Hypothyroidism: Dose selection.

From Lewis S Blevins Jr., MD  –   There is controversy as to how to treat patients with partial hypothyroidism due to pituitary disorders and even primary hypothyroidism. After a quarter of a century of practice, I have come to believe that it is best to treat with a full hormone replacement dose. In those who have partial dysfunction, inadequate treatment does not lead to restoration of health and, if the underlying disease is progressive, the physician is always behind in adjusting dosages. Actual dose requirements depend on underlying disorder, concomitant medications, age, etc. Here are the formulas that I use to calculate the dosage of l-T4 based on ideal body weight.

Typical adult 0.8 mcg/lb wt
Elderly 0.6 mcg/lb wt
Children 1.0 mcg/lb wt

lb wt = IBW + 20% of excess weight
IBW calculated according to the following guessstimate formulas:
men: 106 # + 6#/every in over 5’
women 100# + 5#/every in over 5’

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