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Thyroidectomy and excess thyroid supplementation

Resolved Question:

Hi, I've had a complete thyroidectomy a few years ago. I've been feeling crappy the last 2 months and after seeing my ENT who performed the Sx, and him thinking it was allergies and sinuses, turns out i went to the ER because of how bad i was feeling this past Monday and my thyroid levels were way off. TSH was .080 uIU/ml and T4 was 16.4 ug/dL.

Doctor in the ER told me to stop my Synthroid (levothoroxine) immediately and follow up with ENT for new dosage. ENT wont be seeing me till next Monday. I'm worried that I'll go Hypo in the meanwhile and start crashing. can you suggest a dose i can start right now so I don't? I have a bunch of different doses here between myself and me what i have used so i can pretty much put what i need together for a few days. My weight is 275lb, I'm 6'-2".

Thanks

Category: Endocrinologist

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Dr. J Muthukrishnan
Category: Diabetologist
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 28 Doctors Online

Expert:  Dr. J Muthukrishnan
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Hello,

Thank you for your consult at DoctorSpring.com.

From your report, it is obvious that you are taking an excess dose of levothyroxine. You haven't written what dose you are taking.

Instead of stopping the medication totally, I suggest you reduce the dose. I will be able to suggest the dose once you tell me what dose you are taking.

Regards
Col (Dr) J Muthukrishnan, SM
Senior Adviser (Med & Endocrinology)


Patient replied :

Thanks, Dr. I meant to include that information in the original question. I have been taking 250 mcg daily. Also, if it matters, I am a 35 y/o male.


Expert:  Dr. J Muthukrishnan
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In that case, reduce the dose to 200mcg daily and retest after 6 weeks. If TSH returns to normal, you can continue this dose, or else it will need further adjustments.

Dr. J Muthukrishnan
Category: Diabetologist
Experience: 
Fellowships/Training: 
1. 10th Asia-Pacific Pediatric Endocrine Society  Fellows meeting, Seoul, Korea, Oct 2008
2. Eighth ICMR Course on Genetics and Genetic Counseling – Jul 2008 – SGPGI, Lucknow
3. Annual Certificate Course on Endocrinological Laboratory Techniques at National Institute of Nutrition (ICMR) Hyderabad,India, ( Aug-Sep 2006) 
Fellowship: Endocrinology, Diplomate of National Board, National Academy of Medical Sciences, New Delhi, 2008, Medwin Hospital, Hyderabad
Senior Residency: Diplomate of National Board (General Medicine), National Academy of Medical Sciences, New Delhi, 2002
Residency: MD, General Medicine, 1997-2000, Armed Forces Medical College, 2nd position in University
Medical School: MBBS, Armed Forces Medical College, 1992
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