[Hopeful23]

#1019124

I was just wondering if you could explain to me how my initial dose of synthroid was determined. My TSH was 85*3. My starting dose is 75 mcg.Thanks ahead of time.

[Sue_Conard]

#1069405

Krystal: I know you had the question for Nancy, just wondering how you were doing on your new meds. I start my first of three treatments today of IV Solumedrol…leaving in a min. to get it administered and NOT looking fwd. to it!!

[Hopeful23]

#1069406

I have a close family friend that has MS. She is on a shot daily. She lives a great life. Just got married. Bought a house. Works full time and is a mother and obviously a new wife. They have a great life. Not at all the outcome i thought she would have from how she was suffering. Strokes and everything. It was awful. Good luck and pm me on how your treatments go:)

[npatterson]

#1069407

I’m sorry, I didn’t see this until today–almost a week after you posted it.

I don’t really know how they determine the dose. I would suspect it is "start low and go slow". I will try to get a more specific answer for you and post it.

[npatterson]

#1069408

I just bumped back into this post. I did contact our medical director, and he said that the "start low and go slow" is the approach. The doctors have your original TSH results, and have an idea of how things need to be, and follow you closely. Of course, each doctor’s difinition of "low" is different, and that depends on clinical judgement and experience. The operative phrase is "follow you closely".

Take care,

[Bobbi]

#1069409

A rationale behind the "go slow" approach: the endos prefer to keep us off the hormonal roller coaster as much as possible. In other words, they would rather estimate a touch low and then increase slightly, than go overboard, and put us back into hyper territory and have to reduce things. As much as we were all "used to" being hyperthyroid, it is a very dangerous condition, and while we don’t feel well hypothyroid, it is not as immediately threatening to life as hyper is.

[cathycnm]

#1069410

Hi all – I am reflecting back on my nurse practitioner pharm class – and we were taught start low and go slow, as well. This is especially true with kids and "older" people. (I think by their defination I am older – YICKS). They also take weight into account. So many mcg/kg of weight. I figured my dose out with their weight formula and it seemed too high. Sure enough, I was slightly high. The dose change that I am on now also agrees with the formula I was taught in pharm and I feel pretty good. So, I guess I am saying that body weight is another factor as well as age.

[runlacie]

#1069411

From what I have read, the mean replacement dosage (which I think is to totally replace what your thyroid produced) is 1.6 mcg per kilogram of your weight. Divide your weight by 2.2 to get kilos and then multiply by 1.6 and this is the formula I found for a total replacement of hormone. So if your thyroid still makes some you’d need a smaller levo dose.

[cathycnm]

#1069412

I think that is correct, too.

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