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September 1984

Estimation of a Physiologic Replacement Dose of Levothyroxine in Elderly Patients With Hypothyroidism

Author Affiliations

From the State University of New York at Buffalo School of Medicine, Erie County Medical Center (Dr F. Davis), Buffalo General Hospital (Dr LaMantia), and Buffalo Veterans Administration Medical Center (Drs P. Davis and Spaulding), Buffalo, and the Gerontology Research Center, National Institute on Aging, National Institutes of Health, Baltimore City Hospitals (Dr Wehmann).

Arch Intern Med. 1984;144(9):1752-1754. doi:10.1001/archinte.1984.00350210064009

• We gave graded doses of levothyroxine sodium to 11 elderly hypothyroid subjects (mean age, 66.1 years). The daily levothyroxine sodium dose was initially 75 μg or less, and was increased by 25 μg every six weeks. Serum total thyroxine, total triiodothyronine, and basal thyrotropin levels were measured at the start of the study and at the end of each six-week dose period. A protirelin (thyrotropin-releasing hormone) test was performed when the thyrotropin level returned to normal. Mean daily levothyroxine sodium doses that normalized serum thyrotropin levels and protirelin test were 110±8 μg and 113±9 μg, respectively. Serial basal thyrotropin determinations during stepwise increments in levothyroxine dose indicated physiologic hormone replacement. As determined in our elderly patients, levothyroxine replacement dose was a third less than that formerly recommended.

(Arch Intern Med 1984;144:1752-1754)

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