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Dosage for Thyronorm tablets after TSH test.

Resolved Question:

Dear doctor,
I got my TSH test done today and it is 5.42. I am presently taking 50 mcg of Thyronorm tablets.
please advice if dosage needs to be changed.
The previous TSH readings are mentioned below.
May 2014: 6.5
July 2014: 1.9
Jan 2015: 9.14

Category: Endocrinologist

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Category: Diabetologist
Dr. J Muthukrishnan is online now

Expert:  Dr. J Muthukrishnan replied 4 Days.

Thank you for your query.
I would like to know the following about you before answering your question:
Whats your age?
Do you have any heart ailments or osteoporosis?
What other medications have you been taking.?
Are you regular in taking your medications?

Patient replied :

I have consulted with you earlier in Jan and I have attached the trail mail for your reference in a word document.
Whats your age? 32 Do you have any heart ailments or osteoporosis? None. But I am obese. What other medications have you been taking.? None other than thyroid Are you regular in taking your medications? very regular, not missed once

Expert:  Dr. J Muthukrishnan replied 3 Days.

OK, you need to increase the dose of your thyroxine to 50mcg and 75mcg taken on alternate days. This will be equivalent to 62.5mcg daily.
Retest after 3 months.

Patient replied :

Thyroid medicines are recommended to be taken during early morning on empty stomach.
I work nights. I do feel hungry and have a light snack around 4 am. How many hours gap do I need to give after my early morning snack?
My next breakfast time is 10 am.

Expert:  Dr. J Muthukrishnan replied 2 Days.

Ideally, there should be a 8 hour of sleep period before you take thyroid medication empty stomach.
However, considering your shift, that does not seem possible.
Since you're having light snacks at 4, you can take the thyroid medicine around 8/830 am, and then you can take your breakfast 1 hour after that.

Patient replied :

I usually take lemon with warm water (no honey) in the morning on empty stomach. Can i take it with thyroid tablets instead of taking tablets with plain water?
Thanks and Regards.

Expert:  Dr. J Muthukrishnan replied 1 Day.

It is better to take it with plain water.
The reason being lemon makes the water acidic, which will hamper with the absorption of the tablet.
Please take it with plain water.

Dr. J Muthukrishnan
Category: Diabetologist
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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