Block and Replace Advise - Question and Answer Forum - Elaine Moore Graves' Disease and Autoimmune Disease Education

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Wednesday, February 08, 2012

..:: Q & A ::..

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Welcome to The Q&A with Elaine Moore. Registered members are invited to ask any question of Elaine Moore on autoimmune diseases, Graves' disease, other thyroid diseases and subconditions, laboratory work, traditional and complementary medicine, triggers and environmental influences, thyroid and immune disorders in pets and animals, and other relevant areas of inquiry.

Each thread represents one question with one answer and will only appear at the time it is answered. Once answered, further replies cannot be made to the same thread since each thread represents only one question. A new thread will need to be started for additional questions.

Questions are answered solely by Elaine Moore, a medical writer and clinical laboratory scientist, MT, CLS, with more than 30 years of experience in immunology. Moore has also authored and edited over a dozen books in the area of health sciences and is an editor for McFarland Publisher's Health Topics Series.

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Block and Replace Advise

6/28/2010 4:05 PM

LaKeya

Joined: 6/28/2010

Posts: 1

Block and Replace Advise

Hello Elaine,

I was diagnosed with Graves Disease about 4 years ago. Initially it took about 2 years to get my levels under control using Tapazole. My doctor took me off and I immediately went back hyper. It was a very difficult time with all the emotional and physical symptoms. Once I got back to normal, I have been on only 5mg of Tapazole he wanted me to go off again.

Since I was uncomfortable with this I found a new doctor who monitored my levels and then place me on Block and Replace. My last lab before the Block and Replace was as follows.

TSH - 3.52

T4 Total - 10.1

T4 Free - .9

T3 Total - 111

The doctor put me on the following regiment - I am a 5-11 170lbs

50mcg Synthroid in AM and 5mg of Tapazpole in PM for 2 weeks

75 mcg Synthroid in AM and 5 mg of Tapazole in PM for 2 weeks

75mcg Synthroid in AM and 0 mg of Tapazole until our next appointment in September.

I just finished my first week and have been very tired. I would appreciate your feedback. Are we going in the right direction? I'm wondering why I am being taken off the Tapazole during this. (Realized it was strange once I started to research). Is it too soon to be feeling the affects? When do you suggest I get another lab?

Thank you,

LaKeya

6/30/2010 1:04 PM

Elaine

Joined: 8/1/2008

Posts: 3174

Re: Block and Replace Advise

Hi LaKeya,

Your thyroid hormone levels are too low right now. Your doctor should be adjusting based on you and your labs rather than following a protocol, and he may make some changes based on your labs. Right now, increasing the Synthroid or lowering the Tapazole would work.

There is a popular and effective block and replace protocol in which Tapazole is gradually reduced and the patient stays on Synthroid alone. But usually, this is a gradual process and the patient gets to this point after 6 months or so. The idea here is that the gland is then slowed down and it stops producing any hormone. With the gland put to sleep, thyroid antibody production declines and the patient eventually moves into remission. Of course, the individual doses and when the patient goes on synthroid alone have to be based on the blood levels. As long as when one gets to the point of being on Synthroid alone, their FT4 and FT3 would need to still fall into range, usually near the high end of the range. If someone wasn't ready for Synthroid alone, they'd need to still be on a little of the ATD. So I think the idea is good if it's done right and custom-tailored for the patient. Best to you, Elaine

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Block and Replace Advise

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