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