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Old 03-02-2011, 06:30 PM   #1
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Thyroxine dosage based on weight

I've recently been told that the amount of thyroxine you need to take when you are hypo is dependent on weight and I've then found this information:

Quote:
The American Association of Clinical Endocrinologists Thyroid Task Force ... recommends a mean replacement dosage of LT4 of 1.6 [micro]g/kg of body weight per day with initial dose ranging from 12.5 [micro]g daily to a full replacement dosage based on the age, weight, and cardiac status of the patient.
Has anyone been weighed by their doctor and their possible dosage worked out using this formula? Or been told that they might have to go up to around this amount based on their weight?

 
Old 03-02-2011, 07:42 PM   #2
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Re: Thyroxine dosage based on weight

I've read dosing guidelines based upon weight...and I guess it's a starting point. However, many things affect the absorption of the meds and you'll find that some people require much larger doses than their weight would indicate.

Better to dose with the thought of complete symptom elimination....which will most likely result in thyroid hormone levels towards the top end of the range.

My doctor started me out on the standard 25mcg dose....and it actually brought my thyroid hormone levels to the top of the range (admittedly, I had debilitating hypo symptoms with levels just below mid-range).

That dose "lasted" two months....and, almost one year into taking thyroid hormone replacement meds, I'm still not sure if I'm at my ultimate dose - all I care about is feeling good.

Thankfully, I've been able to achieve that since I found my optimal thyroid hormone levels and my doctor works with me, adjusting my dose to keep my levels where they need to be.
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Old 03-03-2011, 09:03 AM   #3
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Re: Thyroxine dosage based on weight

Almost no doctor uses weight as a guideline for dosing thyroid meds. (That's one of the few things about it they do right!)

I once found a study that demonstrated why this isn't a good method. They found that muscle "takes up" thyroid hormone and that fat is thyroid-resistent. So... People who have a higher fat to lean ratio need less hormone than those who are very muscular, even when they are equal in weight. Sedentary ones need less than those who are active. The variables go on and on.

There are average full replacement doses that are typical for average patients, no matter what their scales say.

 
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Old 03-03-2011, 09:48 AM   #4
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Re: Thyroxine dosage based on weight

midwest1

Thanks SO much for sharing the highlights of that study. I had thoughts along those lines but wasn't sure if they were accurate.

I have an 11-yr post-RAI friend who is tiny (under 100 lbs) - no noticeable muscles and a sedentary lifestyle.

I still have my thyroid (no Hashi's/high TPOab's for me - just Graves' antibodies doing their thing)....I am pretty solid since I workout with weights for 50-60 min/day and have a pretty active lifestyle.

She takes 100mcg levo/day.....I take 88mcg along with 5mcg Cytomel.

Case in point that weight isn't a good guideline at all....
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Last edited by cd37; 03-03-2011 at 09:48 AM. Reason: typos

 
Old 03-03-2011, 10:14 AM   #5
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Re: Thyroxine dosage based on weight

True.
As I recall reading, there are thyroid receptors on muscle tissue. No receptors on fat.

 
Old 03-03-2011, 01:04 PM   #6
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Re: Thyroxine dosage based on weight

That's really useful information as I was also wondering if a person lost weight on being treated for hypo would they have to watch their dosage and maybe lower it due to the weight loss. But it's fat not muscle a person loses so that's not an issue.

 
Old 03-05-2011, 06:11 PM   #7
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Re: Thyroxine dosage based on weight

They found that muscle "takes up" thyroid hormone and that fat is thyroid-resistent. So... People who have a higher fat to lean ratio need less hormone than those who are very muscular, even when they are equal in weight. Sedentary ones need less than those who are active.

That's interesting as I'm on 100 mcg and my sister-in-law is on 150 mcg and I'm leaner and more active than she is.

Sue

 
Old 03-06-2011, 04:19 AM   #8
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Re: Thyroxine dosage based on weight

I think this just goes to show you that there are just as many exceptions to treating thyroid disease as there are rules

Doctors should medicate with the goal of complete symptom elimination in mind rather than adhere to these "rules". Everybody's body is different.
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