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Levothyroxine is a synthetic form of thyroxine (T 4), which is secreted by the thyroid gland. Levothyroxine and thyroxine are chemically identical: natural thyroxine is also in the "levo" chiral form, the difference is only in terminological preference. T 4 is biosynthesized from tyrosine. Approximately 5% of the US population suffers from over ...
Treatment consists of a daily dose of thyroxine, available as a small tablet. The generic name is levothyroxine, and several brands are available. The tablet is crushed and given to the baby with a small amount of water or milk. The most commonly recommended dose range is 10-15 μg/kg daily, typically 12.5 to 37.5 or 44 μg. [8]
Levothyroxine should be used to keep TSH levels within the normal range for that trimester. The first trimester normal range is below 2.5 mIU/L and the second and third trimesters normal range is below 3.0 mIU/L. [15] [43] Treatment should be guided by total (rather than free) thyroxine or by the free T 4 index.
Reference ranges for TSH may vary slightly, depending on the method of analysis, and do not necessarily equate to cut-offs for diagnosing thyroid dysfunction. In the UK, guidelines issued by the Association for Clinical Biochemistry suggest a reference range of 0.4–4.0 μIU/mL (or mIU/L). [15]
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Levothyroxine dosing to normalise TSH is based on the amount of residual endogenous thyroid function and the patient’s weight, particularly lean body mass. [15] Usually the dose prescribed ranges from 1.6 mcg/kg to 1.8 mcg/kg, but can be adjusted based upon each patient. [10]
The procedure is to take the child's weight in pounds, divide by 150 lb, and multiply the fractional result by the adult dose to find the equivalent child dosage.For example, if an adult dose of medication calls for 30 mg and the child weighs 30 lb, divide the weight by 150 (30/150) to obtain 1/5 and multiply 1/5 times 30 mg to get 6 mg.
The package insert contains the following boxed warning, as do all thyroid hormones: [11] Drugs with thyroid hormone activity, alone or together with other therapeutic agents, have been used for the treatment of obesity. In euthyroid patients, doses within the range of daily hormonal requirements are ineffective for weight reduction.