six to 8 weeks after the start of levothyroxine therapy you should reexamine patients and measure their serum thyroidstimulating hormone (TsH) (strength of recommendation [sor]: c, common practice and expert opinion). If thyroid function is normal at that time, examine the patient and measure serum TsH again in 4 to 6 months because clearance of levothyroxine increases in the euthyroid (normal)...

CONTEXT The effect of calcium carbonate on the absorption of levothyroxine has not been studied systematically. Such a potential drug interaction merits investigation because concurrent treatment with both drugs is common, particularly in postmenopausal women. OBJECTIVE To investigate the potential interference of calcium carbonate in the absorption of levothyroxine. DESIGN Prospective coho...

Myxedema crisis is an extreme complication of uncontrolled hypothyroidism. It is usually seen in elderly women with undiagnosed hypothyroidism and is rare among young. There have been very few reports of myxedema coma in labor. This report pertains to a case of undiagnosed hypothyroidism in a 30 year old lady with twin pregnancy which led to hypothyroidism crisis during labor. Levothyroxine 100...

Introduction: Serum Thyrotropin (TSH) level is used to assess adequacy of levothyroxine dosing for patients with hypothyroidism. Some patients have raised TSH levels despite being on an adequate dose of levothyroxine (100 mcg/day 200 mcg/day). Aim: To evaluated the effect of advising patients to take their levothyroxine 45 60 minutes before breakfast on raised serum TSH levels. Patients and Met...

Objective(s): TSH suppression by Levothyroxine consumption is a mainstay of thyroid cancer treatment. Tablet-splitting is a worldwide approach in dose adjustment in patients. However, it is highly recommended to evaluate the validity of tablet splitting for each distinctive drug by clinical trials before routinely using tablet halves in clinical practice. In this study we compared the effect of...

mlU/l. The symptoms of sensitive polyneuropathy manifested soon after introducing levothyroxine therapy. Fatigue, lack of concentration, forgetfulness, depression, and widespread neuropathic pain persisted more than 2 years in spite of levothyroxine replacement therapy (125 g levothyroxine daily) and TSH level of Dear Sir, Five months after radioactive iodine treatment for Graves’ hyperthyroidi...

Introduction Radioiodine is a safe and effective treatment for Graves’ disease. Iatrogenic hypothyroidism is very common after treatment, but its onset is unpredictable. Even a short episode of hypothyroidism can result in significant morbidity and ideally should be avoided. In Newcastle a standard dose of radioiodine (400MBq) is used, but for historical reasons two different protocols are used...

Objective To investigate the cardiometabolic effects of a severe hypothyroid state induced by withdrawal of thyroid hormone replacement before radioactive iodine therapy. Methods Patients with thyroid cancer who were scheduled to receive radioactive iodine ablation were enrolled. Cardiometabolic parameters were measured using blood samples taken immediately before levothyroxine withdrawal, 4 we...

The influence of hypothyroidism on haemostasis is an active research area. Not only bleeding tendency but also hypercoagulable states have been reported in hypothyroid patients. Decreased and increased fibrinolytic activity in hypothyroid patients has been shown in several studies. Thrombin activatable fibrinolysis inhibitor (TAFI) is an inhibitor of fibrinolysis, which has been recently isolat...

known effects of levothyroxine and folic acid on serum homocysteine level