Question about PTU maintenance dose

[Guest guest]

Hi,

You can't count on TSH because of the lag etc but you want your FT4 near the

high end of the normal range not the low end. While most people can be

maintained on 100-150 mg daily, I'd imagine there are people with mild

thyroid elevations that can get by on less. But like I mentioned, this could

also be an indication that you're heading toward remission. You probably need

a TSI level to tell if this is the case or a total TSH receptor antibody test

which includes both stimulating and blocking antibodies. Remember that 20% of

people on ATDs or using no treatment spontaneously move into autoimmune

hypothyroidism so this is always a consideration.

For now, you probably do need levothyroxine added or a reduction in the PTU

and the appropriate antibody tests to see what's going on. Take care, Elaine

[Guest guest]

Hi ,

If your dose was reduced since those labs you should be ok. And if your

thyroid hormone levels are continuing to fall, you should have no problem

waiting another week or two for your blood tests. Happy holidays, Elaine

[Guest guest]

Hi,

I saw that Elaine wrote:

> Since most everyone can be maintained on 100-150 mg daily after the

> initial 6 weeks, this isn't generally a problem.

I've been on PTU since Oct. 24, 2002 and my dose was just reduced

yesterday to 25/12.5/12.5 mg per day. I had started out at

100/100/100 mg per day and have my dosage reduced each time lab

results have come back.

My question is, is 25/12.5/12.5 mg per day of PTU too low of a dose

to help me reach remission? Should I actually be on a higher dose

and be taking Synthroid too as replacement?

I do not have my latest lab results in my hands yet (my copy should

arrive today or tomorrow) but I was told my TSH is normal and FT4 is

just a little low. The previous labs my FT4 was on the low end of

the normal range.

I was in hopes they were going to start me on replacement hormones

too this time as I've been gaining weight easily, am very achy and my

skin is very dry. But, the endo thought just reducing my dose would

be enough.

Thanks for your insights!

[Guest guest]

Hi Elaine,

I had asked him at my last appointment if in January we could test my

TSI levels again and he had said it would be too soon. I'll have to

see if I can convince him to test that and maybe even my FT3 again.

I'll see if I can get him to do the total TSH receptor antibody test

instead of just TSI too.

You wrote:

> For now, you probably do need levothyroxine added or a reduction in

the PTU

> and the appropriate antibody tests to see what's going on.

By this, do you mean that my dose should be reduced beyond the

25/12.5/12.5 mg per day that it was just decreased to, or do you mean

that this current reduction is a step in the right direction? I'll

see if there is any way I can get them to prescribe levothyroxine too.

Here's my next question: Since I'll be traveling most of next week

for Christmas, is it going to be " OK " to wait to do these tests until

the week of New Years? Or, do I need to really try to get my dr.

office to do something today?

Thank you for all your help!

> Hi,

> You can't count on TSH because of the lag etc but you want your FT4

near the

> high end of the normal range not the low end. While most people can

be

> maintained on 100-150 mg daily, I'd imagine there are people with

mild

> thyroid elevations that can get by on less. But like I mentioned,

this could

> also be an indication that you're heading toward remission. You

probably need

> a TSI level to tell if this is the case or a total TSH receptor

antibody test

> which includes both stimulating and blocking antibodies. Remember

that 20% of

> people on ATDs or using no treatment spontaneously move into

autoimmune

> hypothyroidism so this is always a consideration.

> For now, you probably do need levothyroxine added or a reduction in

the PTU

> and the appropriate antibody tests to see what's going on. Take

care, Elaine

>

>

>

[Guest guest]

daisyelaine@... wrote:

>

> but you want your FT4 near the

> high end of the normal range not the low end.

I thought the most common fT4 values was below half way on most

reference ranges? It is the normal advice for fT4 to be high in

range for those on thyroxine treatment but that I thought was to

make up for the lack of T3 secretion by the thyroid.

Now I'm curious - do you have frequency distribution of fT4

results Elaine?

> While most people can be maintained on 100-150 mg daily,

> I'd imagine there are people with mild

> thyroid elevations that can get by on less. But like I mentioned, this could

> also be an indication that you're heading toward remission.

Or odd cases like mine where I relapsed after thyroid surgery,

so have a very active remenants of a thyroid suppressed on 50mg

a day. Although I don't think he can be so small a remenant if I

can feel him on swallowing when he is inflamed.