Question

For a 75-year-old female with primary hypothyroidism requiring levothyroxine, if the projected dose is 88 mcg per day, what would be the most appropriate starting dose for initial therapy, considering her age and medical condition?

Answer 1

In elderly patients with hypothyroidism, a low starting dose of levothyroxine, such as 25 to 50 mcg per day, is recommended with gradual adjustments based on thyroid function tests.

Step-by-step explanation:

For a 75-year-old female with primary hypothyroidism requiring levothyroxine, considering her age and medical condition, it is essential to start with a low dose of levothyroxine and gradually increase as needed. In older adults, starting doses of levothyroxine are generally lower than the full replacement dose to avoid any potential cardiac side effects due to the sudden increase in metabolic rate. A typical starting dose might be 25 to 50 mcg per day, evaluated every 6-8 weeks with thyroid function tests, to slowly adjust to the projected dose of 88 mcg per day. Consequently, a lower starting dose is both safer and in line with standard medical practice for managing hypothyroidism in the elderly.