Use: As replacement or supplemental therapy in congenital or acquired hypothyroidism of any etiology, except transient hypothyroidism during the recovery phase of subacute thyroiditis. Specific indications include: primary (thyroidal secondary (pituitary and tertiary (hypothalamic) hypothyroidism and subclinical hypothyroidism.
This occurs only when initiating thyroxine therapy. Thyroxine and Dilantin: This combination lowers the blood level of thyroxine (T4 but the free thyroxine remains normal. Thyroxine and Metamucil, Coffee, Alcohol: Thyroxine and anything that affects the digestive system should be taken as many hours apart as possible to ensure better absorption of the thyroid medication.
Persistently elevated TSH Poor adherence is the most likely explanation of TSH remaining above the normal range. I advise patients to decant a week's supply of thyroxine into a separately labelled bottle and refill the bottle on the same day each week.
-This drug should be taken in the morning on an empty stomach with water, at least one-half hour before any food is eaten. -This drug should be taken at least 4 hours apart from drugs that are known to interfere with its absorption.
Usual Adult Dose for TSH Suppression. TSH SUPPRESSION IN WELL -DIFFERENTIATED THYROID CANCER AND THYROID NODULES : -The target level for TSH suppression in these conditions has not been established. The efficacy of TSH suppression for benign nodular disease is controversial.
Apr 11, 2015. This calculator provides very basic initial levothyroxine dosage and. The starting dose, frequency of dose titration, and the optimal full.
Regular monitoring of TSH and thyroxine is recommended when starting therapy or changing the dose. -This drug should be taken in the morning on an empty stomach with water, at least one-half hour before any food is eaten.
5 Drug-induced hypothyroidism Lithium and iodine are the common causes of drug-induced hypothyroidism. Amiodarone, iodine-containing contrast media and kelp tablets are common sources of large doses of iodine. All forms of drug-induced hypothyroidism will usually resolve on withdrawal of the drug.
Comments : -The dose should be individualized on the basis of clinical response and biochemical tests. Regular monitoring of TSH and thyroxine is recommended when starting therapy or changing the dose.
It is extremely important to consider cortisol deficiency before starting treatment with thyroxine in patients with pituitary and hypothalamic disease as its use will speed the metabolism of cortisol and can induce an adrenal crisis.
This is increased at intervals of 3-4 weeks until the predicted dose is reached. Patients should feel some symptomatic improvement within two weeks of starting thyroxine. It may take 3-4 months for the full benefit of the drug to become apparent and for the TSH to normalise.
Thyroxine and Cholestyramine (Questran This combination lowers the absorption of thyroxine, therefore the two should not be taken together. A space of three to four hours between each is recommended with thyroxine being taken first.
7 I advise women taking thyroxine who are planning to conceive to increase their dose of thyroxine by 30 at the confirmation of the pregnancy. TSH should be monitored every 8-10 weeks during pregna.
These tests should be done every two or three months until correct dosage has been determined. Once a correct dosage is determined, a yearly check-up is all that is necessary. Most patients feel better with a T4 level in the upper half of normal (110-165 nmol/L).
The safety and efficacy of different initial doses of levothyroxine have, to our. levels within the normal reference range (euthyroidism) as a target of treatment.
A low fT4 will be found in secondary hypothyroidism and treatment should aim to maintain fT4 within the reference range. Most patients with secondary hypothyroidism will be hypogonadal and many will also be cortisol deficient.