Increasing levothyroxine doses - 25mcg every other day too small?

[Fountainsixty]

Hello!

I have subclinical hypothyroidism, my TSH was 5.5 in April and GP agreed to get it between 1-2 since I will be TTC soon.

I have been on 50mcg of levothyroxine for 8 weeks (which is what an endocrinologist my GP spoke to advised) and just had a repeat blood test and TSH is 3.3. I spoke to one of these new physician associate on phone and they advised doing alternate days of 50mcg and 75mcg. I’m due to speak to my GP on Tuesday.

I feel like that’s too low an amount to make much of a difference or it will be very slow, but maybe that’s my impatience to start TTC properly! Does anyone have any advice/any online guidance to point to?

Thanks!

Forgot to add she also said then to wait another 2 months before repeating blood tests….. I’m sure I read online in NICE guidelines that adjustments are over 3-4 week period

Anyone?

Bump…..

If you go onto the Thyroid UK website and join the forum you will get some useful advise. I’m finally being treated with 75mgs per day with a similar starting TSH as you. I think dosage can be weight dependent too but 50mgs is a low dose.

Long term hypothyroid patient here, diagnosed in 2008.

if they increase the dose too quickly it can cause palpitations/racing heart/feeling jittery.

You can read about levothyroxine dosing Here in the BNF which suggests a dose of 1.6mcg/per kilogram of body weight, you should be taking it first thing and 30-60 mins before food or caffeine too so it’s absorbed as well as possible.

Best of luck with TTC, once pregnant they should do your thyroid bloods once a trimester. A Dutch university study found undertreated hypothyroidism increases birth complications so worth keeping a close eye on (my labour was 12 hours and v straightforward).

I’m now on 125 every day but this was increased very slowly, started on 25 and then bloods every 8 weeks, then an increase, more bloods… it takes time.

I was put on 75mcg / 50mcg alternating and was surprised how quickly it brought my tsh levels down - from around 2.8 to 0.95 in maybe 6 weeks (I know the 2.8 isn’t that low but my symptoms were coming back and I don’t feel good when it’s over 1.5ish.)

Im on 150 a day but it's taken 2 years 😱 to get to this point. I started on 25mg when my tsh was around 6. Gradually increased the dose to 75 and that got my tsh to 1-2 which I was happy with. Then I had surgery and my tsh shot up to 13 so for about a year now we have been increasing the dose and it's finally settled between 1-2 with a dose of 150.

I take mine last thing at night approx 4 hours after food as advised by a HCP as morning wasn't working for me as I couldn't leave it long enough between meds and breakfast

I only feel good when it's between 1-2 and had many arguments with doctors who tried to say it was fine at 5 until a wonderful gp said it's a range and some will feel great at 5 and some only like me great at 1-2

Bloody hell my tsh is 13.7 and im on 75mg. My gp hasnt increased my prescription...

Sound like you could try it though for 3mths and see. You arent far off normal

Thank you I didn’t know they had a forum. I’ve had a quick look but a bit overwhelmed by all the detail, I feel I know nothing about it all in comparison!

Thank you. I couldn’t see guidance about amending dose to just 25mcg every other day so will keep looking. Definitely don’t want to rush it if would have adverse affects