Re: TSI Results In - For Elaine

[Guest guest]

Thank you, Elaine, I understand TSI, now, and what to expect.

Some other questions have popped into my mind.

There is not much I have found about Block and Replace in regards to

ongoing treatment. I found one site that said that the dose of

thyroxine is 50 u<(this was a symbol, but I don't know what the word

is to say what it is) after the FT3 has returned to normal. That's

all it says. Then what happens?

In six weeks, I need to have more lab tests. In one place, it says

that you only need to have FT3 done if Block and Replace is the

treatment. Will that be enough for ongoing monitoring?

I am beginning to wonder if my doctor will go along with Block and

Replace since he is a GP. It looks like there is not enough

information available about how it is done.

Diagnosed August 20, tried tincture for 3 months. Lab tests in

December showed severely high FT4 and FT3. TSI 282 (range 125 or

less). Started 30 mg (15 in the morning, 15 at night) methimazole.

Would like to try Block and Replace, if possible.

[Guest guest]

Thank you, Elaine, I understand TSI, now, and what to expect.

Some other questions have popped into my mind.

There is not much I have found about Block and Replace in regards to

ongoing treatment. I found one site that said that the dose of

thyroxine is 50 u<(this was a symbol, but I don't know what the word

is to say what it is) after the FT3 has returned to normal. That's

all it says. Then what happens?

In six weeks, I need to have more lab tests. In one place, it says

that you only need to have FT3 done if Block and Replace is the

treatment. Will that be enough for ongoing monitoring?

I am beginning to wonder if my doctor will go along with Block and

Replace since he is a GP. It looks like there is not enough

information available about how it is done.

Diagnosed August 20, tried tincture for 3 months. Lab tests in

December showed severely high FT4 and FT3. TSI 282 (range 125 or

less). Started 30 mg (15 in the morning, 15 at night) methimazole.

Would like to try Block and Replace, if possible.

[Guest guest]

" vscottbo " wrote:

>

> thyroxine is 50 u<(this was a symbol, but I don't know what the word

> is to say what it is)

The symbol is a " u " with a long left hand side, Greek letter

" mu " , denoted micro (10^-6 or millionths), in this case

micrograms. The amazing thing about hormones is how little you

need of them.

Although I just noted Synthroid's latest prescribing advice has

moved from suggesting normal replacement dose is 1.6mcg/kg/day

to 1.7mcg/kg/day. Can't believe 5% more makes a difference, but

sometimes the devil is in the small print.

(hehe if we convert it to imperial units and round to the

nearest mcg that is 11 mcg/stone/day instead of 10

mcg/stone/day, so we can get 10% extra with a little

mathemagics).

[Guest guest]

" vscottbo " wrote:

>

> thyroxine is 50 u<(this was a symbol, but I don't know what the word

> is to say what it is)

The symbol is a " u " with a long left hand side, Greek letter

" mu " , denoted micro (10^-6 or millionths), in this case

micrograms. The amazing thing about hormones is how little you

need of them.

Although I just noted Synthroid's latest prescribing advice has

moved from suggesting normal replacement dose is 1.6mcg/kg/day

to 1.7mcg/kg/day. Can't believe 5% more makes a difference, but

sometimes the devil is in the small print.

(hehe if we convert it to imperial units and round to the

nearest mcg that is 11 mcg/stone/day instead of 10

mcg/stone/day, so we can get 10% extra with a little

mathemagics).

[Guest guest]

Hi ,

There's quite a bit of information out there, and generally 50 ug (mcg) of

thyroxine is added, which is a .05 mg dose.

You'd still want to be monitored with both FT4 and FT3 levels. There are

mixed studies on the effects of block and replace, but it makes good sense so

I hope your doctor is interested in pursuing this. Take care, Elaine

[Guest guest]

Hi ,

There's quite a bit of information out there, and generally 50 ug (mcg) of

thyroxine is added, which is a .05 mg dose.

You'd still want to be monitored with both FT4 and FT3 levels. There are

mixed studies on the effects of block and replace, but it makes good sense so

I hope your doctor is interested in pursuing this. Take care, Elaine

[Guest guest]

Hello, Elaine

You say there are a lot of studies out there, but I have not been

able to locate any information on what happens after the initial

block and replace with 50 micrograms of thyroxine. When one is

trying to achieve remission without the B&R regimen, the dose of

antithyroid medication goes down as lab results improve. With B&R,

does one just continue on with the 30 mg of methimazole and 50

micrograms of thyroxine indefinitely?

Could you, please, point me in the right direction to get more

information?

Thank you.

[Guest guest]

Hi ,

In Block and Replace, you're kept on the original 30 mg of Tap and Synthroid

is added. Depending on your lab results, your doctor can adjust your levels

by either reducing the tap or the synthroid. Like if you're hypo, tap is

reduced.

Have you been to Medscape or PubMed? Do a search on Hyperthyroidisim

treatment or block and replace theray or antithyroid drugs and thyroxine. Or

do a search on Yamomoto and find the original studies using block and replace.

There is also info in ' Clinical Textbook of Endocrinology.

There are also articles linked to the Thyroid Federation of Canada and

articles in their newsletter, most from the 90's saying there are no benefits

from block and replace. Block and Replace isn't as favored here as it is in

Europe, but you'll find information in support of it. I can send you abstract

URLs after Christmas if you haven't found anything by then.

Take care, Elaine