Getting to the correct levothyroxine dose

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I had a 4cm tumour removed in October 2019 and received a diagnosis of follicular cancer later that year. The remaining thyroid was removed in August 2020 and I had RAI in early October 2020. I went on to 175mg of levothyroxine 8/20, reduced to 150mg in 10/20. Oncologist advised my TSH should be well suppressed for period to 8/21. At that stage thyroglobulin level was almost undetectable so good from cancer aspect. Oncologist said she would steadily reduce my dose so that TSH would rise to between 0.5 and 2. Issue is that despite steady reductions to 100mcg my TSH level is not moving and remains at 0.06.Finding it difficult to stop putting on weight and now weigh 5kg more than I did at time of RAI. Anybody had a similar experience?

  • Hi . I just dropped by and noticed you've not yet had a reply, I have a different type of cancer so I'm sorry I can't help. Whilst waiting for the members here to come along and answer it might be an idea to give the Macmillan support helpline a call on 0808 808 00 00 and speak to a nurse.

    I've been on Levothyroxine for years following a sub-total thyroidectomy back in 2002 and my levels don't change so I hope you get an answer soon.

    All the best, B xx


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  • Hello

    This is certainly not a standard response to reducing the dose. 

    Have you been on the same brand of thyroxine throughout? Sometimes changing brands can mess with things.

    Are you taking any other medication - including herbal supplements or vits and mins?  Lots of things can interfere.

    Logic tends to make us think that a low TSH will make us burn up all the food we eat. The problem is that when TSH is too low, you can find it makes you constantly hungry.  I remember my oncologist (when I was suppressed) asking me if I found I could eat anything and not put on weight. I laughed in his face and asked which crazy 'expert' had told him that story.

    If this continues to be a problem. see if your MDT will agree for you to see an endocrinologist. 

    Best wishes

    Barbara

    “Scars are tattoos with better stories.” – Anonymous

  • Thanks for your reply. Same brand except when I have to take 25mcg. Also take lansoprazole and Vit D but I am quite disciplined about the time of day I take each med. I am to take only 75mcg at weekends and 100mcg on weekdays. i weigh 90kg so seems like quite a low dose. Think I will stay on reduced dose for the next 6 weeks, have my blood test but if things not heading in the right way will as you suggest seek out a chat with my endocrinologist. Thanks for your support.