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Anyone alternate daily levothyroxine dose?


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#1 Sabrina

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Posted 10 March 2021 - 04:56 PM

Wondering if anyone takes (or has experienced) a different levothyroxine dose during the week, like a higher or lower amount a couple of times a week or on alternating days?  I'm wondering if it basically has the same effect as the average daily dose because of the longer half life - I assume 2-4 weeks afterwards it's not noticeable day to day that a different dose was taken?

 

I ask because I need to raise my free T4 very gradually, I'd like to see it happen over six months or so, allowing time to ensure I'm able to manage it and adjust liothyronine down a bit accordingly. 

 

Thank you!


Total Thyroidectomy 2016
75mcg Levothyroxine | 3 x 7.5mcg Liothyronine Daily
Most recent labs 1/30/18:
FT4 0.9 (.8-1.8)
FT3 3.9 (2.3-4.2)

RT3 7 (8-25)
~~My Thyroid Journey~~

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#2 GOLGO13

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Posted 11 March 2021 - 03:41 AM

I've been on alternating doses in the past to achieve something in the middle of the doses. Personally I find it's best to be on a steady dose if possible. And usually that can be achieved by splitting pills of different strengths. I used to split a 50 and an 88 to get 94 for awhile. I liked that better than alternating 88 and 100 each day. When I was alternating, it seemed like my body was going up and down also.

 

Currently I'm on 112 but I switched to Synthroid name brand and it seems to hit me different. 

 

If you seem to be sensitive to dose changes like I was, I think it had to do with other aspects like nutrition and vitamin deficiencies. I had Iron issues and was deficient in Vitamin D (very common for us with hashimotos). Turning those items around seemed to help me process the pills. I also seem to have general gut issues. And addressing those issues through eliminating certain foods seems to impact my absorption of the pills also. I went through some real ups and downs with my tests which I think had to do with my gut issues.

 

It can take some time to figure out how to get this all under control. What are your labs currently. 


  • Sabrina likes this

Original: TSH 71 TPO 1980

Levo 100 (March 2018): TSH 1.02 (range .5-4.5)....FT4 1.65 (range .82 to 1.77).

Levo 100 (April 2018): Felt terrible TSH .68

Levo 88 (May 29 2018): Felt better but low energy TSH 3.010 (.450-4.5)|Free T3 2.8 (2.0-4.4 pg/ml)| Free T4 1.50 (.82-1.77ng/dl) TPO 226

Levo 91 (equivalent) (July 16 2018): Felt sort of OK TSH 4.470 (.450-4.50)|Free T3 2.6 (2.0-4.4 pg/ml)| Free T4 1.44 (.82-1.77 ng/dl)|TPO 181

94 (half 88 and half 100) Best I have felt so far TSH 3.671 uIU/mL (0.350 - 5.000)| Free T4 1.14 ng/dL (0.70 - 1.25)| Free T3 2.2 pg/ml (1.7-3.7)

94 generic (Dec 2018) TSH 4.98...boo...

94 Synthroid (Feb 2019)Name Brand 6 days a week and 100 Sythroid one day a week TSH 4.829 uIU/mL (0.350 - 5.000 uIU/mL)| FT4 1.01 ng/dL (0.70 - 1.25 ng/dL)|FT3 2.6 pg/mL(1.7 - 3.7 pg/mL)

94 Synthroid (April 2019) 5 days a week, 100 twice a week TSH 2.763 uIU/mL (0.350 - 5.000 uIU/mL)| FT4 1.08 ng/dL (0.70 - 1.25 ng/dL)|FT3 2.5 pg/mL(1.7 - 3.7 pg/mL)

94 Synthroid (June 2019) 4 days a week, 100 3 days a week TSH 2.889 uIU/mL 0.350 - 5.000 uIU/mL| FT4 1.15 ng/dL 0.70 - 1.25 ng/dL|FT3  2.7 pg/mL 1.7 - 3.7 pg/mL

94 Synthroid (July 2019) 2 days a week, 100 5 days a week TSH 3.931 0.350 - 5.000 uIU/mL| FT4 1.07 ng/dL 0.70 - 1.25 ng/dL| FT3 2.4  pg/mL 1.7 - 3.7 pg/mL

100 Synthroid (Oct 2019) 7 days a week, 50 once a week TSH 2.479 0.350-5.000 uIU/mL| FT4 1.06 ng/dL 0.70 - 1.25 ng/d

100 Synthroid daily Synthroid 50 once a week TSH TSH 2.874 range .350 to 5 | T3 free 2.5 pg/ml range 1.7 to 3.7

112 Synthroid daily (Jan 2019) TSH 2.43 range .350-5.000 uIU/ml |  FT3 3.3 range 1.7-3.7 pg/mL | FT4 1.04 range .7-1.25 ng/Dl 

112 Synthroid Daily (Mar 2020)  TSH 2.069 range .350-5.000 uIU/ml |  FT3 2.8 range 1.7-3.7 pg/mL | FT4 1.08 range .7-1.25 ng/Dl (doing pretty good in general)

 

 


#3 Isthmus123

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Posted 13 March 2021 - 01:18 PM

Yes I think alternating day to day works fine without noticing ups and downs. I alternate 75 mcg with half a 125 mcg.
  • Sabrina likes this
2012 TSH 1.7 (no issues, no symptoms)Fall 2014 TSH #s pre-surgery= 1.8 & 2.010/13/14 TSH 1.83 (.34-5.6), FT3 2.2 (2.39-6.79), FT4 0.81 (.58-1.64), TSH 1.83 (.34-5.6), T3 Reverse 17 (7-24), 0 antibodies Partial thyroidectomy 12/20014 (benign tumor)2/2015 TSH 1.96, FT3 2.26/2015 TSH 2.512/2015 TSH 3.503/2016 TSH 3.09 (symptoms worsening)4/17/2016 Start 25 mcg Levothyroxine4/30/2016 TSH 2.095/01/2016 Reduce to 0.125mcg Levo5/31/16 TSH 2.66, FT4 0.738/12/16 TSH 2.7710/13/16 Switch to Naturethyroid12/8/16 TSH 2.1, FT4 0.86, T3 1341/16/2017 TSH 2.4, FT4 0.8 (range 0.8-1.8), FT3 3.3 (range 2.3-4.2)2/01/2017 TSH 3.2 (Switched to Synthroid)02/25/2017 TSH 2.09, FT4 1.06 (.82-1.77)04/10/2017 TSH 2.22, FT4 1.0 (0.8-1.8), FT3 3.0 (2.3-4.2)06/12/2017 TSH 2.8, FT4 1.0 (0.8-1.8), FT3 2.9 (2.3-4.2)11/10/2017 TSH 0.58 Free T4 1.2 (0.8-1.8) Free T3 2.7 (2.0-4.6)02/09/2018 TSH 0.06 (after taking 88mcg 2 days a week. 75mcg 5 days a week)
02/28/18 Free T3: 3.9 (2.0-4.4)
05/08/18 TSH 0.01, Free T4 1.5 (0.8-1.8) (after 2 months of 75mcg daily)<p>

#4 Sabrina

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Posted 15 March 2021 - 07:14 PM

I've been on alternating doses in the past to achieve something in the middle of the doses. Personally I find it's best to be on a steady dose if possible. And usually that can be achieved by splitting pills of different strengths. I used to split a 50 and an 88 to get 94 for awhile. I liked that better than alternating 88 and 100 each day. When I was alternating, it seemed like my body was going up and down also.

 

Currently I'm on 112 but I switched to Synthroid name brand and it seems to hit me different. 

 

If you seem to be sensitive to dose changes like I was, I think it had to do with other aspects like nutrition and vitamin deficiencies. I had Iron issues and was deficient in Vitamin D (very common for us with hashimotos). Turning those items around seemed to help me process the pills. I also seem to have general gut issues. And addressing those issues through eliminating certain foods seems to impact my absorption of the pills also. I went through some real ups and downs with my tests which I think had to do with my gut issues.

 

It can take some time to figure out how to get this all under control. What are your labs currently. 

Thanks for the reply!  I will get my labs and post, but essentially my levothyroxine was lowered when I started taking liothyronine due to reverse T3.  That's been resolved for a while but the doctor I had been working with moved and changed his practice, now I'm trying to figure out how to raise my T4 and lower T3 smoothly.  I figured if I did it VERY slowly that it might work. 

 

Do you truly notice that you feel different day to day?  Is it 2-4 weeks out from taking it, or right away?


Total Thyroidectomy 2016
75mcg Levothyroxine | 3 x 7.5mcg Liothyronine Daily
Most recent labs 1/30/18:
FT4 0.9 (.8-1.8)
FT3 3.9 (2.3-4.2)

RT3 7 (8-25)
~~My Thyroid Journey~~

#5 Sabrina

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Posted 15 March 2021 - 07:17 PM

Yes I think alternating day to day works fine without noticing ups and downs. I alternate 75 mcg with half a 125 mcg.

Thank you!  How long have you been doing this?  I think from your signature you've had a partial thyroidectomy, correct? Not sure it would make any difference after a TT versus a partial, just trying to gather all the info.  :) 


Total Thyroidectomy 2016
75mcg Levothyroxine | 3 x 7.5mcg Liothyronine Daily
Most recent labs 1/30/18:
FT4 0.9 (.8-1.8)
FT3 3.9 (2.3-4.2)

RT3 7 (8-25)
~~My Thyroid Journey~~

#6 GOLGO13

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Posted 16 March 2021 - 11:38 PM

Thanks for the reply!  I will get my labs and post, but essentially my levothyroxine was lowered when I started taking liothyronine due to reverse T3.  That's been resolved for a while but the doctor I had been working with moved and changed his practice, now I'm trying to figure out how to raise my T4 and lower T3 smoothly.  I figured if I did it VERY slowly that it might work. 

 

Do you truly notice that you feel different day to day?  Is it 2-4 weeks out from taking it, or right away?

 

I have to say it's pretty hard to judge in my case because I was having a lot of issues during that timeframe. But I personally felt it is better to try and get a consistent number when possible. I think I also had some absorption issues causing inconsistent levels. I'm very careful with taking mine, but my gut had issues in the past and eating better and avoiding certain foods seems to help.

 

What kind of RT3 issues were you having. I personally find RT3 is a bit tricky to gauge when on thyroid medication. It's a controversial subject as conventional doctors find it's not a useful test and some functional doctors think it's the most important. I personally think it's not too important on T4 only. On T3 or combination it could be useful to see if you are over-medicating. But using FT3 might be a better indicator of things (and FT4 of course). 

 

I've been hesitating doing combination medicine because I worry about it being managed correctly or a situation like yours where a doctor moves away. Maybe that same doctor could do distance consulting for you. Seems like this is something where you don't need to be in person.


Original: TSH 71 TPO 1980

Levo 100 (March 2018): TSH 1.02 (range .5-4.5)....FT4 1.65 (range .82 to 1.77).

Levo 100 (April 2018): Felt terrible TSH .68

Levo 88 (May 29 2018): Felt better but low energy TSH 3.010 (.450-4.5)|Free T3 2.8 (2.0-4.4 pg/ml)| Free T4 1.50 (.82-1.77ng/dl) TPO 226

Levo 91 (equivalent) (July 16 2018): Felt sort of OK TSH 4.470 (.450-4.50)|Free T3 2.6 (2.0-4.4 pg/ml)| Free T4 1.44 (.82-1.77 ng/dl)|TPO 181

94 (half 88 and half 100) Best I have felt so far TSH 3.671 uIU/mL (0.350 - 5.000)| Free T4 1.14 ng/dL (0.70 - 1.25)| Free T3 2.2 pg/ml (1.7-3.7)

94 generic (Dec 2018) TSH 4.98...boo...

94 Synthroid (Feb 2019)Name Brand 6 days a week and 100 Sythroid one day a week TSH 4.829 uIU/mL (0.350 - 5.000 uIU/mL)| FT4 1.01 ng/dL (0.70 - 1.25 ng/dL)|FT3 2.6 pg/mL(1.7 - 3.7 pg/mL)

94 Synthroid (April 2019) 5 days a week, 100 twice a week TSH 2.763 uIU/mL (0.350 - 5.000 uIU/mL)| FT4 1.08 ng/dL (0.70 - 1.25 ng/dL)|FT3 2.5 pg/mL(1.7 - 3.7 pg/mL)

94 Synthroid (June 2019) 4 days a week, 100 3 days a week TSH 2.889 uIU/mL 0.350 - 5.000 uIU/mL| FT4 1.15 ng/dL 0.70 - 1.25 ng/dL|FT3  2.7 pg/mL 1.7 - 3.7 pg/mL

94 Synthroid (July 2019) 2 days a week, 100 5 days a week TSH 3.931 0.350 - 5.000 uIU/mL| FT4 1.07 ng/dL 0.70 - 1.25 ng/dL| FT3 2.4  pg/mL 1.7 - 3.7 pg/mL

100 Synthroid (Oct 2019) 7 days a week, 50 once a week TSH 2.479 0.350-5.000 uIU/mL| FT4 1.06 ng/dL 0.70 - 1.25 ng/d

100 Synthroid daily Synthroid 50 once a week TSH TSH 2.874 range .350 to 5 | T3 free 2.5 pg/ml range 1.7 to 3.7

112 Synthroid daily (Jan 2019) TSH 2.43 range .350-5.000 uIU/ml |  FT3 3.3 range 1.7-3.7 pg/mL | FT4 1.04 range .7-1.25 ng/Dl 

112 Synthroid Daily (Mar 2020)  TSH 2.069 range .350-5.000 uIU/ml |  FT3 2.8 range 1.7-3.7 pg/mL | FT4 1.08 range .7-1.25 ng/Dl (doing pretty good in general)

 

 


#7 Isthmus123

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Posted 20 March 2021 - 12:55 PM

Thank you! How long have you been doing this? I think from your signature you've had a partial thyroidectomy, correct? Not sure it would make any difference after a TT versus a partial, just trying to gather all the info. :)


2012 TSH 1.7 (no issues, no symptoms)Fall 2014 TSH #s pre-surgery= 1.8 & 2.010/13/14 TSH 1.83 (.34-5.6), FT3 2.2 (2.39-6.79), FT4 0.81 (.58-1.64), TSH 1.83 (.34-5.6), T3 Reverse 17 (7-24), 0 antibodies Partial thyroidectomy 12/20014 (benign tumor)2/2015 TSH 1.96, FT3 2.26/2015 TSH 2.512/2015 TSH 3.503/2016 TSH 3.09 (symptoms worsening)4/17/2016 Start 25 mcg Levothyroxine4/30/2016 TSH 2.095/01/2016 Reduce to 0.125mcg Levo5/31/16 TSH 2.66, FT4 0.738/12/16 TSH 2.7710/13/16 Switch to Naturethyroid12/8/16 TSH 2.1, FT4 0.86, T3 1341/16/2017 TSH 2.4, FT4 0.8 (range 0.8-1.8), FT3 3.3 (range 2.3-4.2)2/01/2017 TSH 3.2 (Switched to Synthroid)02/25/2017 TSH 2.09, FT4 1.06 (.82-1.77)04/10/2017 TSH 2.22, FT4 1.0 (0.8-1.8), FT3 3.0 (2.3-4.2)06/12/2017 TSH 2.8, FT4 1.0 (0.8-1.8), FT3 2.9 (2.3-4.2)11/10/2017 TSH 0.58 Free T4 1.2 (0.8-1.8) Free T3 2.7 (2.0-4.6)02/09/2018 TSH 0.06 (after taking 88mcg 2 days a week. 75mcg 5 days a week)
02/28/18 Free T3: 3.9 (2.0-4.4)
05/08/18 TSH 0.01, Free T4 1.5 (0.8-1.8) (after 2 months of 75mcg daily)<p>

#8 Isthmus123

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Posted 20 March 2021 - 12:57 PM

At least 2 years if not more. 62.5 a day was way too little for me and I def became hyper at 75 mcg/day. Yes I had a partial thyroidecyomy and I weigh about 215.
2012 TSH 1.7 (no issues, no symptoms)Fall 2014 TSH #s pre-surgery= 1.8 & 2.010/13/14 TSH 1.83 (.34-5.6), FT3 2.2 (2.39-6.79), FT4 0.81 (.58-1.64), TSH 1.83 (.34-5.6), T3 Reverse 17 (7-24), 0 antibodies Partial thyroidectomy 12/20014 (benign tumor)2/2015 TSH 1.96, FT3 2.26/2015 TSH 2.512/2015 TSH 3.503/2016 TSH 3.09 (symptoms worsening)4/17/2016 Start 25 mcg Levothyroxine4/30/2016 TSH 2.095/01/2016 Reduce to 0.125mcg Levo5/31/16 TSH 2.66, FT4 0.738/12/16 TSH 2.7710/13/16 Switch to Naturethyroid12/8/16 TSH 2.1, FT4 0.86, T3 1341/16/2017 TSH 2.4, FT4 0.8 (range 0.8-1.8), FT3 3.3 (range 2.3-4.2)2/01/2017 TSH 3.2 (Switched to Synthroid)02/25/2017 TSH 2.09, FT4 1.06 (.82-1.77)04/10/2017 TSH 2.22, FT4 1.0 (0.8-1.8), FT3 3.0 (2.3-4.2)06/12/2017 TSH 2.8, FT4 1.0 (0.8-1.8), FT3 2.9 (2.3-4.2)11/10/2017 TSH 0.58 Free T4 1.2 (0.8-1.8) Free T3 2.7 (2.0-4.6)02/09/2018 TSH 0.06 (after taking 88mcg 2 days a week. 75mcg 5 days a week)
02/28/18 Free T3: 3.9 (2.0-4.4)
05/08/18 TSH 0.01, Free T4 1.5 (0.8-1.8) (after 2 months of 75mcg daily)<p>




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