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Levothyroxine has a half-life of 7.5 days when taken daily, so about six weeks is required for it to reach a steady level in the blood. [5] Side effects from excessive doses include weight loss, trouble tolerating heat, sweating, anxiety, trouble sleeping, tremor, and fast heart rate. [5]
Each 64.8 mg (one grain) of thyroid extract contains approximately 38 mcg and 9 mcg of measurable levothyroxine (T4) and liothyronine (T3), respectively. [1] Arguments against desiccated thyroid include: Desiccated thyroid preparations have a greater variability from batch to batch than synthetic ones. [9]
Liothyronine is a manufactured form of the thyroid hormone triiodothyronine (T 3). [1] It is most commonly used to treat hypothyroidism and myxedema coma. [1] It can be taken by mouth or by injection into a vein. [1] Side effects may occur from excessive doses. [1]
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]
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]
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