Levothyroxine is a special medication that helps people suffering from hypothyroidism. This disease is a common condition when the thyroid gland doesn’t produce enough hormones. The disease is very insidious and can manifest itself with various symptoms, such as fatigue, poor sleep, depression, problems with hair and nails, menstrual irregularities, and much more. The reduced level of thyroid hormone sufficiently affects the quality of life. It’s impossible to diagnose a disease just like that, a conclusion can only be made by an endocrinologist based on analysis.
Typically, levothyroxine is offered as a tablet, capsule, or solution. Levothyroxine, a synthetic thyroid hormone, makes up for a lack of thyroid hormones. Production of a higher oxygen demand for tissues encourages their development and differentiation as well as a higher degree of protein, glucose, and fat basal metabolism. The medication has an anabolic impact at low dosages and a catabolic effect at high ones. Strengthening energy processes has a positive effect on the functions of the cardiovascular and nervous systems, kidneys, and liver.
After ingestion on an empty stomach, up to 80% is absorbed in the upper small intestine. The maximum concentration in blood plasma is reached after 6 hours. Communication with plasma proteins is 99%.
The therapeutic effect develops 3–5 days after the start of administration. Metabolism in the liver, muscles, kidneys, and brain tissues.
The half-life is 6–7 days. Elimination by the kidneys.
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Levothyroxine is used as a means of replacement therapy for hypothyroidism of various origins, after surgery for goiter, for the treatment of diffuse euthyroid goiter, and as suppressive and replacement therapy for malignant tumors of the thyroid gland, primarily after thyroidectomy. In higher doses, but not causing hyperthyroidism, levothyroxine is used for primary hypothyroidism and myxedema, cretinism, cerebro-pituitary diseases that occur with hypothyroidism, and obesity with hypothyroidism, endemic and sporadic goiter.
However, there are a few inconsistencies that need to be clarified before Levothyroxine therapy begins. These include acute myocardial infarction, myocarditis, thyrotoxicosis, and Duhring’s disease (a chronic skin condition called dermatitis herpetimorphis). A person’s greater susceptibility to the medication, untreated pituitary insufficiency, untreated adrenal insufficiency, ischemic heart disease, heart failure, diabetes and diabetes insipidus, and malabsorption syndrome should also be considered. In conjunction with antithyroid medications, the medicine should be taken with caution during pregnancy. The recommended course of therapy should be followed while pregnant, with the dosage being raised by 25% in the second and third trimesters. The attending physician modifies the medication’s dosage during nursing.
Dosage and administration
The daily dose is set individually depending on the indications, and laboratory data. In hypothyroidism, the initial daily dose for adults is 25–100 mcg, the maintenance dose is 125–200 mcg. In the severe and prolonged course of hypothyroidism, treatment begins with a lower initial dose, gradually increasing it to maintenance.
For children, the initial dose is 12.5–50 mcg / day, maintenance — depending on age: for newborns — 4 mcg / kg, children under the age of 3 months — 25 mcg, from 6 months to 1 year — 37.5 mcg, up to 5 years — 50 mcg, from 5 years to 7.5 years — 75–100 mcg, from 7.5 years to 12 years — 100 mcg.
With euthyroid goiter, adults are prescribed 75–200 mcg / day, newborns — 12.5 mcg / day, children aged 3 months to 1 year — 37.5 mcg, up to 5 years — 25–62.5 mcg, from 7, 5 years to 12 years — 5–100 mcg / day. In thyroid cancer after surgical treatment, 150–300 mcg / day of levothyroxine is prescribed. The duration of treatment ranges from several months to several years.
When taking Levothyroxine in recommended doses, side effects are not observed. When prescribing high doses, tachycardia, arrhythmia, angina attacks, tremors, sleep disturbances, anxiety, hyperhidrosis, and weight loss may occur. In some cases, there may also be a temporary increase in body weight, hair loss.
Caution should be exercised when prescribing to elderly patients, patients with angina pectoris, hypertension, epilepsy, insufficiency of the adrenal cortex and pituitary gland, and patients with diabetes mellitus. If signs of hyperthyroidism appear during treatment with Levothyroxine, it is recommended to reduce the daily dose or interrupt its intake for several days. With the disappearance of side effects, treatment can be gradually resumed.
In children, the administration of Levothyroxine in a high initial dose can lead to impaired renal function. There may be an increase in the frequency of seizures in children with epilepsy. During pregnancy and lactation, levothyroxine therapy is continued under the supervision of a doctor. Levothyroxine has been well studied, so there is no reason to assume that it has embryotoxic and teratogenic properties.