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TSH of 8.8
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TSH of 8.8

I've been taking Synthroid for over 20 years w/varying doses over this time period.  I was recently tested and found that my TSH level is currently 8.8 and free thyroxine is 0.7.  I take a daily dosage of Synthroid of 125 mcg.  My physician has suggested I take an extra dose on Sunday to help alleviate this.  I do not feel that one extra dose per week is going to help.  I feel I should be taking an extra dose two times per week.

Any comments or thoughts to share?

Thanks
Tags: dose
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297 Comments Post a Comment
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231441_tn?1333896366
Hi,

an additional dose once a week may or may not be enough.

two choices:  

1. take the prescribed dose and test in 6 weeks (then you can increase if necessary to 2 doses a week if TSH is still too high).
2. take an extra dose a week and then test in 6 weeks (and maybe you'll need to decrease or maybe not).

However, in my opinion work with your doctor.  Better not to alienate him by not following instructions (unless you intend on not telling him).  As long as you test again in 6 weeks you'll know if you need to increase more or not.

An alternative to ask your doctor is to take 125 on 2 days a week and 150 mcg on 5 days a week.... ask your doc about this.... maybe better than having one extra big dose once a week (this would give you 125 mcg extra over the whole week - a mid ground), and easy to adjust up to 150 every day then if you still need an increase.....


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Avatar_f_tn
Personally I would go for the one increase per week and be retested within 4 weeks.
The reason I say 4 weeks is that my TSH can go from 6.0 to 2.89 in 2 weeks on a small dose of thyroxine.
It all depends on how drug sensitive you are.

If you are very drug sensitive, then go in 3 weeks but if not , then 4-6 weeks.
Everybodys body has a different rate of metabolism and no two are the same.
Your Doctor wants you to increase from 875mcg weekly to 1000mcg weekly.

Sally is correct in what she posted in regards to balancing the meds out over a 7 day period instead of one massive hyper rush.

You can alternate the dose to.......
150mcg  Mon/Tues/Thurs/Fri/Sun = 750mcg
125mcg Wed/Sat = 250mcg

Evened out this way you wont feel the 'hyper rush' on Sunday...it will be balanced out over the 7 day period.
Then when tested , see if the 125mcg dose has changed brought your TSH down to what you want and if not then take the 150mcg dose 6 days a week and the 125mcg on Sundays.
Hope thats all clear.

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393685_tn?1325870933
I just don't understand how this swinging of dosages will benefit a patient on T4 medication?  It seems so confusing to me.

On Deb's post I clearly see her thoughts on the unbalancing when meds are not consistant. Even being drug sensitive, this is someone with a TSH of 8.8 when (for most patients) a variable for optimal levels is .8 to 2.0 at the highest.

I read  - some here  - are told to take "X" dosage M-F but then on the weekends to take a different level. So many come back and say exactly what Deb says - they feel hyper rushed certain days and then doopy the others. Especially on a T4 med with a long release/conversion timing. Even on T4/T3 med - the swinging can be hard when a tweek here and there is done through the week, But in T3 the swing is much harder when direct.

And what about testing then? When do you go for the labs? On the days that you have been taking the increase - or the days you don't? It doesn't seem to me like you will know exactly what will happen. Do you test when you feel hyper - or hypo? I can't see how this protacol evens out ever to stabilize a patient. The conversions are still happening - but now are decreased and increased though the week based on the dosages taking in.

If your doctor is basing your dosage levels on TSH alone then the 8.8 reading you have clearly shows you need more consistant medication each day. Why can't they just up you to the .150 mcg Synthroid every day and test you again in 4 weeks? Why make this more complicated then what it already is?

In respect - to all - If this TSH was even close to normal and just a "tweek" would be needed to see if that improves the situation for this person - then maybe a bump here and there through the week would be understood, but clearly - to me - it seems this up and down of meds each day with this TSH will only prolong the situation  and confuse this for this person further.

Just my thoughts - not trying to throw a wrench in this situation.
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161647_tn?1280611763
I agree with Stella. My doctor has been trying to regulate my thyroid numbers for a year now without success doing exactly what Neeya's doctor is suggesting. I have been dancing around with various recipes of 75 and 88 mcg of Synthroid. 2 days this dose, 5 days another dose. Than 4 and 3, etc. Than test in 6 weeks.

I have found yet another Endo and have an appointment next Wednesday. I am keeping my fingers crossed that this Endo is the "one".

Neeya, I hope you have better luck.

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Avatar_f_tn
Thanks to all for your advice.  It has been very helpful.  I am going to call my doctor to set up a test in 6 weeks.  My next scheduled appointment doesn't happen until July.
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Avatar_f_tn
In regards to my 'dosing'......
I was on 62.6mcg three times a week and 50mcg four times a week.
I then needed an increase so the Doc put it up to 62.5mcg FOUR times a week which sent me to the top end of the scale.
I then went back down to 62.5mcg THREE times a week and have been fine on that for 3 weeks now (I usually have a patter of going too high every 2 weeks).
They calculate the dosage of what you are taking over a weekly period and NOT a daily dosage with T4 med.
As you know I am 'tweaking' to find that 'balance'.
As of the last week or so, I feel great as I am though also feel I am 1% off the mark.
I am in a catch 22 situation because if I add an extra 62.5mcg each week, I know I will go back up to the top end of the scale so am sitting tight and 'waiting'.

Labs are done BEFORE meds usually and it doesnt matter what day they are done on.
I go fortnightly at present on  a Tuesday.
Regardless though...if you have taken T4 meds that day, the FT3 and FT4 will be incorrectly false but the TSH always remains the same.

I found from experience that when it comes to T4 meds, get your FT3 and FT4 in line first THEN fine tune your TSH.
I know some people who have a TSH of 6.0 and feel fine.
If my TSH is under 2.3, I feel like I'm in hell with bad anxiety so I avoid going lower than that.


Complicated ...hey? lol
Who said LIFE was easy!

All the best to whoever is trying to just get that 'right' balance. :)
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Avatar_n_tn
TSH level of 8.78
Prescribed .25 mcg 3 days a week, Monday, Wednesday & Friday.
Anyone familiar with this sceduling, etc?
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Avatar_f_tn
Is your doctor also testing your free T3 and free T4?  How long have you been on meds?

When it comes to a T4 medication (like Synthroid, Levoxyl, generic levothyroxine, et al), the weekly dose is more important than the daily dose.  Often, patients alternate dosages (e.g. 50 one day, 75 the next, averaging 62.5 per day) to reach the appropriate weekly dose.  This is because levo only comes in certain "sizes", so not every dose is available as a single pill.  

If you want more consistency, you might split your 25s and take half every day, except one, but make it the same day every week to make it easier to remember.
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Avatar_m_tn
what do the two figures in the thyroid test relate to and how does the pituatry gland work with this
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