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                Dose titration

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[Up] [Hypothyroidism classification] [Risk factors] [Clinical features] [End organ impact] [Associated illnesses] [Diagnosis] [Treatment] [Dose titration] [Drug interactions] [Monitoring & follow up] [Myxedema coma]

 

 The initial dose of thyroxin sodium administered depends on

  • Patient's age

  • Severity and duration of the hypothyroidism.

  • Existence of the underlying cardiovascular disease.

 

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The dosage needs to be titrated against TSH levels according to individual patient's needs.

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The patient should be reevaluated and the serum TSH level should be measured in about 6 - 8 weeks.

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The dose of thyroxin should be increased if the serum TSH concentration is elevated and decreased if it is low.

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Individualization and titration of proper dose is critical, aiming at normalization of serum TSH levels.

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If proper dosage adjustment is not done then under treatment can lead to persistence and exacerbation of symptoms can lead to end organ damage, while over treatment can lead to following side effects

 

 

 Side effects of over treatment with thyroxin sodium

 

 Children

  1. Thyrotoxicosis due to thyroid hormone

  2. Increased intracranial pressure

  3. Craniosvnastosis

 

 Adults

  1. Accelerates bone loss in postmenopausal women

  2. Increased heart rate

  3. Increased left ventricular wall thickness and contractility

 

 

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