Guest guest Posted December 3, 2002 Report Share Posted December 3, 2002 Hi I agree with your logic, and studies show that most pharmaceuticals are prescribed at too high doses, based on recommendations of the manufacturer (the guy who profits from the higher doses). But I haven't seen anything saying that 1.25 mg daily is effective. I used to study drug pharmacokinetics and there definitely are drug doses that are sub-therapeutic and without benefits. I think, though, that if someone is in remission, proven with TSI levels or a good response to a lowered dose, than weaning slowly from the meds has immune system benefits. That's where a 1.25 mg dose, intended not to lower thyroid hormone levels, but to slowly withdraw the immune suppressing effects of the meds comes in. An example is what happened to our friend Mona, who achieved remission and maintained it the second time around with this slow approach. The 2.5-10.0 recommendation comes from a large study published in the last year, around February, that I have somewhere. I think it's from Sweden. It's point was that there are no additional benefits (but more problems) if high maintenance doses are prescribed. But much has to do with body weight because what you're looking at with drug levels is mg or weight of the drug for every 100 ml of blood (mg/dl, dl being 100ml). A small person with a lower blood volume is going to have a higher drug concentration using the same dose as a very large person. Good hearing from you, as always. Where did the year go? Elaine Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 3, 2002 Report Share Posted December 3, 2002 Hi I agree with your logic, and studies show that most pharmaceuticals are prescribed at too high doses, based on recommendations of the manufacturer (the guy who profits from the higher doses). But I haven't seen anything saying that 1.25 mg daily is effective. I used to study drug pharmacokinetics and there definitely are drug doses that are sub-therapeutic and without benefits. I think, though, that if someone is in remission, proven with TSI levels or a good response to a lowered dose, than weaning slowly from the meds has immune system benefits. That's where a 1.25 mg dose, intended not to lower thyroid hormone levels, but to slowly withdraw the immune suppressing effects of the meds comes in. An example is what happened to our friend Mona, who achieved remission and maintained it the second time around with this slow approach. The 2.5-10.0 recommendation comes from a large study published in the last year, around February, that I have somewhere. I think it's from Sweden. It's point was that there are no additional benefits (but more problems) if high maintenance doses are prescribed. But much has to do with body weight because what you're looking at with drug levels is mg or weight of the drug for every 100 ml of blood (mg/dl, dl being 100ml). A small person with a lower blood volume is going to have a higher drug concentration using the same dose as a very large person. Good hearing from you, as always. Where did the year go? Elaine Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 3, 2002 Report Share Posted December 3, 2002 >>> 2.5 mg daily is the smallest recommended maintenance dose for Tapazole. When you are in remission, then it's best to > wean off slowly using the 2.5 mg every other day to adapt your immune system to the change. <<< Hi Elaine - A while back, I read somewhere that anything less than 2.5 mg a day of Tap is not effective. That's easy for someone to say. I don't think it was backed by any research, so I'm wondering if you have ever located any studies on the lowest possible " effective " daily dose of Tapazole, or do you know where I could look for *official* info on this. If a patient gets to the point where 2.5 EVERY day is too much, wouldn't it make more sense to keep the flow of meds more even with 1.25 mg a day instead of the lopsided dosing of 2.5 one day, and none the next? Even if it is said that this is " ineffective " this may not pertain to ALL people. Wouldn't it make more sense to at least try 1.25 mg every day, and see if this person benefits from it or not--if she gets to the point where this may pertain? After all, some people are more sensitive to even the smallest change in Tap dosage, so who can absolutely confirm the statement that anything less than 2.5 mg a day is ineffective in ALL patients? Thanks, Chris Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 3, 2002 Report Share Posted December 3, 2002 Thanks for the info, Elaine - You say: >>> But I haven't seen anything saying that 1.25 mg daily is effective.<<< Neither have I seen anything that proves beyond a shadow of a doubt that it is NOT effective. >>>....weaning slowly from the meds has immune system benefits. That's where a 1.25 mg dose, intended not to lower thyroid hormone levels, but to slowly withdraw the immune suppressing effects of the meds comes in.<<< The 1.25 a day dosing could be used in helping the body to wean from the meds, and I wasn't specifically referring to further lowering this patient's thyroid levels, but what's to say that is not a possibility to be explored in at least some of the people? There could be those so sensitive that dropping from 2.5 a day to nothing, or even 2.5 mg every other day, might cause a rebound effect. Who knows? If I came to that fork in the road (as 3 mg a day was the lowest I got until I ran into a batch of expired meds and had to start over), I would at least give it a whirl. I'd take 1.25 a day until I saw whether or not it did any good in MY case. What harm can be done in experimenting with this? Almost everything that this group has done with ATDs so far has been a guessing game anyway, thanks to the ignorant, lying endos. I just feel it is wrong to give absolutes one way or another when nobody really knows how each individual will react in any given situation. I'm not trying to be antagonistic with this, but there are so many aspects to this medication that have hardly been explored. And this is due in part to the popular 18-month, predetermined cut-off, leaving few patients to use for comprehensive data in long term usage of the meds. So few people up until now have even been allowed to taper down this far, that there is no etched-in-concrete, one-size- fits-all determination regarding the usage of ATDs. Mona was using PTU for 4 years, and tapered very, very slowly. I'll have to ask her how she worked it at the finish line. Thanks again, Chris Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 3, 2002 Report Share Posted December 3, 2002 Thanks for the info, Elaine - You say: >>> But I haven't seen anything saying that 1.25 mg daily is effective.<<< Neither have I seen anything that proves beyond a shadow of a doubt that it is NOT effective. >>>....weaning slowly from the meds has immune system benefits. That's where a 1.25 mg dose, intended not to lower thyroid hormone levels, but to slowly withdraw the immune suppressing effects of the meds comes in.<<< The 1.25 a day dosing could be used in helping the body to wean from the meds, and I wasn't specifically referring to further lowering this patient's thyroid levels, but what's to say that is not a possibility to be explored in at least some of the people? There could be those so sensitive that dropping from 2.5 a day to nothing, or even 2.5 mg every other day, might cause a rebound effect. Who knows? If I came to that fork in the road (as 3 mg a day was the lowest I got until I ran into a batch of expired meds and had to start over), I would at least give it a whirl. I'd take 1.25 a day until I saw whether or not it did any good in MY case. What harm can be done in experimenting with this? Almost everything that this group has done with ATDs so far has been a guessing game anyway, thanks to the ignorant, lying endos. I just feel it is wrong to give absolutes one way or another when nobody really knows how each individual will react in any given situation. I'm not trying to be antagonistic with this, but there are so many aspects to this medication that have hardly been explored. And this is due in part to the popular 18-month, predetermined cut-off, leaving few patients to use for comprehensive data in long term usage of the meds. So few people up until now have even been allowed to taper down this far, that there is no etched-in-concrete, one-size- fits-all determination regarding the usage of ATDs. Mona was using PTU for 4 years, and tapered very, very slowly. I'll have to ask her how she worked it at the finish line. Thanks again, Chris Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.