Levoxyl dosages

[dpleiman]

It states on the Levoxyl drug website that: In patients with severe hypothyroidism, the recommended initial levothyroxine sodium dose is 12.5-25 mcg/day with increases of 25 mcg/day every 2-4 weeks, accompanied by clinical and laboratory assessment, until the TSH level is normalized.

Does anyone know why?
could i be considered "severe hypothyroidism" with TSH of 102 and Free T4  .17?
If so, why would my doc want me to start with 88mcg - 100mcg?
Could the above statement from the drug website be for someone who has NEVER taken levoxyl or can it be an exception since i was on it previously not so long ago?

I'm worrying myself here...

[goolarra]

I'm sorry to hear that...believe me, I know how miserable you feel.  I think Totie has a good suggestion...you should contact your doctor, tell him about your symptoms, make sure he knows that you're obviously sensitive to the meds, and ask for a reduction to 25 mcg.  (You'll probably need a new prescription to do this anyway.)  If you can't get him right away and if it were me, I'd break those 88s in half and get down to 44 right away.  

From 25 mcg, I literally hit every step along the way that I could combine pills, break them in half, break two different dosages in half and combine them.  You name it...I have a drawer full of different dosages!  I hit 25, 37.5, 44, 50, 62.5, 68.5, and finally 75.  That took over a year, and I ended up having to get on atenolol (a beta blocker) to control the tachycardia, which was still an issue at 25 mcg.

Just move very slowly...take baby steps.  You know, I've never done this before, but looking at my steps and putting six weeks between each increase, I'd have gotten to 75 mcg in 36 weeks, instead of over a year if my doctor had just taken the conservative approach.  So, she not only wasted a lot of my time, but caused me a whole lot of grief, too.

Let us know what your doctor has to say,    

[Totie]

I think everyone is different on how they react to certain dosages. After my TT, I was on 200mcg and stayed on that dose for 10yrs. But as I grow older my hormones change to where I needed dosage adjustments. I have been on 125mcg for the past 3yrs.

Make sure you keep your doctor informed of the symptoms. They may need to adjust dosage or they may say wait it out until we re do lab work. Whatever the choice, LET THEM KNOW your symptoms...very important, you do not want to be under or over medicated....

[dpleiman]

And it begins.. 2 doses of 88mcg and i am having extreme fatigue/weakness.. Stomach cramps, diarrhea, mild tachycardia, tremors, headache, hyperactivity, hot flashes and a menstrual cycle that looks like an extreme massacre.... What should I do?

[goolarra]

Oooooh, yeah, do I know why!  If you are over 50, OR if you have been hypo for more than a few months (severely hypo), OR if you have a history of heart arrhythmias, the starting dose should be, as you stated, 12.5-25 mcg.  I qualified for all three categories, and my (former) PCP started me on 88 mcg (had never been on thyroid meds before).  Within a couple of weeks, my heart arrhythmia had gone wild.  I backed off to 44 mcg.  Another couple of weeks, same scenario.  Backed off to 25 mcg.  My PCP insisted that this had nothing to do with the levo...dead wrong.

However, I think that I am extremely sensitive to levo and increases in levo.  Also, my PCP started me on 88 mcg by "looking it up" on her computer.  I increased from 25 to 75 (my current dose), but I did it in such baby steps that it took me over a year to get there.  I doubt I'll ever be on 88 mcg.  A conservative approach with regular increases would have probably gotten me there a lot faster and with a lot less tachycardia.

However, that being said, have you been sensitive to levo and increases in the past?  Whether or not you have been on levo before is not important,  It's how long your body has been starved for thyroid hormones that's important (and how starved it is).  When in doubt, I always think it's best to be conservative and avoid the side effects of proceeding too fast.  You have to give your body time to acclimate to having the hormones available again and adjust to the increased metabolism.  

[karenscar]

Generally doctors will try to start you with the full dose if their is no cardiac history.  When I was first diagnosed, my TSH was >100.  My doctor started my on 88 mg, and I eventually ended up on 100 mg.  Hope this helps.