Anytime I've made a med adjustment I would get confusing symptoms. There were many times I thought I was going hyper again only to find out that I wasnt. You have to watch out for cross over symptoms when making adjustments...it seems to happen to a lot of us. For me...the first 2 or 3 weeks were the worst. Also there were many times that I didnt level out until my 2nd blood test which was at the 8 week mark. So if you can...perhaps just wait it out,. If you get really concerned you can always go in for an early blood draw. You want to avoid the knee jerk reaction of adjusting your meds by symptoms alone...that can cause the yo yo effect. Always make adjustment based on symptoms and blood tests. Symptoms are not always accurate but labs are. Big Hugs...Kathy

I agree WAIT! Don't rush in to anything. As you said you have never waited to see how you really feel.
Stop thinking about it all the time and just go with flow for a bit.
The problem is we read in to everything and google topic to no end.

Thanks you guys! Guess I just needed a little hand holding. This is new uncharted territory for me as you know. I'll hang out until the next blood draw.

Have a wonderful day!
Cindee

I have to say that I just go about my day and that is it. My meds have been adjusted twice and now I am on a new regimen due to being t3 dominant. I don't pay attention to every detail. Just take my pills in one fell swoop about 5a and hit the road. Did put on my calendar the week I need to have blood drawn so I don't forget, which is 6 weeks from now. Just saw MD on Monday. Of course I am not stupid and know in the back of my mind will pay attention to changes but quite honestly it doesn't even cross my mind even when I take the meds.

Make sure to take that 2.5 mg in divided doses of twice a day, if you haven't already, of 12 hours a part.

{{{hugs}}}

I asked my MD about the divided dose for methamazole and he said NO. You take it all at once. You are not supposed to split the dose and they (groups of MD's) have been trying to work with pharma companies to have this changed. The research shows that organically the med is working as it should and is in your system. If you MD has said split than go ahead but do not split on your own.

atc:

I'm sorry atc, once a day dosing does not work for me and for a lot of other people who come on the different thyroid boards I've participate at. Maybe it works for you. I sincerely hope those doctors know what they are doing to some of the poor patients when they do it this way.

My Endo is a twice a day dosing for the Methimazole and three times a day dosing for the PTU.

{{{hugs}}}

P.S. Go and do a search and you'll see what I mean why once a day dosing does not work for so many of us.

Here's a link explaining why the Methimazole needs to be taken more than once per day:

http://www.medicinenet.com/methimazole-oral/article.htm

http://www.elaine-moore.com/QA/tabid/57/forumid/6/postid/5484/scope/posts/Default.aspx

When I began on 40 mg once per dosing, my thyroid levels would not drop. Finally I went twice a day and it still wouldn't drop. After several months and hardly any results, I split up to three times a day and finally saw results and stabled blood levels.

It is suggested to do this so the patient is not overly hypO for the first 12 hours followed by extreme hypER the last 12 hours.

{{{hugs}}}

More links on twice or three times a day dosing for the MMI:

http://www.drugs.com/dosage/methimazole.html

http://endocrine-system.emedtv.com/methimazole/methimazole-dosage.html

My own copy of pharmaceutical insert calls for three times a day dosing:

http://www.parpharm.com/generics//images/pdf/0640_po.pdf

{{{hugs}}}

P.S. Any thyroid patient should always insist to their doctor that if the once per day dosing does not work for them, to look into multiple dosings during the day.

I am not disputing what the inserts say or dosing states they do call for splitting dosing. I am just stating that my MD who has been doing this for a long time and is well know in the field stated this to be this is false and should be taken at once. He states that experts are trying to have this dosing corrected.

This is from Elaine Moore who I have not read her book becasue I am sick of reading:)
"Methimazole with its longer half life of 4-6 hours can be taken once daily".

I once asked my doc this (old endo) and he said under 10 can be taken once a day,anything over that should be used twice a day. I took such a small amount I never took it more than once but it seems to work for some to not feel hyper half the day if they split the dose.I would say in the beginning anyway when people are on a bigger dose.MM is near remission so I'm sure she knows what she's talking about.I wouldn't change doses until labs are done. Kathy is RIGHT, many symptoms do cross over and many think they went hyper again when it's usually hypo.

I guess it is what we know that works with our body and feelings. When I ask my end about this she said it was up to me whichever I felt it worked for me. So that is to split. I take 10 mgs in the morning and 10 at night. My alarm is set on my cell phone so that I will remember cause I would forget my head if not attached.

LOL, I always snicker at these MD's who are "well known in the field" and tell patients to dose once per day. Let me tell you about my experience with a "Well known MD". He almost killed me. Pulled me totally offf the PTU (because of elevated liver enzymes) and should have put me on Methimazole as the Methimazole has a different mechanism inthe liver and will not raise liver enzymes the same way, if at all, that PTU does. So, within 2 days I was super hyper, and worse than ever, I called the on-call, less known doc who put me back on 30mg's methi and told me to take it 2-3 times per day. Some docs think they know so much they forget to take continuing education classes.As for changing the dosing through the pharma companies, they can't do this without running the clinical trials to test the safety and efficacy of this, maybe your doc should learn that as well. I work for major pharma company and all I will say is good luck doc.

There are docs out there that do not know what they are doing. There are also patients out there that do not know what they are doing. Both can be harmful! Some of the "experts" on this board are giving misleading information to individuals who come to this board to seek support and perhaps advice. Dosing instructions should not be given and a patient needs to take advice from their medical provider not someone on this board. This board can be very helpful and a great support but you need to keep in mind it is not always safe to take advice from someone who does not know what they are talking about.

It is know that methimazole should be once per day. Apparently most on this board do not take that and go with the dosing the pharma companies state which in fact is wrong.

Just saying.

I highly doubt the pharmaceutical dosing instructions are wrong. They would be looking at potential lawsuits and no company is going to let dosing instruction go on incorrect for years and not take accoutability for it. They test the drugs rigorously and take the years of compiled data to see if the drug can even go to market, let alone what dose should be used. I do agree there is some incorrect advise on this board, and dosing should be based on the advice of their physician, not on a board. I have worked with two excellent endos, both advised on Methimazole dosing to be twice per day. I believe you can dose once per day, but it is not recommended for those with really severe Graves Disease. I think it comes down to a matter of doc/patient preference, and what is working out well for the patient.