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I have a friend who has been on HRT for 4 years, she takes levothyroid 25 mg once daily, recently she visited her doctor at Kaiser and asked if she could get off her medicine for the rest of her life, the doctor advised her to take the dose of 25 mg EVERY OTHER day and come back in a month to check her thyroid function( TSH level) and see if she is able to stop her treatment regimen completely,
Yeah, forgot to mention she had a hemithyroidectomy in the past and her current status is well controlled and euthyroid for 4 years
DEAR DOCTORS, do you think that doctor will be able to get a right thorough picture of my friend's thyroid status?
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You gotta believe ur doctor, what makes u think s/he may be not able to treat ur friend in a competent manner ?
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just a simple fact, that T 1/2 of thyroid hormone is 14 days, and in order to evaluate her condition you need to get her off the medicine for at least 2 weeks and then measure her TSH,
Don't you think so???
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and sorry in this case you gotta pick another doctor, that's a competent way
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Look, it is not as simple as it may seem, each doc has its own way of going about, from what I can decipher from ur description is that s/he is trying to taper the dosage and then see what is the response to this maneuvre, it seems logical to me.
On the other hand u recommend abrupt cessation of thyroxine, it may not be a very wise decision, as ur friend's thyroid is already small coz of prior surgery, and now coz she is on external thyroid medication, it is likely to be suppressed further, so it would be better to taper the medicine and let the gland recover rather than precipitate a crisis by abruptly stopping the drug.
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tapering of thyroid hormone would not affect TSH level in any way, in this situation you have to stop, plus 25 mg doesn't make any difference, is not that dose that can precipitate a crisis after cessation.
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I agree wid the crisis part, it is a very small risk, but a real one none the less.
But I certainly don't agree wid the TSH theory u have, wud u explain me why tapering of thyroxine won't affect TSH, I think it should make TSH rise as there wud be no more a feedback effect.
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listen, the purpose of this procedure to see how your thyroid works on its own, so if T1/2 is 2 weeks, you need to have her off for 2 weeks to get any additional doses that she takes washed off.
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practising medicine is way different from the theory we stuff ourselves with....first of all according to the Hippocratic oath, we are to refrain from jugding each one's approach to treating thier patients. if u have any problems with how some docs practise medicine it should not be discussed openly in a public forum. u nor anyone else in this forum has no right to judge. as professionals we are to maintain equal respect and not to look upon each others approach to medicine condescendingly.
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clst - she is just asking for all of our opinions and not mentioning Names. Whats Wrong with that?? Would you stay Silent or would you consult another professional if you felt that you may not be worked up the rite way. Would you sticj with the same Doc or would you consider 2nd and 3 rd and 4th opinions? Sharing information is very Empowering not only for Pts but also for Doc'. Always Ask, never stay silent, its your Rite.
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