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June 16, 1978

Error in Dose of Levothyroxine

Author Affiliations

Southfield, Mich

JAMA. 1978;239(24):2552. doi:10.1001/jama.1978.03280510036013

To the Editor.—  We were surprised to read in the QUESTIONS AND ANSWERS section (239:1205-1208, 1978) that the patient who had surgery for an autonomous hot thyroid nodule subsequently was treated with levothyroxine sodium (Synthroid), 0.5 mg/day. Our experience is consistent with Stock et al1 and Cotton et al2 in suggesting that the vast majority of hypothyroid patients are adequately treated, both from the clinical standpoint and in terms of restoration of elevated concentrations of serum thyroid-stimulating hormone to normal, with 0.2 mg or less of levothyroxine sodium daily. We have never found it necessary to exceed 0.3 mg/day. Therefore, we have questioned in the past the propriety of tablets too potent to be useful and perhaps too potent for human consumption.3,4 We have encountered four patients for whom pharmacists erroneously dispensed tablets containing 0.5 mg rather than 0.05 mg of levothyroxine. Two of these patients had