From the Research
Levothyroxine (Levo) drip is typically started at a dose of 0.1-0.2 mcg/kg/min and titrated to achieve the desired effect, with a maximum recommended dose of 0.5-1.0 mcg/kg/min. The dosing of Levo drip should be individualized based on the patient's condition and response to treatment. According to the most recent and highest quality study available, 1, the treatment of hypothyroidism with levothyroxine should aim to restore thyroid-stimulating hormone (TSH) concentrations to normal.
Some key points to consider when administering Levo drip include:
- The dose of Levothyroxine should be adjusted based on the patient's TSH levels, with a goal of achieving a TSH level within the normal range.
- The use of Levothyroxine in combination with liothyronine (L-T3) may be considered in some patients who are dissatisfied with treatment, especially those with a polymorphism in type 2 deiodinase, as suggested by 2.
- The pharmacodynamic equivalence of levothyroxine and liothyronine has been studied, with one study finding that the therapeutic substitution of L-T3 for L-T4 was achieved at approximately a 1:3 ratio, as reported in 3.
- Another study found that the substitution of L-T3 for L-T4 at equivalent doses reduced body weight and resulted in greater thyroid hormone action on lipid metabolism, without detected differences in cardiovascular function or insulin sensitivity, as shown in 4.
It is essential to monitor the patient's response to treatment and adjust the dose of Levothyroxine accordingly, taking into account the potential benefits and risks of treatment, as discussed in 5. Regular monitoring of TSH levels and clinical assessment of the patient's condition are crucial to ensure optimal treatment outcomes.