Thyroid meds dose reduction in weight maintenance

cmriverside

I've been on varying doses of levothyroxine for 25 years. I've been stable on my dosage for probably 6/7 years. I've been experiencing more nervousness and I've been eating way above the normal calories for my age/height/weight in the last couple years. I've been thinking it may be levo-related, and last week I had labs done and my doctor has lowered my dose from 88mcg to 75mcg. Of course the first thing I did was gather all my data regarding weight and net calories and I'm hoping I don't have a struggle to maintain while adjusting. So far so good, no hunger and I'm staying at 1/2 pound per week weight loss numbers for this adjustment period since I have no clue what to expect.

I don't know if the reduced med-level is related to what I weigh, meaning that if I weigh less, I may need less levo? Seems reasonable that it would be the case, but it also seems weird that after so many years suddenly I need to reduce the dose.

So I'm wondering if anyone in long-term weight maintenance and also long-term levo use has any experience to share about it? I'm going to keep meticulous records in the next six weeks until I do follow-up labs. I'll keep it under control, just asking.

Also just a bit sad that maybe that extra 60,000 (yes 60 thousand) calories without weight gain may be med-related. However, cha-ching! Less money to spend on groceries if that's the case!

spiriteagle99

I've wondered about that as well. I am maintaining much too easily, in some ways. I didn't get a blood test last year at my annual, so it is possible that with the weight loss over the past few years my meds are a bit stronger than needed. OTOH, I don't have any signs of overactive thyroid except the fact that I was able to lose weight faster than expected and keep it off while eating more calories than recommended.

cmriverside

Thanks @spiriteagle99 . I guess it's not good to be on too high a dose, either.

I get labs done yearly...I've been eating at fairly high level for two years with all other factors really remaining the same.

Weight stable, same level of daily activity and same level of exercise as before. It must be the meds, just not sure why the meds level changed after years of being stable. I quit drinking several years ago and I eat pretty much all home-prepared meals from whole ingredients. I've cut out most sugary treats. I suppose I could just be improving in all ways? I dunno. I don't think thyroid issues heal themselves - so it's just a mystery.

We'll see what happens with my weight and keeping calories a full level below what I've been doing. (300 fewer daily calories )

MostlyWater

I have no idea. Are you using a specialist or your regular dr?

SummerSkier

Mine has stayed the same since last April during and after losing weight. Of course everyone is going to be different. I was getting them checked about every 3 months because we actually upped the dosage to from 50 to 125/2 daily last year. I haven't been in maintenance that long - only about 6 months now tho. My dosage went up slightly after being on the 50 for about 6 years - I think its aging and depending on what causes your thyroid issue I don't think it ever get's better. LOL.

cmriverside

I did a little research, and apparently dosage is related to age and weight. If we go by the recommended guidelines, I should have been lowered ten years ago. Still doesn't explain why the dose went down now as opposed to in say 2010 - which was three years after I lost my 70 pounds. I'm not arguing or upset that she lowered the dose, I think it's probably past time to do it by several years is all - and it kind of irritates me that they wanted to give me anti-anxiety meds as a first line of defense instead of lowering my thyroid meds. Last year my TSH was 0.9. That is really low - I would think they would have lowered the dose last year.

My gripe is with medical professionals. Why do I have to do all the research to find out this stuff? Isn't this your JOB? Seems like a pretty common medical issue - and it has definite guidelines.

Okay. Rant over for now. We'll see my numbers this year...oh, wait. Another gripe WHY do I have to log onto the internet to get my results? Send me my labs! Get off my lawn.

Okay, now I'm really done. Thank you for reading...if you did.

cheryldumais

Interesting... I feel like although I'm down around 100 pounds that my dosage should be increased. My hair has thinned, skin is dry, headaches are back and bowels aren't working well. I'm also freezing and tired. All symptoms of low thyroid. I'm maintaining on 1400 calories. I wonder why it's so different. I think @SummerSkier is right it depends on what causes the thyroid issue... Mine is damaged and perhaps that has gotten worse. Might be time for another ultrasound... Glad you got it figured out though OP.

not_a_runner

I've not yet been in maintenance long term, (I'm 24 and been on meds for about 10 years, not always kept close track of bloodwork, etc though), but when I took a diet break for a few months last year I did notice that my dosage could have been lowered- via bloodwork and also coming to know the 'feeling' of when I'm likely over medicated.

I also was able to maintain on significantly higher calories than expected (I was losing 1 lb per week on about 2000-2100, worked up to eating 2800 at the time).
ETA I was 5'1'' 180 lbs ^ I'm curious to know where I can maintain once I get to a reasonable weight for my height.

I assumed not being in a calorie deficit and actually feeding my body kind of made everything 'work better'.
I agree on thyroid issues not healing themselves, but I do feel that with improved nutrition mine seems to improve slightly.
I've wondered if 'adaptive metabolism' is sort of a thing. My TDEE decreases when I eat less, and increases when I eat more. I guess that could be just the result of where my numbers are at though. I've never considered my meds to have given me any sort of advantage calorically, but based on my maintenance stint, maybe there is something to it.
I'm pretty active, I lift weights 5 days a week and have done so for a few years, and I've been told that's the likely the reason for my calories being above average.
Definitely something I will pay more attention to in the future!

Thehardmakesitworthit

I have also been on that med for over 10 years. When I asked my doc about lowering the dosage he said that it is not necessarily weight driven like some other drugs.....I may ask again when I go to my physical.

faythe621

My med dosage actually went up from 50mcg to 75mcg when I lost over 100 pounds. I don't think Levo is weight-related necessarily, it's more like weight fluctuation is a side effect of poor thyroid function. I could be wrong, lol.

Brendalea69

faythe621 wrote: »

My med dosage actually went up from 50mcg to 75mcg when I lost over 100 pounds. I don't think Levo is weight-related necessarily, it's more like weight fluctuation is a side effect of poor thyroid function. I could be wrong, lol.

I agree!

hughjazz74

Interesting topic! I too have wondered about this over the years. My endo claims my dosage/function won't affect my weight that much. I've been on 100 mcg for years now and still battling my weight or yoyo'ing I should say! Good Luck to you all!

CSARdiver

cmriverside wrote: »

I did a little research, and apparently dosage is related to age and weight. If we go by the recommended guidelines, I should have been lowered ten years ago. Still doesn't explain why the dose went down now as opposed to in say 2010 - which was three years after I lost my 70 pounds. I'm not arguing or upset that she lowered the dose, I think it's probably past time to do it by several years is all - and it kind of irritates me that they wanted to give me anti-anxiety meds as a first line of defense instead of lowering my thyroid meds. Last year my TSH was 0.9. That is really low - I would think they would have lowered the dose last year.

My gripe is with medical professionals. Why do I have to do all the research to find out this stuff? Isn't this your JOB? Seems like a pretty common medical issue - and it has definite guidelines.

Okay. Rant over for now. We'll see my numbers this year...oh, wait. Another gripe WHY do I have to log onto the internet to get my results? Send me my labs! Get off my lawn.

Okay, now I'm really done. Thank you for reading...if you did.

0.9 isn't low - Optimal range for TSH is 0.2-2.0. Even so this is a population range, so you may "feel" sub par and still be within range. This has more to do with what you have been used to.

All hormones are free cycling, so largely dependent on weight (mass). Think of adding a cup of sugar to a glass vs. a pitcher of water. If you lose a significant amount of weight you will need to adjust any hormone supplement accordingly as you don't need as much to function.

ggeise14

I had my thyroid removed in Feb 2014. Bloodwork had been stable until Dec 2016 when I was close to maintenance (within five pounds). At times I could tell by how I felt (a bit jittery, etc.) and suspected that my meds were off. At my Dec 2016 physical and bloodwork the doc lowered my meds from 125 mg to 113 mg. Stayed on that for 6-8 weeks, more bloodwork then lowered to 100 mg. During 2017 I yo-yo'd weight wise and in Nov/Dec 2017 was more focused. At my annual in Dec 2017 my bloodwork was off and the doc talked about lowering my dose. I asked if I could stay at 100 mg and check bloodwork again in Jan (after the holidays). I had put on 4-5 pounds and made sure I didn't take my thyroid med before having my blood drawn. Levels were ok and no change needed.

Personally, I think my thyroid med is a factor in my weight loss. Last blood draw, they also checked my Free T3 levels and that has been on a slow decrease ever since my thyroid was removed. I need to revisit my thyroid info since I do think that could have something to do with my lack of energy later in the day -- could also be partly my age (54), but it's worth checking into. I don't expect to feel 30 but I get frustrated feeling like someone has unplugged me by 8-9 pm!

cmriverside

CSARdiver wrote: »

cmriverside wrote: »

I did a little research, and apparently dosage is related to age and weight. If we go by the recommended guidelines, I should have been lowered ten years ago. Still doesn't explain why the dose went down now as opposed to in say 2010 - which was three years after I lost my 70 pounds. I'm not arguing or upset that she lowered the dose, I think it's probably past time to do it by several years is all - and it kind of irritates me that they wanted to give me anti-anxiety meds as a first line of defense instead of lowering my thyroid meds. Last year my TSH was 0.9. That is really low - I would think they would have lowered the dose last year.

My gripe is with medical professionals. Why do I have to do all the research to find out this stuff? Isn't this your JOB? Seems like a pretty common medical issue - and it has definite guidelines.

Okay. Rant over for now. We'll see my numbers this year...oh, wait. Another gripe WHY do I have to log onto the internet to get my results? Send me my labs! Get off my lawn.

Okay, now I'm really done. Thank you for reading...if you did.

0.9 isn't low - Optimal range for TSH is 0.2-2.0. Even so this is a population range, so you may "feel" sub par and still be within range. This has more to do with what you have been used to.

All hormones are free cycling, so largely dependent on weight (mass). Think of adding a cup of sugar to a glass vs. a pitcher of water. If you lose a significant amount of weight you will need to adjust any hormone supplement accordingly as you don't need as much to function.

Thanks for commenting, CSARdriver.

My concern or question is twofold: 1. Why now, after 6-7 years at the same dosage/weight and activity level, would the dose change? and 2. How carefully will I have to stay within calories now? I know the second part is going to be wait-and-see, I guess. I suppose this thread will be me reporting how it goes. I'm pretty sure I've been getting "assistance" from the levo with my ability to eat way more than is typical.

cmriverside

So much for my humblegragging about that 2300 calories per day for the past two years at 5'7" 140lbs and in my sixties.

cheryldumais

cmriverside wrote: »

So much for my humblegragging about that 2300 calories per day for the past two years at 5'7" 140lbs and in my sixties.

I'm green with envy, lol. 2300 calories sounds like heaven to me.

ggeise14

Me too!

xLyric

I don't see why your calorie goal would change. What do you think the levo is doing that would allow you to eat 'more' than you think you should be able to?

The only thing that would make sense is that having a correctly functioning thyroid often gives you more energy than you had before, and thus you burn more calories, allowing you to eat more. It wouldn't normally give you so much extra energy that you burn more than the standard statistic for your age/weight/height, though.

If your calorie goal does lower and you have to adjust down, it's because you're moving less or eating more. Is that a byproduct of how the levo affects you? Possibly, energy-wise, though I think very unlikely, since your dose only would have been lowered to keep it stable. Stable is stable whether your dose is high or low.

I've been on several different doses as we've figured out where my 'stable' level is. It's never had any affect on my calorie burn. Blaming the levo definitely wouldn't be my first guess if it had changed.

_BlahBlah_BlackSheep_

I also don't believe it's weight related. I weigh less now than I did 10 years ago and my dosage is higher. Also, I've never adjusted my calorie intake when my medication dosage changes (which it does every few years). I don't see that the two are related and I maintain my weight without issue.

deannalfisher

cmriverside wrote: »

CSARdiver wrote: »

cmriverside wrote: »

I did a little research, and apparently dosage is related to age and weight. If we go by the recommended guidelines, I should have been lowered ten years ago. Still doesn't explain why the dose went down now as opposed to in say 2010 - which was three years after I lost my 70 pounds. I'm not arguing or upset that she lowered the dose, I think it's probably past time to do it by several years is all - and it kind of irritates me that they wanted to give me anti-anxiety meds as a first line of defense instead of lowering my thyroid meds. Last year my TSH was 0.9. That is really low - I would think they would have lowered the dose last year.

My gripe is with medical professionals. Why do I have to do all the research to find out this stuff? Isn't this your JOB? Seems like a pretty common medical issue - and it has definite guidelines.

Okay. Rant over for now. We'll see my numbers this year...oh, wait. Another gripe WHY do I have to log onto the internet to get my results? Send me my labs! Get off my lawn.

Okay, now I'm really done. Thank you for reading...if you did.

0.9 isn't low - Optimal range for TSH is 0.2-2.0. Even so this is a population range, so you may "feel" sub par and still be within range. This has more to do with what you have been used to.

All hormones are free cycling, so largely dependent on weight (mass). Think of adding a cup of sugar to a glass vs. a pitcher of water. If you lose a significant amount of weight you will need to adjust any hormone supplement accordingly as you don't need as much to function.

Thanks for commenting, CSARdriver.

My concern or question is twofold: 1. Why now, after 6-7 years at the same dosage/weight and activity level, would the dose change? and 2. How carefully will I have to stay within calories now? I know the second part is going to be wait-and-see, I guess. I suppose this thread will be me reporting how it goes. I'm pretty sure I've been getting "assistance" from the levo with my ability to eat way more than is typical.

it could be that there was a slight change to the forumation or they are using a different brand - that necessitated a change; i found when my lean muscle mass increased my dosage increased