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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Should I Increase The Dosage Of Levothyroxine For Decrease In TSH Levels?

Hi I am a 60 year old women and have had hoshimoto disease for many years treated with levothyroxine. My TSH levels have steadily decreased over the years from just under 4 to .394. My doctor has recommended decreasing my medication from .75 to .50. That seems backwards to me. Shouldn t he increase the dose?
Wed, 19 Feb 2014
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Endocrinologist,  's  Response
Hi Dear,

good day. Decision to alter Levothyroxine dose is based on TSH levels. When your levothyroxine dose is in excess, TSH tend to go down ( like in your case). That might have made the doctor to reduce the dose. The TSH of 0.394 is not too bad. I strongly recommend that you do the test once again before altering the dose. TSH is best done in the mornings than evenings. It should be done in a good laboratory using third generation methods like CLIA.

TSH is a hormone produced by Pituitary gland and levels of TSH can vary based on a number of factors. Hence it may be wise to repeat the TSH before you change the dose ( especially so in your case since you have hypothyroidism for many years). Hope this answer helps.
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Should I Increase The Dosage Of Levothyroxine For Decrease In TSH Levels?

Hi Dear, good day. Decision to alter Levothyroxine dose is based on TSH levels. When your levothyroxine dose is in excess, TSH tend to go down ( like in your case). That might have made the doctor to reduce the dose. The TSH of 0.394 is not too bad. I strongly recommend that you do the test once again before altering the dose. TSH is best done in the mornings than evenings. It should be done in a good laboratory using third generation methods like CLIA. TSH is a hormone produced by Pituitary gland and levels of TSH can vary based on a number of factors. Hence it may be wise to repeat the TSH before you change the dose ( especially so in your case since you have hypothyroidism for many years). Hope this answer helps.