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BACK GROUND: Hypothyroidism (underactive thyroid) is a condition in which thyroid gland doesn't produce enough of thyroid hormone. Women, are more likely to have hypothyroidism, as it is chronic illness, lifelong therapy with levothyroxine is necessary. The dose should be individualized in the hypothyroidism patients on the basis of clinical response and biochemical tests. Regular monitoring of TSH and thyroxine is recommended when starting therapy or changing the dose. AIM AND OBJECTIVES: (i) To evaluate the dosage adjustment of levothyroxine in patients with hypothyroidism and with coronary artery disease. (ii) To assess the serum TSH, serum T3 and serum T4 levels in patients with hypothyroidism. (iii) To monitor the levothyroxine therapy related side effects and dosage adjustments. (iv) To improve patients quality of life. METHODS: The study was conducted in Government General Hospital, Guntur, a tertiary care teaching hospital. The sources of data will include the relevant data cards of the patient along with direct observation of the patient. Family history of the patient and risk factors if any are also included. Dose adjustments was done to the subjects included in the study and management parameters are collected. RESULTS: We reviewed the following therapeutic categories in the total of 100 subjects 3% of subjects are at the risk of developing coronary artery disease and dosage adjustment was done in 72 subjects and remaining 28 subject’s does not require the adjustment. 15% were under replaced and 5% were over replaced. CONCLUSION: We concluded that levothyroxine should remain the standard of care for treating hypothyroidism. Thyroid hormone therapy should be initiated as an initial full replacement or as partial replacement with gradual increments in the dose titrated upward using serum thyrotropin as the goal. Dose adjustments should be made with thyrotropin assessment 4–6 weeks after any dosage change. Additional research is also needed to develop thyroid hormone analogs with a favorable benefit to risk profile. |
