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Thyroid testing - after dose increase

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Posted 9/17/2016 7:50 PM (GMT 0)
This one's about my husband...not me this time.

He has untreated lyme...but is trying to get his optimum dose of T4.

He was on 125 mg of Synthroid and wanted to see if bumping it up a bit would help. So, he split the 125 into 4 and was taking 156. But, it was too much of a jump, so he went back to 125 and was retested - but only TSH was ordered.
A walk-in clinic Dr. would not give him 137.5 based on the results of the TSH (.61) (he couldn't get in to see our Dr.) - so gave him another script for 125. (he was almost out of his meds)

When I went to the pharmacy to fill it, I requested to have it filled in 100's and 25's and the Pharmacist agreed (most likely because he gets an extra dispensing fee..lol) Now he is splitting the 25 in half, so is able to take 137.5 daily.

My question: he has a Dr. appt. in two weeks...I'm thinking he should request a TSH and FT3 at this time.
But, he should hold off doing the test until it is 4 weeks past the increase?
Posted 9/17/2016 9:39 PM (GMT 0)
Correct. After a dose adjustment you should wait at least 4-6 weeks. Some docs prefer 6 weeks.
Posted 9/17/2016 9:48 PM (GMT 0)
okay, thanks.

If he gets symptoms (sweating, anxiety) - in the next week or so going from 125 to 137 - could that just be an adjustment period...or does that mean the 137 is too high?
Posted 9/17/2016 9:54 PM (GMT 0)
Typically when there are symptoms with an increase it is your body trying to process that extra hormone. Sometimes what I will do is slow it down more. He could split that 12.5 in half if he begins to get symptoms. I always titrate up in baby steps allowing my body to slowly adjust.

Some people can jump into large increases and some have to take it slower.
Posted 9/17/2016 10:09 PM (GMT 0)
okay - so it could be the right dose, even if he has symptoms.

Good luck keeping him at it..if that happens.
Maybe I should right away tell him to half it again (it's not going to split easy - as the tablet is only scored once)


He already splits his daily dose in two...so this could get confusing if he's not paying attention. I'm going to suggest he put out his daily dose each morning...when it's gone, he knows he's taken the full amount.
Posted 9/17/2016 10:15 PM (GMT 0)
You can easily split it again with a pill cutter. That's what I use. Also called a pill splitter.
Posted 9/17/2016 10:19 PM (GMT 0)
You know a while back I spoke to someone at the Pharmacy about it...and she said that it wouldn't split that well and it would most likely crumble.

I think I will buy one anyway and give it a try.
Posted 9/17/2016 11:16 PM (GMT 0)
Mine has always worked perfectly and I've had it for 2 years. I know there are different types, though. Mine is a cylinder which at the top is the cutter (with lid obviously), then if you screw the lid off it becomes a pill crusher and a cup. And lastly if I flip it over at the bottom is where I can store pills.
Posted 9/17/2016 11:18 PM (GMT 0)
This is the one that I have. I bought it from Wegmans.

/jet.com/product/detail/e6638eaca113468282f60a70950a40c5?jcmp=pla:ggl:gen_health_beauty_a3:health_care_pillboxes_a3_other:na:PLA_348226380_24173425620_pla-161718428460:na:na:na:2&code=PLA15&ds_c=gen_health_beauty_a3&ds_cid=&ds_ag=health_care_pillboxes_a3_other&product_id=e6638eaca113468282f60a70950a40c5&product_partition_id=161718428460&gclid=CLWTx7rEl88CFQsmhgodvnQC0w&gclsrc=aw.ds
Posted 9/18/2016 3:28 AM (GMT 0)
"..................... he has a Dr. appt. in two weeks...I'm thinking he should request a TSH and FT3 at this time."

Dont forget FT4, since hes on a T4 med.

The 6th week is how long it takes for the thyroid lab #'s to "mature" with the med increase.

People sometimes test at intervals in between when trying a new med. But hes on the same with a small increase- wait till 6 weeks.

That sounds challenging taking T4 so many times a day. Remember T4 clings to protein, and then wont work properly. T3 does not do that with food.

Symptoms from the body getting use to the med change can occur as far out as two months (from med or dose change). This puzzles people. Patients is hard. Being sick is harder.

AM

Post Edited (astroman) : 9/17/2016 9:32:18 PM (GMT-6)

Posted 9/18/2016 7:13 AM (GMT 0)
Right, FT4 test as well.

He's only taking the T4 twice a day. Half in the morning...and half in the late afternoon.

He takes his med on empty stomach.
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