# Is it important to taper a dose when lowering it?



## slivola (Jun 27, 2012)

Hi there,

I started 30mg methimazole on June 11th and my Free T4 and T3 levels are now in normal range. My endocrinologist said it's really a guessing game on what to do now. He said I could lower to 20mg or stay on 30mg. After starting a different thread about this, I read the FDA guidelines which are 5-15mg for maintenance. I'm inclined to go to 10mg but I'm wondering if I should taper it. Like 20 mg for 2 weeks and then move onto 10mg. Any thoughts you have would be very appreciated since my endocrinologist says everyone is different.

Thank you!


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## Lovlkn (Dec 20, 2009)

slivola said:


> Hi there,
> 
> I started 30mg methimazole on June 11th and my Free T4 and T3 levels are now in normal range. My endocrinologist said it's really a guessing game on what to do now. He said I could lower to 20mg or stay on 30mg. After starting a different thread about this, I read the FDA guidelines which are 5-15mg for maintenance. I'm inclined to go to 10mg but I'm wondering if I should taper it. Like 20 mg for 2 weeks and then move onto 10mg. Any thoughts you have would be very appreciated since my endocrinologist says everyone is different.
> 
> Thank you!


You have been on a fairly high dose - which obviously worked for you. Can you share your labs - "in range" is very vague.

If you are in mid to low range you likely can go straight to the 10mg dose. It's important to re-test in 4 weeks and make sure they test your FT-4 and FT-3 as TSH is useless at this stage.

If you have any symptoms go and get tested as well. I tested every 4 weeks for 4 years and had dosing adjustments about as often.


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## slivola (Jun 27, 2012)

Thanks for your thoughts! I realized I had posted the ranges in my other thread but not this one. Here they are:

T4 FREE (range 0.8-1.5 ng/dL)
6/7/2012: 3.08
7/30/2012: 1.3

T3 (range: 58-159 ng/dL)
6/7/2012: 341
7/30/12 : 118

TSH: still <.01 but this is to be expected earlier on in treatment so the result isn't relevant.

On the FDA website, the starting range of 30mg puts me in the middle of the range (lower doses as 10-15; mid at 30-40mg; high at 50-70+mg). It says that once labs are in range, then go to maintenance at 5-15mg. That makes me think I should be in 10-15mg range.) My doctor says it's a guessing game, which I know it is.

Any suggestions or ideas you or anyone else has would be appreciated!
Thank you!


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## slivola (Jun 27, 2012)

Sorry, I accidentally reposted the same response so I've deleted it now.


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