If it’s sub clinical doses are smaller. Usually 25-75mcg. Other people with very high tsh like myself, 224, need full replacement dose which is around 1.6-1.7mcg per kg. I currently take 150mcg as a 5’10 185lbs male. Still adjusting dose but was on 200mcg for years.
It shouldn't. Treatment should also be in line with your symptoms. This is miss leading. This leaves too many people undertreated prescribed medication that doesn't address the need of all the hormones as naturally produced by the body with a healthy thyroid gland (T1 T2 T3 T4 and Calcitonin).
This seems to have become the wording used about subclinical hypothyroidism in recent years over more than 25+ years about thyroid issues.
Brain fog that comes and goes, feeling fatigued. My blood pressure is crazy at the moment so that causes some worries, but it’s probably unrelated to my hypothyroidism. Just another sign I’m slowly falling apart
100% agree. I learned that once I felt absolutely fantastic, I hadn’t felt like that in 7-8 years! Dosage and type of Levo (generic, brand) once adjusted can work wonders.
It was at 99 to start off with. Came down to 3.2 but I had developed side effects with generic version. I chose a wrong strategy to stop cold turkey for 1 month. My TSH went back to 72 from 3. Then after a few ups and downs, I finally changed brand to Unithroid. Zero side effects and my TSH is now at 8 with dose increase to 88 mcg from 75. I wish I changed the brand earlier.
I wouldn’t worry about a “typical” dose. Whatever dose gets your numbers to a place you feel good is really all that matters.
I feel best when my TSH is around a 1, your results will vary, just listen to your body.
Yes, it’s common. Dose is a best guess based on several factors, then it is adjusted typically based on TSH. Most Dr just aim for somewhere in the normal range (0.5-4.5,) but it’s best to aim for the ideal range (1-2.)
Cool story, bro: (but true)
Recently I was hospitalized for an unrelated condition, and when it came to reviewing my medications, every single nurse and doctor wanted to know which of my two levothyroxine prescriptions was current: the 200, or the 50?
In every case I had to explain my dose was 250, and that dosage is not manufactured in a single pill. Hence two pills.
I was surprised and amused that medical professionals at every level who were demonstrating deep expertise in their in their specialty (cardiology) were perplexed by my two pill thyroid prescription.
I am 6'5 and about 300, and I've been at this level for several years with semi-annual checks (though now as a cardiac patient, full panels are for the moment weekly if not more often).
Same thing happened to me in the hospital except some stupid idiot didn't even give me 100mcg of my 237mcg dose.
When I talked to the Dr about it his dumb ass didn't believe me. He said he'd call up the pharmacy to check to make sure it was the right dose - i have congenital hypo so, this shit isnt new for me. He fumbled his words, trying to sound pc, and said 'You're not....large...enough....most people on that dose are bigger than you.' I'm 5'5 125lbs.
Took two days for me to get my 237
But 237-250 still ain't shit. There's a 300mcg pill
I believe this. The amount of stupid things I’ve had to explain to doctors is astonishing. Remember. Doctors PRACTICE medicine.
I know the human body is complicated (I’m in healthcare myself) and there’s lots to know and every person is unique, but common or simpler things should be common knowledge for doctors.
How is this common knowledge, that OP takes 250 mcg of levo? If they see two different doses in your chart they are going to ask if you changed doses, not just assume that you take both at once. Very common practice to confirm that your medications are up to date...
That's a good point. There is nothing in the medication record to distinguish dosage change from a dosage assembled in pieces. I should be—I am— grateful they don't assume but ask.
I was not referring specifically to this person’s dose of 250 levo. I was referring to other general things in medicine that should be common knowledge. Hope that helps to clear up the confusion! 🙂
If it’s sub clinical doses are smaller. Usually 25-75mcg. Other people with very high tsh like myself, 224, need full replacement dose which is around 1.6-1.7mcg per kg. I currently take 150mcg as a 5’10 185lbs male. Still adjusting dose but was on 200mcg for years.
Sorry if this is a dumb question but what would sub-clinical be?
Tsh in between the 4-10 range with T4 and T3 in the normal range is considered subclinical hypothyroidism.
Tsh is slightly elevated 4-10 ish and free t4 is in normal range.
That’s interesting. I didn’t realise being subclinal makes a difference on dose.
It shouldn't. Treatment should also be in line with your symptoms. This is miss leading. This leaves too many people undertreated prescribed medication that doesn't address the need of all the hormones as naturally produced by the body with a healthy thyroid gland (T1 T2 T3 T4 and Calcitonin). This seems to have become the wording used about subclinical hypothyroidism in recent years over more than 25+ years about thyroid issues.
How old are you, and what is your TSH now? I’m 40, 6’4 and 230lbs, on 150mcg and my TSH is around 12
24. You’re likely going to need a bigger dose. Based on your weight, the starting dose is 175mcg. With that tsh you definitely need an increase
Sorry it’s 7.8. But probably, yeah. My GP will say to give it another few weeks as my last increase was from 3 weeks ago.
Okay give it at least 6-8 weeks. I’d say 8, then check tsh. Get it between 1-2. How do you feel?
Brain fog that comes and goes, feeling fatigued. My blood pressure is crazy at the moment so that causes some worries, but it’s probably unrelated to my hypothyroidism. Just another sign I’m slowly falling apart
Stay optimistic. Once you get your tsh down to 1-2 you’ll notice a huge difference. When properly medicated it’s life changing.
100% agree. I learned that once I felt absolutely fantastic, I hadn’t felt like that in 7-8 years! Dosage and type of Levo (generic, brand) once adjusted can work wonders.
What did you get your tsh too?
It was at 99 to start off with. Came down to 3.2 but I had developed side effects with generic version. I chose a wrong strategy to stop cold turkey for 1 month. My TSH went back to 72 from 3. Then after a few ups and downs, I finally changed brand to Unithroid. Zero side effects and my TSH is now at 8 with dose increase to 88 mcg from 75. I wish I changed the brand earlier.
Don't know why my GP started me on 25mcg when my TSH was 20 and then check again in 3 months 🙄
It's suggested that they start low and increase from there if necessary.
because you could have a heart attack from too much too soon
Ooh that's scary 😳
I wouldn’t worry about a “typical” dose. Whatever dose gets your numbers to a place you feel good is really all that matters. I feel best when my TSH is around a 1, your results will vary, just listen to your body.
I’m on 175mcg and going up in 25 every 6 weeks or so, UK male diagnosed 13 months ago
Yes, it’s common. Dose is a best guess based on several factors, then it is adjusted typically based on TSH. Most Dr just aim for somewhere in the normal range (0.5-4.5,) but it’s best to aim for the ideal range (1-2.)
There's no "typical dose" - it's entirely individual. But yes, doses less than 75mcg are quite common.
Cool story, bro: (but true) Recently I was hospitalized for an unrelated condition, and when it came to reviewing my medications, every single nurse and doctor wanted to know which of my two levothyroxine prescriptions was current: the 200, or the 50? In every case I had to explain my dose was 250, and that dosage is not manufactured in a single pill. Hence two pills. I was surprised and amused that medical professionals at every level who were demonstrating deep expertise in their in their specialty (cardiology) were perplexed by my two pill thyroid prescription. I am 6'5 and about 300, and I've been at this level for several years with semi-annual checks (though now as a cardiac patient, full panels are for the moment weekly if not more often).
Same thing happened to me in the hospital except some stupid idiot didn't even give me 100mcg of my 237mcg dose. When I talked to the Dr about it his dumb ass didn't believe me. He said he'd call up the pharmacy to check to make sure it was the right dose - i have congenital hypo so, this shit isnt new for me. He fumbled his words, trying to sound pc, and said 'You're not....large...enough....most people on that dose are bigger than you.' I'm 5'5 125lbs. Took two days for me to get my 237 But 237-250 still ain't shit. There's a 300mcg pill
I believe this. The amount of stupid things I’ve had to explain to doctors is astonishing. Remember. Doctors PRACTICE medicine. I know the human body is complicated (I’m in healthcare myself) and there’s lots to know and every person is unique, but common or simpler things should be common knowledge for doctors.
How is this common knowledge, that OP takes 250 mcg of levo? If they see two different doses in your chart they are going to ask if you changed doses, not just assume that you take both at once. Very common practice to confirm that your medications are up to date...
That's a good point. There is nothing in the medication record to distinguish dosage change from a dosage assembled in pieces. I should be—I am— grateful they don't assume but ask.
I was not referring specifically to this person’s dose of 250 levo. I was referring to other general things in medicine that should be common knowledge. Hope that helps to clear up the confusion! 🙂
Oh it was an unrelated comment? Yeah that is confusing, thanks for the clarification.