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2.5 mg per day Methimazole

I was diagnosed with Graves Disease nearly one year ago. For the last 8 months I have been on 2.5 mg per day. I saw my endo today and he reported that I am doing fine and should continue with the 2.5 mg. As I read through the forums, I've yet to find anyone on a dosage that small. Is this a standard maintenance dosage?
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Avatar universal
I'm on 2.5mg and my doctor has lowered it to every other day. Soon we'll see if I can achieve remission
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Avatar universal
I was diagnosed with Graves in May of last year.  I have continually reduced my methimazole every two months.  I saw my endo tuesday, and he told me I am still a bit hypo on the meds.  I have been on 2.5 mg daily for the past two months.  He now says to skip the Sunday dose each week.  He told me the recuurece rate was lower if I stay on the meds for at least eighteen months?  Have you all heard this?
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I have also been on 2.5 for 3 years.  Dr wants me to go off because my numbers are good so I just did 4 days ago.
Avatar universal
With a methi dose that low, I would do some research and see if you don't feel you are going into remission. Agree that RAI would be nuts. Congrats on getting so well after only a year of graves!
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Avatar universal
Yeah paula....I totally agree with seeing another Endo or Doctor.
In regards to meds ...I break my 50mcg Thyroxine in 4 to get 12.5mcg...easily done and just use the other 3 x 1/4 over the next 3 days.
Although I did find the Carbimazole crumbles a lot and I must admit I wasted a bit of mine lol.
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Avatar universal
I am seriously thinking about going to another endo. He started talking about doing RAI on me the minute I walked in the door, and I can tell he is a little ill with me for not doing it. Like you say, if it ain't broke, don't fix it.
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Avatar universal
As far as how do I get my dosage so small--I break a pill in half and break the half in half. You can easily do it with your fingernails. Doesn't cost me much money for my meds. :-)

I am seriously thinking about going to another endo. He started talking about doing RAI on me the minute I walked in the door, and I can tell he is a little ill with me for not doing it. Like you say, if it ain't broke, don't fix it.
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3 Comments
Don't do RAI unless absolutely necessary. Your meds are working so you can stay on those if remission doesn't work. I started out on the 10mg pills, went to 5mg and I'm now on 2.5mg. the person asking about how you get a small dose, they do make 5mg tablets and you break them in half with a pill splitter
You've commented on a thread that's 9 yrs old and the previous posters are no longer active on the forum; it's unlikely they will respond to your comments.
It is October 2020 - I have been on methimazole since 1997 - I am currently at 2.5 a day and what that means is I simply take the 5mg pill (in lieu of the 10) every other day.  My TSH recently hit 10 so they cut my 5mg dose a day in half and the best way is just every other day at this juncture.  If they cut it down more I will probably simply choose another day to skip - very religious about taking the meds, same time  as well - definitely gives you a better or at least truer outcome.  As an aside had gestational diabetes at almost 33 when I gave birth to our only child and obviously the Graves hit afterwards but didn't notice it until the heart palpitations and anxiety surmounted beyond control and was blacking out from lack of sleep - was nice and thin without trying much but after having a child after 3 prior ectopic pregnancies was very much involved in my baby and didn't notice health issues, or ignored them.  So, turning 60 next month I am still alive though heavier - some from menopause, some from finally quitting smoking at 55 and yes some from the methimazole but also have had 2 surgeries in the past two years making me sedentary so that attributed as well.  All in all the methimazole is probably responsible for 20 pounds and considering my friends with hashimotos it is about the same so glad I never had the surgery or RAI treatment - the person who said if it's not broken don't fix it - is absolutely right!  When my endo and I first decided to try out what they were doing in Europe (staying on methimazole like people use synthroid) I had read about the horrors of RAI and I was considered moderate graves and at the time otherwise healthy.  To-date I have found no one else on any forum that has been on methimazole over 20 years but here I am.  So if anyone is on a low-dose and also doing the right things like avoiding seafood and iodized salt and trying to get moderate exercise for stress - I had given up aerobics and walk a couple of miles a few times a week - even if no weight loss helps stress levels.  There are auto immune issues in my family so perhaps I was prone to it - in hindsight my smoking aggravated it but actually it was the post-partum over 30 first baby and having gestational diabetes that kicked it in since I didn't smoke during that time.  For anyone out there who struggles to FIX THIS themselves faghetaboutit! LOL! It's not your fault and there are worse things - And for those people who keep saying, "I thought people with Graves disease were skinny!" Well you use your own appropriate response -lol!  So, as of late embrace (and it is so true) each day with gratitude and that there are meds that can keep me from surgery.  In fact my endo of 23 years told me that he has discovered that the RAI is easier for the doctor, not the patient - some have done well and I don't mean to dismiss the positive outcome for those who have achieved that - but overall he said low dose methimazole, as long as liver enzymes and white blood cell count good, is the same approach to HYPER and taking thyroid supplementation for HYPO so far as the approach goes.  Also, may I suggest lemon balm and or chamomile tea for stressful evenings - have gone to half calf coffee and even a low acid version (developed Gerd from antibiotic use and also upper body weight gain) because I am not giving up coffee - if I knew it would cure me I would - have tried it only headaches and actually more stress.  Have looked at these forums for decades and just decided to chronicle this - sorry if it's all over the map!  If someone derives some comfort or hope from my experience that is what I am doing - sharing my Graves story.  It is filled with panic attacks and trips to the hospital thinking I am having a heart attack - being so hungry even though I just ate - being mad at myself for weight gain even after exercising and eating healthy and lean - seeing some hair in the shower and crying (and then realizing self pity is counterproductive!) and now finding out my thyroid is going the other way (TSH 10 crazy!) an requiring such a low dose I may actually be able to accomplish some things.  The thyroid is one little gland in the entire body that I personally think no one truly appreciates until something goes awry - however, there are certainly worse things in life and suffering is part of our lives on earth so the mind and soul are tougher - so you decide to research because knowledge dispels fear and eat right and treat yourself better and yes you may have to let go of vainer aspirations and cling on to the more intrinsic values in life - so hug and kiss someone you love today and let them know how much you are grateful that they have been through this with you.  And on the days you feel better find someone who could use your help and encouragement.  If that doctor is insistent on RAI and you don't feel good about it - get another opinion!
Avatar universal
While you are stable on such a small dose and if your liver enzymes arent in the 1000's then tell the Endo to go run and jump.
If your levels are stable, you would be mad to do RAI in my opinion.
Usually RAI is only done if there is cancer and if levels are unstable.
if you have RAI done, you are looking at a whole new ballgame so to speak.
Why fix it if it isnt broken (so to speak) ?
Sit on the ATD's....unless yr levels go haywire and cant be controlled.
If my levels were stable on ATD's, and I didnt have Thyroid Storm and Cancer , there is no way on this earth I would let some Endo do RAI.
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Avatar universal
How do you take such a small dose? My pills only come in 10mg and I have to cut them in half and take every other day.
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Avatar universal
Thanks for responding smiler. The endo doesn't seem to be interested in getting me off methimazole. He really wants to do the RAI.
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Avatar universal
Yes it is a standard maintanance dose and yr lucky to have found it works.
Usually they keep you on a low dose  for 6 months then take you off it to see if your levels  still stay stable.
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