Hypothyroidism needs life long treatment & patient compliance can' be an issue hence monitoring & follow up are important.
Adults
Titration of dosage
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Titration of dosage of thyroxine is done to maintain TSH in normal range of O.2-5 uIU/L and |
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In cases of central hypothyroidism to maintain T4 levels in normal range( 5- 13.5 ug/dl) |
Follow up
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Follow up of these patients is done with TSH testing at 6-8 weeks intervals. |
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In severe hypothyroid patients, older patients or in young patients with a history of a cardiovascular disease, TSH testing is done at 3-6 weeks interval. |
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In central hypothyroidism FT4 /T4 testing at 4-6 week intervals. |
Maintainance
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Once the dose is titrated and TSH /T4 maintained within normal limits, patient should be followed up at 6 months or yearly intervals. |
Infants and Neonates
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Serum T4 and TSH measurements should be evaluated at the following intervals, with subsequent dosage adjustment to normalize serum total T 4 or FT 4 and TSH. |
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2 and 4 weeks after the initiation of Thyroxine sodium treatment ; |
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Every 1 to 2 months during the first year of life; |
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Every 2 to 3 months between 1 and 3 years of age; |
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Every 3 to 12 months thereafter until growth is completed |
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Evaluation at more frequent intervals is advisable when compliance is poor or abnormal values are obtained. |
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Patient evaluation is also advisable approximately 6 to 8 weeks after any change in Thyroxine sodium dose. |