Management of hypothyroidism
1. Lifelong Levothyroxine (starting dose: 1.6mcg/kg/day)
2. Taken on an empty stomach, ideally 30-60 minutes before breakfast
3. Serum thyroid hormone concentrations increase first and then TSH secretion begins to fall
4. Goal of treatment is normalization of TSH level
5. Symptoms may resolve after 2-3 weeks, but normal TSH levels are not achieved for at least 6 weeks
6. TSH is assessed after 6 weeks on a steady dose, if still elevated increase dose by 25-50 and recheck in 6-8 weeks
7. In conditions that cause an increase in serum binding proteins, the dosage of levothyroxine must be increased