# dosage question



## mccreel (Apr 13, 2010)

I have a question on my dosage. anyone who has read my posts know I had to argue with my dr. just to get a starting dose of 25 mcg of synthroid even though my tsh was5.4 and his lab had norm from .27 to 4.23. Even though I have seen articles from official endo sites that says the official high has been changed to 3. Anyway, after I have been on my meds for a little bit and see whether or not i will need more, (I bet I will), since i am having to fight with him, should I shoot to get him to go up to 50 mcg's. I will have to fight with him until I get into my new Dr in Birmingham in about 8 weeks. And with my numbers being what they are, what is the normal dosage that dr.'s that know what they are doing, that you don't have to fight with to get medication, usually give you to get you back on track? I know it starts with a low dosage. I was just wondering what is the normal dosage for someone with numbers in the range of mine. give or take. So I will have an idea when I talk to him again.
Thanks guys,


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## Andros (Aug 26, 2009)

mccreel said:


> I have a question on my dosage. anyone who has read my posts know I had to argue with my dr. just to get a starting dose of 25 mcg of synthroid even though my tsh was5.4 and his lab had norm from .27 to 4.23. Even though I have seen articles from official endo sites that says the official high has been changed to 3. Anyway, after I have been on my meds for a little bit and see whether or not i will need more, (I bet I will), since i am having to fight with him, should I shoot to get him to go up to 50 mcg's. I will have to fight with him until I get into my new Dr in Birmingham in about 8 weeks. And with my numbers being what they are, what is the normal dosage that dr.'s that know what they are doing, that you don't have to fight with to get medication, usually give you to get you back on track? I know it starts with a low dosage. I was just wondering what is the normal dosage for someone with numbers in the range of mine. give or take. So I will have an idea when I talk to him again.
> Thanks guys,


Okay.....................most of us feel great w/TSH @ 1 or less. Then we strive to get the Free T4 at least mid-range and the Free T3 just about in the middle between mid-range and the top of the range.

The above is not true for all but I will bet a lot of folks here will back me up on the above!!

The lower your TSH, the quieter your antibodies are. I for example with the help of my doctor keep my TSH @ 0.03 or less with the Frees as mentioned above.


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## mccreel (Apr 13, 2010)

so basically however much medication it takes to get me to that level? How long before I know if the medication is taking my numbers in the direction I want? The appointment with my new Dr. is at the end of May. Should I stay on the 25mcg until then or call and bother the other dr, even though he does not want to do any other testing at all exept the tsh, and see if he will at least up me to 50 tsh until I can get to my new dr. since the dose of synthroid is so low for my numbers? I know no one here is dr.'s but I know with a lot of things, (at least my experiance with problems I had,) I had to tell the dr. things before his light bulb went off and he agreed with me and went "Oh my God, you are right," you do need treatment, more meds, or whatever.
Thanks guys.


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## Lovlkn (Dec 20, 2009)

Call your doctor's office in another week and tell him how you feel - if you still have very strong hypo signs he should increase your dose without much argument. I actually thought the "norm" for beginning hypo treatment was 50mcg if you had a thyroid gland and know for fact it's 100mcg if you do not.


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## mccreel (Apr 13, 2010)

I still have a thyroid gland. I think a lot of medication I have takein over the last 4 years due to all of my surgeries may have threw my thyroid out of whack. I have had 6 surgeries since 2007. 5 due to my endometriosis and 1 due to gallbladder. 9 Surgeries since 2002. 2 knee surgeries and tmj surgerie to repair a muscle that literelly popped off my jaw joint, they had to reattatch that muscle to my jaw. I have had to take a lot of muscle relaxers, tylenol with codine, different levels of hormone suppression due to my condition, different other hormones after hysterectamy, antibiotics after all surgeries, ect. I have noticed that over the last couple of years that my sinus infections that I always get have been getting harder to get rid of. I have always been prone to sinus infections but it has been taking at least 2 rounds of antibiotics to get rid of the infections lately, sometimes three. This last infection I have now I have had for over a month and he has given me a month's supply of antibiotic to try to get rid of it because i have already been on 3 rounds of antibiotic and as soon as I finish, within a couple of days, the infection comes back on me. I think i read infections more often and harder to get rid of is a sign of low thyroid function as well. 
As far as the argument aspect of it, he did not even comment on my thyroid test portion of the results when I was talking to the nurse on my results because I was also having problems with my potassium keeps dropping and no one can find out why. She only commented on the posassium. There was no notes at all to tell me on my thyroid test results and when I asked I had to wait for her to go run him down and ask him about it and that is when he said it was slightly low but he wanted to wait 6 month's. That is when I started pestering him and said I did not want to wait 6 month's because I had been feeling bad for a while and I had been taking b12 shots and still loosing energy and feeling worse and after pesteing him and calling the office often is when he gave in and gave me the 25 dose of synthroid.


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## mccreel (Apr 13, 2010)

I think what I may do instead of arguing with him though is, my rx insurance insists in having anything I am supposed to take constantly to be mail order on a 90 day supply. After about a week, I may go ahead and start taking 50 mcg myself if I am still feeling run down and draggy and when I have the appointment with the new Dr. in Birmingham tell him I am on the 50mcg dosage and let him know how I feel on my symptoms and let him suggest dosage from there. I just feel better about talking to the new Dr. about my meds and what is going on instead of fighting with the origonal Dr. since he obviously did not want to treat me for this to begin with.
Melissa


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## Phoenix (Mar 20, 2010)

Hi Mccreel,

Like you, I started at 25 mcgs.

It takes at least 6 weeks for the new dose to level out in your system, so most doctors will not do any kind of increase before 6 to 8 weeks and a new set of labs. Everyone is different, and for some, even the smaller doses can send you hyper, so changing meds yourself is not a good idea. Most people do wind up somewhere between 75 mcg and 150 mcg, but I have talked to more than one that had to start with 12.5 mcg, and one stayed there. If she went to 25, she was hyper. Unfortunately, this is a long slow process. It is better to take it slow and easy, than to have to make a trip to the ER.

I slowly worked my way up to 125 mcgs of Synthroid, and 10 mcgs of Cytomel. My endo was very careful not to send me hyper, since there can be some very bad side effects from that.

I would strongly advise you to just stay with the dose you have now until you see your new doctor. And hopefully when you see him, he will order some antibodies tests. All those sinus infections could be made worse due to you having an autoimmune disease like Hashimoto's Thyroiditis.

Hang in there, and I hope you start to feel better soon. Good luck at the endo's, and let us know what you find out.

Hugs

Phoenix


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## mccreel (Apr 13, 2010)

what exactly is Cytomel. Is it a supplement to Synthroid, does it help with absorbsion? How does it work differently than Synthroid?
Thanks,


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## mccreel (Apr 13, 2010)

also with the Cytomel, do they give it instead of the synthroid or do they give it as a supplement to synthroid? If the synthroid seems like it is not working very well when I go see the other Dr. should I ask about the cytomel or should I ask about it anyway? What does it help with as a supplement? 
Thanks,
Melissa


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## arizonamom (Mar 10, 2010)

mccreel said:


> what exactly is Cytomel. Is it a supplement to Synthroid, does it help with absorbsion? How does it work differently than Synthroid?
> Thanks,


Hi there, McCreel: Cytomel is another thyroid med that can be given in conjunction with Synthroid and other hypo meds. It is a med used to treat low FreeT3 levels (if my research is correct).

I am a new hypo patient and just started a low dose of Levoxyl (25mcg) three weeks ago. I am as frustrated as you are. I too had to push my endo into giving me more tests other than the tsh and standard t4/t3 tests. I told her I wanted the FreeT4 and FreeT3 tests done as I was sooooo tired all the time, along with a host of other symptoms. Well, what do you know - my FreeT4 was low. When she told me that all I wanted to do was to say to her "I told you something was wrong!". :anim_08:

Well, I don't think my low dose Levoxyl is working well but I am trying to be patient until my next labs, which are scheduled for May 10th (8 weeks after I first started my meds). I don't want to up my meds on my own for fear it might not be what I need. I do think, however, that I need to add Cytomel to my medicine regime as my T3 was kind of low too. However, I will be patient (hard for me to do sometimes) and will see what my next labs have to say.

SOmetimes we just have to keep pushing these docs who look at our lab numbers and think "well, they are in the normal range, or just above, you're fine!". They have no idea how we are feeling and what is "normal" for one person may not be normal for another.

Keep after your doc if you're not doing well. Ask for FreeT4 and FreeT3 labs to be run, in addition to a vitamin D level test. Low D can make us feel crappy too.


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## hillaryedrn (Dec 14, 2009)

Hi there! Yes, definitely do not change your meds on your own. That can be very dangerous. You do need to allow yourself a minimum of 6 weeks on any dose before you talk about making changes. This isn't an immediate thing. It takes time to build up and get effective. Frustrating, I know, but that's just the way it is. Cytomel you have to be VERY careful with. Cytomel is pure T3. That is the hormone that gives you the energy, boosted metabolism, etc. It can be quite dangerous if too much is taken. It is possible that you do needs this supplement, but there needs to be more tests to know. You need to have a FREE T3 and FREE T4 done before you start Cytomel. If your Free T3 is in range, then taking the Cytomel wouldn't be a good idea. If your Free T3 gets too high, it leads to palpitations, high blood pressure, chest pain, etc. Not pretty. I am sorry that you aren't feeling well yet! Hang in there, it will get better!


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## Andros (Aug 26, 2009)

mccreel said:


> so basically however much medication it takes to get me to that level? How long before I know if the medication is taking my numbers in the direction I want? The appointment with my new Dr. is at the end of May. Should I stay on the 25mcg until then or call and bother the other dr, even though he does not want to do any other testing at all exept the tsh, and see if he will at least up me to 50 tsh until I can get to my new dr. since the dose of synthroid is so low for my numbers? I know no one here is dr.'s but I know with a lot of things, (at least my experiance with problems I had,) I had to tell the dr. things before his light bulb went off and he agreed with me and went "Oh my God, you are right," you do need treatment, more meds, or whatever.
> Thanks guys.


The usual protocul is to get labs every 8 weeks to assess titration process. And yes, however much medication it takes.

See if you can get on a cancellation list for the new doc; I believe that would be the best alternative for you.


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## Phoenix (Mar 20, 2010)

I'm sorry, I should have explained a little about the Cytomel.

They won't consider doing the Cytomel, until they see if the Synthroid alone is going to be enough. I was on Synthroid alone for over a year before my endo decided that I had a problem converting from T4 to T3. I know it is a long process, but treating thyroid disease is one thing you can't rush through.

Hang in there, and we all know what you are going through. As the others said, it does get better.

:hugs:

Phoenix


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## Andros (Aug 26, 2009)

mccreel said:


> also with the Cytomel, do they give it instead of the synthroid or do they give it as a supplement to synthroid? If the synthroid seems like it is not working very well when I go see the other Dr. should I ask about the cytomel or should I ask about it anyway? What does it help with as a supplement?
> Thanks,
> Melissa


Melissa............Cytomel is T3 only. T3 is the active hormone and T4 (Synthroid) is supposed to be converting to T3 in your liver and other bodily organs.

I agree w/Phoenix. I have never advocated self-medication changes and I also think that you might skew your tests w/ this new doctor that you are going to be seeing.

My humble opinion is to stay on track here, don't make any changes and give this new doc a chance.

I know how you feel; I can feel your anger and I am angry with you but you don't want to make your situation worse nor do you want to mess up this upcoming doctor's visit re labs and "stuff!"


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## daisy_ysiad2002 (Aug 17, 2009)

I agree with waiting... my endo said it takes 6 weeks for your 'thyroid' to complete it 'full cycle' from start to finish and then they test your tsh level. I know its slow and annoying but if you can hang in there the better off you will be...increasing your dose ahead of time can backfire!


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