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Hypothyroidism

Updated : September 3, 2022





Background

Epidemiology

Anatomy

Pathophysiology

Etiology

Genetics

Prognostic Factors

Clinical History

Physical Examination

Age group

Associated comorbidity

Associated activity

Acuity of presentation

Differential Diagnoses

Laboratory Studies

Imaging Studies

Procedures

Histologic Findings

Staging

Treatment Paradigm

by Stage

by Modality

Chemotherapy

Radiation Therapy

Surgical Interventions

Hormone Therapy

Immunotherapy

Hyperthermia

Photodynamic Therapy

Stem Cell Transplant

Targeted Therapy

Palliative Care

Medication

 

levothyroxine

1.7

mcg

Orally

once a day


Age: >50 years old or less than 50 years with CV disease 
25-50 mcg orally once a day
Or 12.5-25 mcg every 6-8Week 
Age: >50 years with CV disease 
12.5-25 mcg orally once a day
Or 12.5-25 mcg for every 4-6weeks until the patient becomes euthyroid 
Severe Hypothyroidism 
12.5-25 mcg orally once a day
Subclinical Hypothyroidism 
1 mcg/kg orally once a day



liothyronine 

Initially, 25-75 mcg orally each day
It increases by 25 mcg every 1-2 weeks, do not exceed 100 mcg/day
Maintenance dose- 25-75 mcg orally each day
May also use 10-12.5 mcg triiodothyronine (T3) combined with tetraiodothyronine (T4) Decrease the T4 dose by 50 mcg



liothyronine 

Initially, 25-75 mcg orally each day
It increases by 25 mcg every 1-2 weeks, do not exceed 100 mcg/day
Maintenance dose- 25-75 mcg orally each day
May also use 10-12.5 mcg triiodothyronine (T3) combined with tetraiodothyronine (T4)
Decrease the T4 dose by 50 mcg



liotrix 

1 tablet Thyrolar 1/2 daily, followed by 1 tablet Thyrolar 1/4 every 2 to 3 weeks
In long-standing myxedema, a lower initial dose of 1 tab is recommended, especially if cardiovascular damage is suspected, in which further caution is advised
Maintenance: one tablet of Thyrolar 1 to 1 tablet Thyrolar 2 daily; failure to respond to tab Thyrolar 3 can suggest a lack of compliance and malabsorption.
After necessary clinical laboratory analyses of T4 bound and free TSH blood levels, adjust the dosage within the first four weeks of therapy



 

levothyroxine

Age1-3 months
10-15 mcg/kg orally once a day
5-7.5 mcg/kg IV/IM once a day
For patients' risk of heart failure: 25 mcg/day
start a higher dose (50 mcg/day) as initial if serum T4 is lower than five mcg/dL
Age 3-6 months
8-10 mcg/kg orally OR 25-50 mcg orally once a day
4-7.5 mcg/kg IV/IM once a day
Age: 6-12 months
6-8 mcg/kg orally OR 50-75 mcg orally once a day
3-6 mcg/kg IV/IM once a day
Age: 1-5 years
5-6 mcg/kg orally, OR 75-100 mcg orally once a day
2.5-4.5 mcg/kg IV/IM once a day
Age: 6-12 years
4-5 mcg/kg orally OR 100-125 mcg orally once a day
2-3.75 mcg/kg IV/IM once a day
Age: >12 years
2-3 mcg/kg orally, OR 150 mcg orally once a day
1-2.25 mcg/kg IV/IM once a day



liothyronine 

Indicated for Congenital hypothyroidism
Initially 5 mcg orally each day
May increase the dose by 5 mcg every 3-4 days
Maintenance dose
For <1 year: 20 mcg orally each day
For 1-3 years: 50 mcg orally each day
For >3 years: 25-75 mcg orally each day



liotrix 

0 to 6 months: 3.1/12.5 to 6.25/25 orally;
6 to 12 months: 6.25/25 to 9.35/37.5 orally;
1 to 5 yrs: 9.35/37.5 to 12.5/50 mcg orally;
6- to 12 yrs: 12.5/50 to 18.75/75 mcg orally;
Above 12 yrs: more than 18.75/75 mcg orally;



 

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References

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Hypothyroidism

Updated : September 3, 2022




levothyroxine

1.7

mcg

Orally

once a day


Age: >50 years old or less than 50 years with CV disease 
25-50 mcg orally once a day
Or 12.5-25 mcg every 6-8Week 
Age: >50 years with CV disease 
12.5-25 mcg orally once a day
Or 12.5-25 mcg for every 4-6weeks until the patient becomes euthyroid 
Severe Hypothyroidism 
12.5-25 mcg orally once a day
Subclinical Hypothyroidism 
1 mcg/kg orally once a day



liothyronine 

Initially, 25-75 mcg orally each day
It increases by 25 mcg every 1-2 weeks, do not exceed 100 mcg/day
Maintenance dose- 25-75 mcg orally each day
May also use 10-12.5 mcg triiodothyronine (T3) combined with tetraiodothyronine (T4) Decrease the T4 dose by 50 mcg



liothyronine 

Initially, 25-75 mcg orally each day
It increases by 25 mcg every 1-2 weeks, do not exceed 100 mcg/day
Maintenance dose- 25-75 mcg orally each day
May also use 10-12.5 mcg triiodothyronine (T3) combined with tetraiodothyronine (T4)
Decrease the T4 dose by 50 mcg



liotrix 

1 tablet Thyrolar 1/2 daily, followed by 1 tablet Thyrolar 1/4 every 2 to 3 weeks
In long-standing myxedema, a lower initial dose of 1 tab is recommended, especially if cardiovascular damage is suspected, in which further caution is advised
Maintenance: one tablet of Thyrolar 1 to 1 tablet Thyrolar 2 daily; failure to respond to tab Thyrolar 3 can suggest a lack of compliance and malabsorption.
After necessary clinical laboratory analyses of T4 bound and free TSH blood levels, adjust the dosage within the first four weeks of therapy



levothyroxine

Age1-3 months
10-15 mcg/kg orally once a day
5-7.5 mcg/kg IV/IM once a day
For patients' risk of heart failure: 25 mcg/day
start a higher dose (50 mcg/day) as initial if serum T4 is lower than five mcg/dL
Age 3-6 months
8-10 mcg/kg orally OR 25-50 mcg orally once a day
4-7.5 mcg/kg IV/IM once a day
Age: 6-12 months
6-8 mcg/kg orally OR 50-75 mcg orally once a day
3-6 mcg/kg IV/IM once a day
Age: 1-5 years
5-6 mcg/kg orally, OR 75-100 mcg orally once a day
2.5-4.5 mcg/kg IV/IM once a day
Age: 6-12 years
4-5 mcg/kg orally OR 100-125 mcg orally once a day
2-3.75 mcg/kg IV/IM once a day
Age: >12 years
2-3 mcg/kg orally, OR 150 mcg orally once a day
1-2.25 mcg/kg IV/IM once a day



liothyronine 

Indicated for Congenital hypothyroidism
Initially 5 mcg orally each day
May increase the dose by 5 mcg every 3-4 days
Maintenance dose
For <1 year: 20 mcg orally each day
For 1-3 years: 50 mcg orally each day
For >3 years: 25-75 mcg orally each day



liotrix 

0 to 6 months: 3.1/12.5 to 6.25/25 orally;
6 to 12 months: 6.25/25 to 9.35/37.5 orally;
1 to 5 yrs: 9.35/37.5 to 12.5/50 mcg orally;
6- to 12 yrs: 12.5/50 to 18.75/75 mcg orally;
Above 12 yrs: more than 18.75/75 mcg orally;



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