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THE Q & A

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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ForumForumDiscussionsDiscussionsQuestion and An...Question and An...How to monitor using ATDs?How to monitor using ATDs?
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 8/18/2008 12:21 PM
 

I use anti-thyroid drugs for my course of treatment. What is the best way for me to approach using this drug protocol regarding lab work, understanding symptoms as they change, how often I need to see a doctor, what kind of doctor?

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 8/18/2008 2:13 PM
 
 Modified By Elaine  on 8/18/2008 2:25:07 PM

Hi Cy,

Ideally, you would have started out with a higher starting dose, for instance 20-30 mg methimazole or 200-300 mg PTU.

As soon as FT4 fell into range, regardless of the TSH level, your dose should have been lowered to what's called a maintenance dose. This is usually 2.5-10 mg daily for methimazole and 25-150 mg daily for PTU.

Gradually, over time the dose would be lowered based on your FT4 level. You want to make sure your FT4 is at least at mid-range and preferably closer to the high end of the range depending on your symptoms.

If your FT4 is at mid-range, for instance, and you're noticing symptoms of hypothyroidism, your levels could be, while normal, too low for your body's needs. In this case, your ATD dose would need to be lowered a bit raising it closer to the high end of the range. It's a good idea to have regular FT4 for monitoring your meds along with a TSH every now and then as it can quickly predict a move into overt hypothyroidism and it can help predict remission.

If FT3 was elevated at the time of diagnosis then you'd want FT3 levels as well at least until they're back within range. In general, it takes longer for FT3 than FT4 to fall. But since we have so much more FT4 than FT3 dosing is usually based on the FT4 level.

You want a doctor with experience using meds who's willing to work with you. This could be an endocrinologist, family practice doctor, internist, naturopath, or osteopath. A doctor who you can communicate with means more than his or her title.

If you're on a maintenance dose and your labs are stable, you could have follow-up appointments every 2-3 months. But if you were to notice any changes in symptoms you'd want to schedule an appointment sooner.

Best, Elaine

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 8/18/2008 3:01 PM
 

Thanks, Elaine, for such a thoughtful reply. I'm sure many will get great value out of it.

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TO USERS: Q&A posts are visible to all readers. Users can delete their own threads at any time. Users must provide information which is true and correct to the best of their knowledge as well as provide sources or references to any health / medical information if not taken from personal experience. All users including the moderator must behave at all times with respect and honesty. Advertising and self-promotion is not allowed. The moderator or site administrator has the right to ban users with or without warning for not following the basic rules of this site. All posts by default are not to be considered that of medical professionals unless otherwise indicated. As sole moderator, Moore has no conflicts of interest in the sponsorship of this forum.

 

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