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Q. My TSH level is 0. 5. Should I increase my Thyronorm dose?

Answered by
Dr. Zulfiqar Ahmed
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Jul 09, 2020

Hello doctor,

I have hypothyroidism. I am taking Thyronorm 37.5 mg after the blood report otherwise 25 mg. My previous blood report shows TSH 0.5 in April 2020.

Dr. Zulfiqar Ahmed

Diabetology Endocrinology
#

Hi,

Welcome to icliniq.com.

Your last TSH is 0.5 and you told previously you were taking 25 mcg which you increased to 37.5 mcg. Is it correct?

If your TSH is 0.5 you should have decreased your medication from the dose you are taking not that will increase your medication. So I will advise you to decrease it to 12.5 mcg once daily before breakfast if you were taking 25 mcg previously. Check your test again after three months.

Your TSH target should be from 0.4 to 4. Do you have any symptoms? If you have done TPO antibodies?


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Thank you doctgor,

I have increased the dose due to an increase in TSH level tested on June 13th which is 10.55, so increased to 37.5. When I was taking 50 mg Thyronorm it came to 0.5 TSH as per 25th April report. Hence now, I feel tired easily and feel sleepy after having food in lunch. No other symptoms. Why my dose is not stabilizing? How to be on constant dose?

Dr. Zulfiqar Ahmed

Diabetology Endocrinology
#

Hi,

Welcome back to icliniq.com.

If TSH (thyroid-stimulating hormone) was high then you are right to increase to 37.5 mcg. Maybe the way you are taking your medication will be interfering with drug metabolism so you please check it.

Typically, patients are advised to take their Levothyroxine first thing in the morning, at least 30 minutes but preferably an hour before eating, on an empty stomach, and with only water. The goal is to achieve consistency in taking the medication to avoid fluctuations in thyroid levels and variable control of symptoms.

But for patients who may want to add milk to their morning coffee or cereal, there are alternative dosing strategies, including taking Levothyroxine at night. While not all patients may be candidates for bedtime administration, those who have a consistent sleep routine and do not take other medications before bed might consider making this switch.

It is important to realize that there must be four hours between your last meal or snack when you plan to take your Levothyroxine at bedtime. If you are a nighttime eater, this is likely not a good chance for you to make.


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