Higher Initial Levothyroxine Doses in Thyroid Disorders?
Even though the mantra for treating hypothyroidism is usually “start low and go slow”—irrespective of a patient’s age or health status—that may be unnecessary, say researchers from Rotterdam.
The practice stems from concerns that hypothyroidism is associated with ischemic heart disease. After finding no prospective studies on various starting doses, the researchers conducted their own trial and found, in fact, that a full starting dose of tablet levothyroxine (Synthroid generic, Abbott) was safe and effective. They compared a full dose of 1.6 mcg/kg with a low starting dose of 25 mcg/kg in 50 patients with newly diagnosed cardiac asymptomatic hypothyroidism.
The study results apply only to patients without suspected silent ischemia, the researchers caution. Because it isn’t known what the initial dose should be in patients with hypothyroidism and cardiac disease, starting low is still the prudent choice in this situation.
