I am currently on .50mcg of Synthroid, have Hasthimotos disease and multi nodules, thinking about having total thyroidectomy performed. How would this effect my Synthroid dosage? The surgeon says he has seen patients on anywhere from .25mcg of Synthroid to over .100mcg of Synthroid after a total was done. Also why is it that I hear some people have a hard time regulating their dosage after surgery?
After a total thyroidectomy, the dose requirement will generally be about 0.7mcg/pound of weight -- of course, sigificant overweight or underweight status may alter this calculation. You are currently on 50mcg (0.05mg) so I expect a dose increase which I typically start when the patient comes home from the surgery.
Regulating the dose is usually not difficult -- taking the synthroid first thing in the am, at least 30min before food and not along with other meds --- and doing this consistently every day --- will help. Avoid generic thyroid meds.
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