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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 ...
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] For example, the dose may be lowered for elderly patients or ...
Blood free thyroxine and TSH levels are monitored to help determine whether the dose is adequate. This is done 4–8 weeks after the start of treatment or a change in levothyroxine dose. Once the adequate replacement dose has been established, the tests can be repeated after 6 and then 12 months, unless there is a change in symptoms. [8]
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]
Triiodothyronine (T 3) and thyroxine (T 4) can be measured as free T 3 and free T 4, which are indicators of their activities in the body. [73] They can also be measured as total T 3 and total T 4 , which depend on the amount that is bound to thyroxine-binding globulin (TBG). [ 73 ]
For comparison, those with a V d L/kg body weight of less than 0.2 are mainly distributed in blood plasma, 0.2-0.7 mostly in the extracellular fluid and those with more than 0.7 are distributed throughout total body water.
Thyroid function should be normalised prior to conception in women with pre-existing thyroid disease. Once pregnancy is confirmed the thyroxine dose should be increased by about 30-50% and subsequent titrations should be guided by thyroid function tests (FT4 and TSH) that should be monitored 4-6 weekly until euthyroidism is achieved.
Thyroid-stimulating hormone (also known as thyrotropin, thyrotropic hormone, or abbreviated TSH) is a pituitary hormone that stimulates the thyroid gland to produce thyroxine (T 4), and then triiodothyronine (T 3) which stimulates the metabolism of almost every tissue in the body. [1]