Question

A 70 year old female patient's labs indicated elevated TSH with low T3 and T4. Her calculated replacement is 101 mcg daily. Which of the following treatment plans is best for this patient?

a. Begin patient on 25 mcg of Levothyroxine (Synthroid)
b. Begin patient on 50 mcg of Levothyroxine (Synthroid)
c. Begin patient on 100 mcg of Levothyroxine (Synthroid)
d. Begin patient on 125 mcg of Levothyroxine (Synthroid)

Answer 1

The best treatment plan for the 70-year-old patient with signs of hypothyroidism is to start with a lower dose of Levothyroxine at 25 mcg to minimize the risk of adverse reactions, with subsequent adjustments based on response and follow-up lab tests.

Step-by-step explanation:

For a 70-year-old female patient with elevated TSH and low T3 and T4 levels indicating hypothyroidism, a cautious approach to thyroid hormone replacement is recommended, considering her age and the potential for cardiac side effects. The best treatment plan for this patient would be to:

a. Begin the patient on 25 mcg of Levothyroxine (Synthroid).

Starting at a lower dosage allows the patient's body to adapt to the hormone replacement and minimizes the risk of adverse reactions. The prescription can be adjusted based on the patient's response and follow-up lab tests to achieve the calculated replacement goal.