> 
> ...


It sure makes a lot of sense to me for in the summer you are waaaaaaaaaaaaaaaaay more active and burning up your body's FREE T3 like nobody's business.

You have to be able to power through your work.


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## joplin1975 (Jul 21, 2011)

Ok, good, so it doesn't sound totally nutty? 

Now, who's done this?? Come out, come out, where ever you are!


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## StormFinch (Nov 16, 2012)

Too early for me to say joplin. And, as you tend to haunt the same threads as me you know that I wasn't adjusting doses each season, I was switching drugs completely; from replacement to anti-thyroid and back again.  However, I have read that some patients find they need to adjust doses between seasons. Although the info I was reading mentioned that Hashi's symptoms tended to get worse during the winter months, it does make perfect sense that you are more active during hay season so are needing more replacement. Needless to say, dosage adjustments seasonally definitely aren't unheard of.


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