How does the doctor decide what kind of thyroid meds to give and how much to give?

[momsi3]

How do name brands & generic brands of thyroid meds compare and are any better than others?

[lhowell]

It's best to always take name brand levothyroxine (i.e., Synthroid) as opposed to a generic brand.  When you are Rx'ed generics, the pharmacy is able to fill the prescription with that month's "bargain".  Dosage may not be consistent between Generic Company A and Generic Company B.  Synthroid will always have a much more consistent dosage and that's very important.

When my doctor writes my rx for Synthroid, he always adds DAW (dispense as written).

I think some doctors will Rx generics if the pt doesn't have insurance.  I've read too many stories of people who have have bad TSH test results and it was because they took generic levothyoxine.  

Just my two cents.

Also, Synthroid offers $3 off coupons on their site.  Just print and give it to the pharmacy.

[Justicemom]

I was told by the family doctor never to take the generic Synthroid, because it works differently than the brand name.  When I was started on it in May, my husband filled the rx and didn't tell the pharmacy to fill it with the brand name.  I didn't realize it until I started taking it.  I wasn't feeling any better...  I was on it until I saw the endo...she switched me to the brand name, and boy what a difference.  I felt better on the brand name for sure.  

[ChitChatNine]

Believe it or not the NAME BRAND SYNTHROID was CHEAPER than the generic .. I'm not kidding .. some kind of deal with my ins. co and the pharmaceutical company they told me so ASK ASK ASK .. even mentions  to ask on the Synthroid website .. apparently it is little-known secrets out there!

C~

[momsi3]

How do they decide how much to give?

[Justicemom]

I just asked that question to my ENT last week...He said I would be started out at 100mcg's of Synthroid.  I think all the doctors start somewhere and then just do follow ups with bloodwork.  I do know that he said it would be much easier to regulate the doses without a thyroid to cause problems.

[lhowell]

Doctors always want to start you on the lowest possible dose, but it depends on how high your TSH levels are.  If you have subclinical hypothyroidism, you may only start with a 25mcg dosage....which is very low.  Usually, the doctor will start you on between 50-100mcg and check your progress at 6 weeks.  If a patient is Rx'ed too much to start out on, it can cause the heart to race and give symptoms of being hyper.  I'm referring to levothyroxine and not Armour.

[lhowell]

Doctors always want to start you on the lowest possible dose, but it depends on how high your TSH levels are.  If you have subclinical hypothyroidism, you may only start with a 25mcg dosage....which is very low.  Usually, the doctor will start you on between 50-100mcg and check your progress at 6 weeks.  If a patient is Rx'ed too much to start out on, it can cause the heart to race and give symptoms of being hyper.

[AnnetteV]

I am starting on Synthroid in the morning (total TT on 2/5/06).  The doctor said to ALWAYS look at the pill itself and make sure it is by Synthroid.  If it is a generic, there are subtle differences, so even though the Pharmacy gives you what appears to be the same dosage of a generic, it can actually be quite different.

[ChitChatNine]

What is subclinical Hypothyroidism ? Does it mean having the symptoms but the bloodwork is normal or near the high end of the range?

This is all new to me as of January.

My TSH is aprox. 2.5 .. I am on 25mcgs and probably will be upped after my first bloodwork which will be in 2 weeks.  Goal is .5-1.0 for supression of other side of thyroid for cancer found on the side taken out (after surgery it was found 48hrs later in 2 small areas).

Thanks,

Cheryl

[momsi3]

Does the doctor base inital dosage on height, weight, lean muscle tissue, metabolism (pre surgery) or by some other criteria?

[mocha232]

I'm not currently on any type of thyroid meds. Momsi3, if you mean the dose your Dr will put you on after your surgery, here is what my ENT told me: Initial dose after TT will be based on height and weight.

Hope this helps. :)

[momsi3]

Thank you for your answers