[buriedsunshine]

#1060473

Hi all!

From May to June, I was taking 100 mg Levo. I was feeling great and my TSH was 1.20 (normal range). I thought this was the right dosage for me. I also started eating healthier and following a diet plan in order to lose the weight I gained throughout this whole journey. I lost 9 pounds but started to feel hyper symptoms again. I’m pretty short so weight loss/weight gain shows easily on my body type. I asked my endo and he said to stick with the 100 mg Levo for a few more weeks and then come in for a blood test.

Mid July, taking 100 mg of Levo. I come in for a blood test, still feeling the hyper symptoms. My TSH was 0.36. Does anyone have any idea why I would go from normal to feeling hyper so quickly? I asked my endo and he said: “The needed levothyroxine treatment dose is estimated based on a person’s size/weight, but then needs to be adjusted based on follow-up lab monitoring because the absorption of the medication differs from person to person.”

Since I was feeling the hyper symptoms and my TSH was 0.36, we lowered my Levo dose to 88 mg.

Has anyone been normal for a month and then back to hyper?

Thanks!

[snelsen]

#1182832

Interesting! I could not find any study, reference, etc. that states or alludes to the fact that weight is a factor in the amount of thyroid hormone needed. This question came up once, and I asked my endo, he said no relation. That , of course hyper folks lose weight, cause they are so hyper, and everything about their metabolism is racing, and hypo folks are sluggish, with the hypo symptoms you are familiar with.

I am not questioning your endo, but this is strange to me. Especially because I have been told it is not a factor in thyroid hormone replacement.

Did you have RAI or thyroidectomy? If RAI sometimes it does need to be repeated, cause not enough radiation to destroy the gland.

I hope Kimberly checks in with her knowledge about this.

In answer to your question, yes, my TSH T3 and T4 vary, and combined with my symptoms, the thyroid hormone dose is changed.
Shirley

[Kimberly]

#1182833

Hello – Weight is a factor in making the initial estimate of thyroid replacement hormone, although a recent study suggests that BMI might be a more appropriate marker:

(Note on links: if you click directly on the following link, you will need to use your browser’s “back” button to return to the boards after viewing, or you will have to log back in to the forum. As an alternative, you can right-click the link and open it in a new tab or new window).

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3658157/

Once that initial dose has been established, further adjustments are made based on labs and symptoms, as your doctor noted.

Like Shirley, I have not seen any specific studies on this, but if the 9 pounds was a significant % of your total body weight, perhaps that did contribute to the need for a tweak in the meds. Hard to say, though, as many patients find that they do need dosage tweaks along the way.

One other thing to look at is whether you have made any changes in your routine in the last month – when you take your meds, when you eat breakfast, take supplements, etc.. If you still have some residual thyroid function, consuming more foods high in iodine could have also had an impact.

Take care!

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