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Why must one wait eight weeks between adjustments for low thyroid medication?

The eight-week wait between thyroid medication adjustments can be hairy if the last adjustment wasn’t sufficient to correct the hormonal imbalance.

Typically, the low thyroid patient will have a blood test to determine how much bioidentical hormone is needed on a daily basis to restore thyroxine levels to normal.

It takes eight weeks for the dose’s optimal effect, or ultimate effect, to manifest itself.

This is why the low thyroid patient must wait eight weeks in between adjustments for the medication.

“This is due to the slow effect of the typical formulations used to treat hypothyroidism, which are T4 only (thyroxine, Synthroid and Levoxyl),” says Dr. Kent Holtorf, MD, thyroidologist and founder of Holtorf Medical Group in California.

He continues, “With the use of T4/T3 combinations and T3, which are quicker acting and more effective, the tests can be done much sooner at 2-3 weeks.”

Unfortunately, not all medical establishments rely upon this more definitive testing and treatment for low thyroid, and as a result, some patients suffer needlessly in between the dose re-evaluations.

So if your TSH level is abnormal, indicating low thyroid, you will be given the medication.

It may seem that it’s not working, however, because several weeks later, you may still be suffering symptoms of low thyroid, or, there may be improvement, but not enough to make life comfortable again.

You may then believe that the dose (either first-time or an adjustment) was not enough, and ask your doctor if you can get an increase in micrograms.

Your doctor will reply that you must wait eight weeks, because medication for low thyroid is “long-acting.”

The T4-only protocol can really be problematic, because hypothyroidism can create considerable issues…symptoms severe enough to debilitate the patient.

These symptoms include deep depression, need for excessive sleep, short-term memory problems, and irrational thinking, and not just the other symptoms that most people think are the only symptoms associated with low thyroid: weight gain, fatigue and feeling cold.

Surgery can render current T4-based treatment insufficient in a patient with a pre-existing diagnosis of low thyroid.

Post-surgery, the patient experiences hypothyroidism symptoms, despite continuing to take the daily-prescribed dose of Synthroid or Levothyroxine.

The dose is increased a week after surgery while the patient recovers in the hospital, but the increase wasn’t enough; the patient is sent home to recuperate.

However, there are problems that don’t seem connected to the surgery. The patient continues to be depressed, lethargic, not sensible, not interested in eating, and “always tired.”

Unfortunately, if on a T4-based treatment, the patient must wait six or seven weeks for another blood test to see where the thyroxine levels are at.

However, it’s possible that over that 6-7 weeks, the symptoms will disappear as the long-acting hormone replacement begins kicking in full force.

So now you know why low thyroid medication adjustments have an eight-week wait in between – unless it’s the more effective T4/T3 or T3 treatment plan.

Dr. Holtorf has published a number of endocrine reviews on complex topics in peer-reviewed journals on controversial diseases and treatments.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.