Levothyroxine is the drug of choice for the treatment of primary hypothyroidism. All forms of this disease (congenital, 'spontaneous', end stage of an autoimmune thyroid disease [Hashimoto], after a thyroidectomy or a radioiodine therapy, etc.) respond to levothyroxine. The aim of the treatment is to normalize increased thyrotrophin levels (TSH). The periodical monitoring of these values makes an individual dosage possible. Specialists sometimes administer intravenous levothyroxine or tri-iodothyronine for myxoedema, the end stage of decompensated hypothyroidism.

Levothyroxine is also effective for secondary hypothyroidism due to pituitary or hypothalamic disease; in this case monitoring of the free T4 index has to be performed.

Moderately raised TSH values (between 5 and 10 mU/L) without clinical symptoms should only be treated if thyroid autoantibodies or a goiter can be detected.

The administration of levothyroxine is also recommended after a thyroidectomy (without hypothyroidism) for the prevention of recurrences, for the inhibition of growth of nodular goiter, after the operation of a differentiated thyroid carcinoma, as well as after radiation of the neck (cancer prophylaxis).

Table of Contents | Pharmacology | Adverse Reactions & Interactions | Contraindications & Cautions | Risk Groups | References