Medical Health Encyclopedia

Appropriate Dosage Levels. Initial dosage levels are determined on an individual basis and they can very wide depending on the person's age, medication condition, other drugs they are taking, and, in women, whether they are pregnant or not. For example, pregnant women with hypothyroidism may require higher than normal doses.

• Starting out. Most individuals need to build up gradually until they reach a maintenance dose. In uncomplicated cases, the dose typically starts at 50 micrograms per day, which then increases in three- to four-week intervals until thyroid hormone levels are normal. Seniors and those with heart disease may start at 12.5 to 25 micrograms per day. On the other hand, young adults with a short history of hypothyroidism might be able to tolerate a full maintenance dosage right away.
• Maintenance dose. Maintenance dose for most patients averages 112 micrograms but it can vary between 75 and 260 micrograms. If conditions, such pregnancy, surgery, or taking certain drugs, alter hormone levels, the patient's thyroid needs will have to be reassessed.

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Daily Regimen. Because thyroid replacement is usually lifelong, setting up a regular daily routine is helpful. Here are some tips to remember:

• Establish a habit of taking the medication at the same time each day. This may help prevent missed doses.
• Levothyroxine is very forgiving. The hormone remains in the body for several days, so one missed dose should not cause a noticeable decline in well-being. The patient can safely take two doses the next day.
• Fiber and common daily supplements, such as calcium, may interfere with thyroxine absorption. Although levothyroxine can be taken at any time of day either with or without food, some experts recommend taking thyroid hormone upon awakening and at least 30 minutes before consuming anything, including breakfast or supplements.