Advice on dose

[karenscar]

Hi.  I just received my TSH results after being on 100 mcg of synthroid for 10 weeks. They show that I am receiving too much and I am definitely feeling the symptoms.  When I take 88 mcg of synthroid, I don't feel like it is enough.  So, does anyone alternate doses, and if so, how is that typically done?  

Thanks

[Jenipeni]

Hi again,
Genelady reminded me of a point that an endocrinologist recently pointed out to me;

Previously I had been taking 100mcg on odd days and 150mcg on even days AND before that I had tried to write in my diary which dose was due each day as a reminder.  This can get a bit confusing and messy at times - especially as it is always early morning when I'm taking my dose! Lol!

Anyway my endo recommended that I do every Monday to Thursday 150mcg and Friday to Sunday 100mcg because it means that you get a more consistent dose - ie; you don't have to make changes to factor in either;
-the change in month when you have two odd days in a row, eg. 31st July then 1st August
-If you go every second day alternately then you always end up on a different dose at the start of each week because of the odd number of days in a week eg. Monday 1st week 150mcg, Monday 2nd week 100mcg - so the average over 7 days changes from fortnight to fortnight.  One week I'd get 4 days on 150mcg & 3 on 100mcg and the next I'd be getting 3 days on 150mcg and 4 days on 100mcg.

You might have thought (like myself) that as long as you do the same thing consistently it doesn't really matter.  Well in one sense that could be said.

But in another sense I wasn't being as consistent as I could be - why does this matter, isn't it just splitting hairs when you get to this point?  Well as many of you might find a very fine dose adjustment can make a big difference in your TSH (as it did for me).

Just some food for thought anyway.  It makes sense to me but I'm not sure if I can clearly communicate what I mean right now -SORRY if it doesn't make much sense!!!!!!!!!! (too much on my mind and too little time).  
~Jen  

[genelady]

Hi, I alternate 100mcg and 88 mcg. I bought a weekly pill minder and on Sunday morning I put a pill in each slot. If I finish the week with an 88, I start the next week with 100 and vice versa. I found that 100 was too big and 88 was too small, but for me an average of 94 is jussst right.

[Jenipeni]

Hi Karen,

I take alternate doses - in Australia we only have three strengths available in tablets (50mcg, 100mcg and 200mcg).  So I take 150mcg for four days per week, Monday to Thursday and then 100mcg for three days per week.  Typically it is worked out by dividing the total dose received over a week by 7 (ie; the total of 7 days doses - divided by 7).  So I average about 128mcg per day.  It is only possible to do alternate dosing because thyroxine is such a slow acting drug.  

I searched the internet a number of times for info on alternate dosing (or intermediate dosing as it is sometimes known) but I haven't come up with anything.  Let me know if you find anything.

Did your TSH register at all - if you were having way too much it may not even register I'm told?  Or was it just a bit lower than aiming for?

Best wishes finding the right dose for you.   I hope you continue feeling better and better each day.
~Jen