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When TSH is low (over-replacement), the daily dosage should be decreased by 12.5 to 25 mcg. When TSH is high (under-replacement), the daily dosage is increased by 12.5 to 25 mcg per day.
A TSH blood test should be obtained at least every 6-12 months while you are on a stable thyroxine dose, and more often if your dose is changed. Your doctor will usually wait 6-8 weeks after a thyroxine dose adjustment to measure your TSH, when the levels of thyroxine have reached a steady state.
The goal of therapy is restoration of the euthyroid state, which can be readily accomplished in almost all patients by oral administration of synthetic thyroxine (T4, levothyroxine). Appropriate treatment should reverse all the clinical manifestations of hypothyroidism.
Duration and dose — Your health care provider will prescribe an initial dose of levothyroxine and then retest your blood level of TSH after six weeks. Your dose can be adjusted at that time if needed.
starting dose, the TSH and Free T4/T3 are measured again in four to six weeks to see if they have improved. Testing TSH, Free T3 and Free T4 will help determine if you will need to have your dosage of medication adjusted.
This means that very small changes in serum free T4 concentrations induce very large reciprocal changes in serum TSH concentrations. As a result, thyroid function is best assessed by measuring serum TSH, assuming steady-state conditions and the absence of pituitary or hypothalamic disease.
For most cases of mild to moderate hypothyroidism, a starting levothyroxine dosage of 50-75 µg/day will suffice. Clinical benefits begin in 3-5 days and level off after 4-6 weeks. Achieving a...
ANSWER: Yes. Make an appointment to have your condition re-evaluated at this time. For some people, lifelong treatment of hypothyroidism with the drug levothyroxine is necessary. But studies have found that for many others who have elevated levels of thyroid-stimulating hormone, or TSH, the medication isn’t needed.
Importantly, patients should undergo reassessment and therapy should be titrated after an interval of at least 6 weeks following any change in levothyroxine brand or dose. The serum TSH level is most important, and a free T 4 estimate may be included in the assessment as well.
Titrate dose by 12.5-25 mcg/day every 6 weeks until TSH normalizes; Takes 6 weeks to achieve steady state; Check TSH at 6 months after treatment onset and then annually for maintenance therapy; Goal = normalization of TSH, improved symptoms, and avoidance of under/overtreatment (induced hyperthyroidism can reduce bone mass and increase risk of ...