[mckatherine July 3, 2012 at 11:51 am Post count: 1]

#1059172

I’ve been feeling hypo symptoms for a couple of months, but my doctor keeps wanting me to stay on the same meds. I’m on a very low dose as it is (2.5mg methimazole every other day), but I’d really like to reduce it further given my symptoms (deep fatigue, stubborn weight in spite of very careful diet, lots of exercise)

My recent labs (below) show that my FT4 and FT3 have fallen (FT3 actually just below range) so I do feel like this supports how I’ve been feeling.

I also see a naturapath who has recommended I reduce my meds, but it feels strange to do this when my endo says to stay the course.

I’m wondering what other people did to reduce meds when they were on a similar dose as I’m currently on – ie is it better to move to 2.5mg every third day or reduce to 1.25 mg (not sure how i’d slice the pills that small) every other day??

Any suggestions very much appreciated!!

TSH normal range (.465-4.68)
Free T4 normal range (.59-2.19) NG/DL
T3 Free normal range (2.77-5.27)

2/13/12: TSH: 1.14   FT4: 1.49   FT3:  2.99
4/17/12: TSH: 1.18   FT4: 1.24  
5/30/12:  TSH: 1.48   FT4: 1.17  
6/30/12: TSH: 1.36 FT4: 1.03 FT3: 2.76

[Carito71 July 3, 2012 at 1:23 pm Post count: 333]

#1172706

Hello mckatherine,

You can call me Caro. I don’t know much about Methimazole for I just started on it myself (yesterday was 2 wks) and my #s are still high (the same and a little higher on the FT4 than when I started the Rx). I have read though that there is something you can take while on Methimazole so your #s don’t get too low. Maybe one of the other members who know what I’m talking about will leave a message soon. Mean while, feel better soon. I’m not looking forward to they hypo part of things but I’m super tired of the hyper. Wish you the best.

Caro

[KimberlyOnline Facilitator July 3, 2012 at 1:56 pm Post count: 4294]

#1172707

Hello – Personally, rather than trying to adjust the dose myself, I would push your endo for an explanation as to why he/she does not want to adjust your dose with your current symptoms and with your FT3 at the bottom of the “normal” range…and then try to work with them on an appropriate adjustment.

Another option, which was mentioned by a presenter at our 2011 Boston conference, is that it can sometimes be easier to stabilize patients on Anti-Thyroid Drugs by giving the patient a consistent dose of ATDs, and then supplementing with a small amount thyroid hormone replacement – as needed – to make sure the patient doesn’t go hypO.

Keep in mind that this option is *not* the same as traditional Block & Replace therapy, which involves using large doses of Anti-Thyroid Drugs to completely shut down thyroid production and taking replacement hormone to normalize thyroid hormone levels. There was a study in Japan done where the results of B&R were highly successful – but these results haven’t been replicated here in the U.S. Also, there is concern that the higher doses of meds may be correlated with a higher rate of side effects, such as liver and white blood cell issues.

Take care – and keep us posted on how you are doing!

[naumanb July 5, 2012 at 4:05 pm Post count: 22]

#1172708

I feel you on this. My Endo is continuing to decrease my dose, I am on 5mg every other day, even though I feel the hyper symptoms coming back. It is all very confusing to me as well. I hope everything goes well for you and you get everything back to comfortable for you!

[Harpy July 5, 2012 at 5:03 pm Post count: 184]

#1172709

I’ll second Kimberly’s comments,
The concept she mentions is sometimes called “Add Back therapy”, and allows patients to maintain a consistant low dose of ATD’s while supplementing a small amount of thyroid hormone to keep hormone levels high enough to support normal metabolic rate.
The reason for this process is that some practitioners in the thyroid field believe that the ATD’s not only reduce hormone production, but also have a suppressive effect on antibody activity so by using ATD’s for a longer period will have a better chance to reduce antibodies to normal levels and increase probability for a lasting remission.
Have you had your Thyroid Receptor antibodies (aka TRAB’s, TSH Receptor AB’s) tested recently to determine if they are close to being in range, maybe ask your Endo about this as well?

[paleblue July 6, 2012 at 11:31 am Post count: 18]

#1172710

I was in that same situation before, and my doctor was easy to work with and reduced my meds to 1.25 every other day. She even told me to try to scrape off a tiny bit from that.

You also might want to get your antibodies tested to let you know exactly where you are. I might try to talk to the doctor one more time because it always feels better to be up-front, and it can be helpful b/c if you maintain at that level, and your antibodies hold for a good while, you may be able to attempt to stop taking medication.

Good luck!

[paleblue July 6, 2012 at 11:31 am Post count: 18]

#1172711

I was in that same situation before, and my doctor was easy to work with and reduced my meds to 1.25 every other day. She even told me to try to scrape off a tiny bit from that.

You also might want to get your antibodies tested to let you know exactly where you are. I might try to talk to the doctor one more time because it always feels better to be up-front, and it can be helpful b/c if you maintain at that level, and your antibodies hold for a good while, you may be able to attempt to stop taking medication.

Good luck!

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