MMI titration

[Lorilynn]

I read your post to me about how you don't like block/replace therapy, and that you like MMI titration, what is that?  HOw do you keep your patients from going hypo thyroid on only ATD's? and if they do go hypo, how do you help them if you don't use replacement? Also, does  using ATD's burn out your thyroid? and does replacement burn out your thyroid?  Do you consider 5mg of MMI to be a high dose of ATD?  HOw long do you recommend ATD therapy for your patience, I have heard a year is standard, but do you go shorter sometimes?  Do you believe that ATD therapy is what kills the TSI antibodies?

thank you,
Lorilynn

[BABYGIRLSCHAN]

WHAT IS MMI? I HAVE HYPOTHYROIDISM AND TAKE SYNTHROID AND HAVE FOR 14 YEARS. I STILL FEEL VERY TIRED AND DEPRESSED ALOT. MY HAIR IS NOW FALLING OUT AT A HIGH RATE OF SPEED.  I TAKE 100MCG OF SYNTHROID DAILY.  COULD THIS MMI HELP ME?

[Mark Lupo, M.D.]

ATD duration is usually 12-18 mos, the dose is weaned down to as low as 2.5mg every other day then stopped (sometimes this happens as early as 6 mos).  ATD may or may not lower TSI.  ATD's and replacement are not known to burn out thyroid.  5mg MMI is a low/medium dose.  Most patients can be started w/ 10-20mg  (avg 15) and weaned down.