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Thyroid Cancer, Nodules & Hyperthyroidism (Expert Forum)
Reasons why my medication was lowered and any possible side effects?
Answered by
Mark Lupo, M.D. - Thyroid Nodules, Thyroid Cancer, hyperthyroidism, hypothyroidism, Thyroid Ultrasound
Thyroid & Endocrine Center of Florida
Sarasota - FL
Questions in the Thyroid forum are answered by Mark Lupo, MD. Topics covered include Goiter, Graves Disease, Hyperthyroid, Parathyroid/Calcium Problems, Thyroid Cancer, Thyroid Nodules/Cysts, Thyroiditis, Thyroid & Pregnancy, Thyroid Stimulating Hormone (TSH), Thyroid Tests, and Thyroid Surgery.
Reasons why my medication was lowered and any possible side effects?
by jstrong32, Nov 10, 2005 12:00AM
Hello. My doctor recently lowered my thyroid medication dose from .50 mg to the lowest dosage possible because apparently my levels have improved. I am worried about weight gain from going from a larger dose to a smaller dose. Could this happen or will the smaller dose make things "normal." Are there any side effects I should be looking for if the lowered dose isn't correct? Why did my levels change?
Doctor's Answer
by Mark Lupo, M.D., Nov 11, 2005 12:00AM
, Nov 11, 2005 12:00AM
Without knowing more about your history I don't know why the levels changed. There is not usually a signficant weight change unless the levels change drastically. Usually we change a dose because the TSH (see below) is too high or two low - not just for "improvement" -- follow the labs closely and see what happens - if the dose is too low you may have increased hypo symtpoms.
Here's some background info to help understand how most of us approach treatment:
The treatment of hypothyroidism means striking a careful balance between a patient's symptoms and the lab (usually TSH) value. TSH is the most relied upon lab by thyroid experts world-wide to determine appropriate levels of thyroid hormone replacement. It does not directly reflect tissue activity of thyroid hormone but there is no test available that does that and TSH is the best approximate we have now.
That being said, the target TSH is 0.5-2.0 for a patient on replacement. In general, patients who are older or have heart disease do better with a TSH that is not <0.5 as shown in several studies that these patients have increased risk of premature death.
Younger patients who are otherwise health may feel better with a TSH that is slightly lower than 0.5. There are definite risks associated with TSH <0.1 even in patients who "feel fine" -- studies show that a TSH this low over time can significantly alter heart function.
Here's some background info to help understand how most of us approach treatment:
The treatment of hypothyroidism means striking a careful balance between a patient's symptoms and the lab (usually TSH) value. TSH is the most relied upon lab by thyroid experts world-wide to determine appropriate levels of thyroid hormone replacement. It does not directly reflect tissue activity of thyroid hormone but there is no test available that does that and TSH is the best approximate we have now.
That being said, the target TSH is 0.5-2.0 for a patient on replacement. In general, patients who are older or have heart disease do better with a TSH that is not <0.5 as shown in several studies that these patients have increased risk of premature death.
Younger patients who are otherwise health may feel better with a TSH that is slightly lower than 0.5. There are definite risks associated with TSH <0.1 even in patients who "feel fine" -- studies show that a TSH this low over time can significantly alter heart function.
Member Comments (2)
by PNWBabe, Nov 11, 2005 12:00AM
To: jstrong32
I would get yourself educated about your disease and get a copy of your labs from your doctor so that YOU can see what is going on and see why the change was made. You are your own best advocate towards great health.
