Re: Elaine - Should I Be Starting BRT?

October 2, 2003

Hi Barb,

I don't think you need to increase the Tap. I'd just add the 25 mcg of

Synthroid. Studies show that a maintenance dose of 2.5-10.0 mg Tap daily is

effective so your 2.5 dose should be fine. With your levels being borderline low

and

steadily falling, your thyroid gland has to work hard to prevent

hypothyroidism. TSH itself causes thyroid cells to grow and this encourages

antibody

production.

You'd do better with a TSH of about 0.4 and thyroid hormone levels near the

high end of the normal range. I think adding the Synthroid and leaving the Tap

alone should get you there. You may even need a bit more Synthroid than this.

There isn't too much difference between a 107 and a 120 TSI level especially

within only a few months. TSI stay in the circulation for several months

before breaking down. So you could have reduced TSI production but not see a

change

just yet. With the Synthroid your gland is sort of " put to sleep, " and this

will help your immune system. Ideally, you want the lowest dose of meds needed

to do the job. A higher dose of ATD than is needed to slow down thyroid

hormone production offers no extra benefits but ups the risk of side effects.

Take

care, Elaine

October 7, 2003

Hi Alice,

Studies show that the longer you're on ATDs the greater your likelihood of

permanent remission. For this reason, many doctors like to keep patients on ATDs

for 12-18 months even if they appear to be in remission. To keep thyroid

hormone levels from falling to low, while on ATDs, B & R is a perfect solution.

It probably is best to find a doctor experienced with their use or one who is

at least interested in using them. There are many studies on PubMed

describing the use of B & R, and there is info in most endocrinology or

thryoidology

textbooks. Take care, Elaine

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