The treatment for hypothyroidism primarily involves levothyroxine replacement, starting at a low dose and gradually increasing to a maintenance dose of 100-150 micrograms. Special considerations include adjusted doses for ischaemic heart disease and pregnancy, as well as monitoring TSH and free T4 levels. Additional guidelines are provided for managing subclinical hypothyroidism and various thyroid conditions.

1. TREATMENT OF
HYPOTHYROIDISM
Dr. Maria Sheraz Khan

2. HYPOTHYROIDISM
• Treatment of hypothyroidism is levothyroxine
replacement.
• It start with low dose of about 50 microgram
daily for 3 weeks
• Then increased to 100 microgram daily for
further 3 weeks
• And finally to a maintenance dose of 100-150
microgram.

3. TREATMENT OF HYPOTHYROIDISM
ASSOCIATED WITH VARIOUS
CONDITIONS

5. ISCHAEMIC HEART DISEASE
• Thyroid hormone replacement should start
with low dose and it is increased very slowly.
• T3 is better than T4 because of shorter half-life
adverse effects will reverse quickly.

7. PREGNANCY
• Dose of levothyroxine is increased 20-25
microgram daily.
• Serum TSH and free T4 should be measured in
each trimester to adjust dose and maintain
normal levels of TSH.

8. SUBCLINICAL HYPOTHYROIDISM
• Levothyroxine should be given in a sufficient
dose to restore the serum TSH level to normal.

9. Permanent
T4
replacement
Spontaneous
Atrophic
Hypothyroidism
Thyroidectomy
Or
Thyroid ablation
Hashimoto
Thyroiditis

10. Transient
Thyroiditis
Temporary T4
replacement

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