symptom thyroid

Treatment of hypothyroidism with thyroxine therapy is relatively straightforward. Most patients required maintenance doses of 100 to 150 ug daily. Alower initial dose is generally recommened usally 50 ug daily because patients with longstanding severe hypothyroidism can experience unpleasant symptoms such as palpitations if thyroxine is introduced too quickly, but occasionally an initial dose of 100ug may be used if the TSH level is very high and the patients is young and fit.

In the elderly and patients with cardiac disease, a lower starting dose of 25ug daily is more appropriate. Throids function tests should be performed six weeks after introducing thyroxine and after any dose adjustment but not within five weeks of the change, with tests result guiding gradual dose increases. In patients with cardiac disease, increased should be made gradully in increments of 25 ug.

The aim is to restore euthyroidism, but occasionally patients require TSH levels to be at the lower end of the normal range before they feel completely well. Once euthyroidism is achieved, thyroid function tests should be repeated yearly, unless a dose adjustment is made.

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