The initial dose of thyroxine sodium administered depends on
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Patient's age
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Severity and duration of the hypothyroidism.
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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 thyroxine 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 normalisation of serum TSH levels. |
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If proper dosage adjustment is not done then under treatment can lead to persistance and exacerabation of symptoms can lead to end organ damage, while over treatment can lead to following side effects |
Side effects of over treatment with thyroxine sodium
Children
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Thyrotoxicosis due to thyroid hormone
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Increased intracranial pressure
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Craniosvnastosis
Adults
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Accelerates bone loss in postmenopausal women
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Increased heart rate
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Increased left ventricular wall thickness and contractility