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Internist
Internist, Board Certified Physician
Category: Medical
Satisfied Customers: 1066
Experience:  MBBS,MD (USA)Diplomate American Board of Internal Medicine
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Please help me I don't know what to do...I have had results

Resolved Question:

Please help me I don't know what to do...I have had results of my thyroid test today and I have been told I have to gp from 100 to 200mg??????? I have missed quite a few doses of thyroxine meds ,I honestly do not know how many ??? what should I do ???<...
Submitted: 1 year ago.
Category: Medical
Expert:  Internist replied 1 year ago.
Hi there,I am online and wil be happy to answer your questions,i am sorry to hear about your problem, For how long you have been taking thyroxine 100 mg. how many doses you missed?what was your recent tsh level?please reply so i can help you. thanks
Customer: replied 1 year ago.

2/3 years roughly it is not the first time between bloodtests that I have missed doses ,I am not sure of what my tsh level is ....

i have recently moved house so i have a new doctor .she i don't really know her ,and am unsure of how to tell her

Expert:  Internist replied 1 year ago.
The average replacement dose of T4 in adults is approximately 1.6 mcg/kg body weight per day (112 mcg/day in a 70-kg adult), but the range of required doses is wide, varying from 50 to &ge;200 mcg/day. T4 requirements correlate better with lean body mass than total body weight. T4 should be taken on an empty stomach, ideally an hour before breakfast. taking with meals can decrease the absorption of drug. Patients who are treated with T4 usually begin to improve within two weeks, but complete recovery can take several months in those with severe hypothyroidism. it takes about six weeks (six half-lives) before a steady state is attained after therapy is initiated or the dose is changed.T4 dose is ajusted in every 3 to 6 weeks depending on response to treatment and TSH levels.
Expert:  Internist replied 1 year ago.
do you take thryoxine on empty stomach ?you also must avoid any other calcium/iron or any other supplements with thyroxine. they decrease absorption of thyroxine. you should tell your doctor about any probelms you have, she will most likely ask following questions.change in bowel habits. temperature intolerances, eating behavior, sleep disturbances, change in skin texture, cold intolerance, and then depending on your symptoms and TSH levels , your total thyroxine dose will be adjusted if needed
Expert:  Internist replied 1 year ago.
please let me know if you have any questions.kindly leave positive ratings above chat box. thanks.
Customer: replied 1 year ago.

yes i do take it on an empty stomach ,i take it with omeprazole 20mg

Expert:  Internist replied 1 year ago.
thanks for replying.you should not take it with omeprazole or any other antacids. it can decreas absorption.if you have to take omeprazole for other reasons at least 4 hour interval should be observed.
Expert:  Internist replied 1 year ago.
although effect of decreasing throxine absorption is more pronounced with antacids like calcium carbonate , but prolonged treatment with omeprazole can also do the same.am i clear? please feel free to ask any follow-up qeustions, and kindly do leave positive ratings above chat box / click on accept. thanks
Customer: replied 1 year ago.

i have been doing this since 2012!!! my former gp said this was ok to do so

Expert:  Internist replied 1 year ago.
http://www.medscape.com/viewarticle/742089this article also explains the same. if your TSH level is within reference range, and you do not have symptoms, then its okay to use. but i think it is better if you try taking them apart. you can take omeprazole in evening. before mealconsider discussing this with your new pg. as possible reduced effect of thyroxine with omeprazole
Expert:  Internist replied 1 year ago.
The goals of therapy are amelioration of symptoms and normalization of TSH secretion. We aim to keep TSH within the normal reference range (approximately 0.5 to 5.0 mU/L
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