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25 mcg? 50? Effective Levothyroxine doses are 200 to 400 mcg

Discussion in 'T4' started by youngandold, Dec 1, 2015.

  1. youngandold

    youngandold Member

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    I keep on reading reports that large thyroid dosages are required.
    This is specially true on old reports long before TSH tests were available so they focused mostly on symptoms and body temperature.

    Are 200 mcg the absolute minimum to feel completely well?

    Could modern insufficient 25 or 50 mcg dosages explain why most people feel worse on Levothyroxine?
     
  2. OP
    youngandold

    youngandold Member

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    The dosage range
    that’s safe and effective for most patients is between 2-to-4 grains
    (120-to-240 mg) of desiccated thyroid. The equivalent dosage range
    for T4 is 200-to-400 mcg (0.2-to-0.4 mg). If you’re not improving
    within this dosage range, you may have thyroid hormone resistance, or
    the potency of the tablets or capsules you’re using may be lower than
    what’s stated on the label.

    http://web.archive.org/web/201010301944 ... herapy.htm
     
  3. OP
    youngandold

    youngandold Member

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    Seldom is low-dose T4 effective in keeping
    metabolism normal in most body tissues. In fact, the low dose of T4
    may actually slow metabolism further. This can happen when the T4
    dose lowers the pituitary gland’s secretion of TSH, which in turn
    reduces the thyroid gland’s secretion of T4 and T3. If the patient’s T4
    dose is too low to compensate for the thyroid gland’s reduced release
    of T4 and T3, metabolism slows further. To the patient's surprise, she
    develops more symptoms of hypothyroidism after beginning the use of
    T4 alone.

    So this proves that low doses of Levothyroxine are ineffective and worse than high doses?

    So they should aim to get T4 near the top of the range.
     
  4. answersfound

    answersfound Member

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    200 mcg Levothyroxine is equal to 2 grains of armour. So 400 mcg is 4 grains. 4 grains is full thyroid replacement. I would guess the people who require 400 mcg had their thyroids removed.
     
  5. YuraCZ

    YuraCZ Member

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    Problem is. What if all this T4 will convert to rT3? Here in Czech we don't have rT3 test available. :( Right now I'm taking 125 mcg of T4. I was also trying 25 mcg of cynomel from France I with zero difference( TSH was lower..) My thyroid is completely shut down because when I was off T4. My TSH was 19 and I was literally dying.. So is a good idea to try larger doses of T4? But like Peat was describing the story with woman on 400 mcg of T4 in coma. So I don't know.. But I think increase dose at 150 mcg for a while and see what happens is not bad idea..
     
  6. OP
    youngandold

    youngandold Member

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    At first I thought the same thing
    These doses are too large so they must be for those on full replacement after thyroidectomy.

    But then I remembered posts in websites about using thyroid for plain weight loss (many of those with naturally 'normal' labs and no mention of hypothyroidism symptoms other than weight gain)
    They also advised to use hundreds of mcgs of Levothyroxine as lower doses just suppress TSH and natural thyroid production thus ending up the same or worse.
     
  7. OP
    youngandold

    youngandold Member

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    It doesn't matter if rT3 is formed as it doesn't prevent T3 from binding and activating the receptors. Look at naturally hyperthyroid people as they have extremely high rT3 levels yet still have nasty hyperthyroid symptoms.

    You should get new lab tests done as the lower TSH may have lowered thyroid output so much that T3 and T4 remain the same despite the supplementary thyroid tabs.
     
  8. Giraffe

    Giraffe Member

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    Until here it is correct.

    Most hypothyroid people have a sluggish liver. They are not converting enough T4 to T3. They need to supplement a combination of T4 and T3.

    Dr. Peat has quite often talked about it. Last I think in this 2015 interview KMUD: 10-16-15 Current Trends on Nitric Oxide. Please check the link.
     
  9. OP
    youngandold

    youngandold Member

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    So the bottom line is that EVERYBODY should aim at FULL replacement doses as the lower TSH sharply lowers natural thyroid production?

    This reminds me of those aging guys getting extra testosterone injections.
    In the long run their natural testosterone production gets so suppressed that they must end up with full replacement doses, often for life.
     
  10. answersfound

    answersfound Member

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    No. Everyone should use the dose that gets their body temperature to about 99 degrees. Labs are overrated. I don't think Synthroid is the best option because you don't get the feedback that a med with t3 gives you when you take too much. Some people may initially need 2-3 grains and then scale back to just 1 grain. 99% of thyroid patients are not Peatarians so there are tons of things they are doing wrong, which therefore, makes them require more thyroid.
     
  11. Spondive

    Spondive Member

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    I'm still having trouble with the logistics of temperature..it seems so inaccurate. Using skin vs rectal vs oral and the kind of thermometer etc. Is it picking one and watching a trend? For example using a infrared skin temp probe I might get 97.6 on forehead and temple and using same device get 99.8 axillary
     
  12. OP
    youngandold

    youngandold Member

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    Unfortunately, both studies were still operating under the flawed
    assumption that whatever amount of T3 was added to any patient’s
    treatment, an equivalent amount of T4 had to be subtracted. Using
    my approach, the T4 dosage would have been increased in many
    patients due to its level still being suboptimal prior to the addition
    of T3 being added. Because of the feedback loop in which a high T3
    level would suppress the TSH level, which would then cause the T4
    level to drop because of less stimulation by TSH, the addition of T3
    would have actually lowered the total amount of T4 in the blood
    stream, thus requiring additional amounts of T4. On the increased
    intake of T4 and the addition of T3, these patients would have really
    experienced improved thyroid function and physical and mental
    well-being, and not just the minimal improvements noted in these
    articles.

    http://www.westonaprice.org/modern-dise ... pt-secret/

    Since the early 1990s, Dennis Wilson, an MD in Florida, has been
    advocating a T3-only approach to the treatment of fatigue and low
    body temperatures that has been helpful in some patients. But it is
    puzzling as to why he should eschew T4 treatment altogether,
    especially since T3-only treatment lowers the T4 level to below or at
    the low-normal blood level and, as we know, the brain requires a
    good blood level of T4 to ensure sufficient crossing of the chronoid
    plexus (blood-brain barrier) by sufficient T4 for conversion to T3 in
    the brain cells. My suspicion is that many of Wilson’s patients, while
    attaining good physical thyroid function, remain deficient in the
    brain’s thyroid function for memory and mood.
     
  13. OP
    youngandold

    youngandold Member

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  14. tara

    tara Member

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    People seem to commonly not get diagnosed as hypothyroid unless their TSH is above a pretty high threshold - typically around 4 o r 5, depending on country. I can imagine that such people might need higher doses of suplementary thyroid than someone with less dramatic lab results who is non-the-less suffering hypothyroid symptoms. Doesn't necessarily mean no-one benefits from a much smaller dose.
     
  15. Spondive

    Spondive Member

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    , as we know, the brain requires a
    good blood level of T4 to ensure sufficient crossing of the chronoid
    plexus (blood-brain barrier) by sufficient T4 for conversion to T3 in
    the brain cells.


    Do we know this for sure?
     
  16. Spondive

    Spondive Member

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    I'm asking the question youngandold because you seem to have a good grasp of thyroid..I'm interested in that when using T3 or a combo t4/t3 I also see serum levels of low normal t4 if a combo product is not high enough..also with a combo product if high enough in order to get t4 levels in a normal to high range the T3 serum levels usually are in the supra physiological range..thoughts?
     
  17. Giraffe

    Giraffe Member

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    Yes, pick the one that works well for you and stick with it.

    The text the OP posted is mostly copied from the websites that are linked, though the citations are not marked clearly as such.

    I am not sure someone wants a T4 in the upper normal range. If someone has hypothyroid symptoms with a high T4, this means that the tissue (mainly the liver) can not convert enough T4 to the active T3. More supplemental T4 will downregulate the thyroid gland's production even more, hence even less T3.

    Hypothyroid symptoms despite a normal or normal high T3 mean that something else is hindering metabolism.

    Dr. Peat has talked in many interviews about thyroid function, the 2011 radio show "The Thyroid" being one. In the interview I linked above post 112302 Peat and the herb doctors shortly discussed thyroid supplementation.
     
  18. Blossom

    Blossom Moderator

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    I sent you a private message youngandold.
     
  19. Daimyo

    Daimyo Member

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    1 grain of dessicated thyroid (or most other brands) is 60 or 65 mg of dessicated thyroid extract. That's about 35-39 mcg of T4 and 8-9 mcg of T3.
     
  20. Spondive

    Spondive Member

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    No most people I see that have had total thyroidectomy are on a dose of around 150 to 200 T4 ...their endocrinologists dose by their TSH only
     
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