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Regular blood tests are recommended to verify the appropriateness of the dose. [1] They contain a mixture of thyroxine (T4) and triiodothyronine (T3). [1] Desiccated thyroid has been used since the late 1800s. [3] It is usually made from pigs, sheep, or cows. [4] It is available as a generic medication. [1]
The plasma half-life is one hour and is not altered appreciably by the thyroid status of the patient. Due to the concentration in the thyroid, however, dosing intervals may last 8 hours or longer. Less than 10% of the drug is excreted unchanged, with the remaining fraction undergoing extensive hepatic metabolism via glucuronidation.
Repeated administration of a medication is also different from single dosing, as many drugs have active metabolites that can build up in the body. [6] Patient variables such as sex, age, and organ function may also influence the effect of the drug on the system. These variables are rarely included in equianalgesic charts. [7] [3] [8]
Broda Otto Barnes (14 April 1906 – 1 November 1988) was an American physician and professor of medicine who studied endocrine dysfunction, particularly hypothyroidism. [4] [5] In the 1970s, Barnes published several books arguing that hypothyroidism was underdiagnosed in the U.S. and was responsible for a wide range of health problems.
A randomized control trial testing single dose treatment for Graves' found methimazole achieved euthyroidism (normal thyroid function that occurs within normal serum levels of TSH and T4 [23]) more effectively after 12 weeks than did propylthiouracil (77.1% on methimazole 15 mg vs 19.4% in the propylthiouracil 150 mg groups). [24]
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Thyroid hormone requirements increase during and last throughout pregnancy. [14] As such, pregnant women are recommended to increase to nine doses of levothyroxine each week, rather than the usual seven, as soon as their pregnancy is confirmed. [14] Repeat thyroid function tests should be done five weeks after the dosage is increased. [14]
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