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Levothyroxine has a half-life of 7.5 days when taken daily, so about six weeks is required for it to reach a steady level in the blood. [5] Side effects from excessive doses include weight loss, trouble tolerating heat, sweating, anxiety, trouble sleeping, tremor, and fast heart rate. [5]
Thyroxine, also known as T 4, is a hormone produced by the thyroid gland.It is the primary form of thyroid hormone found in the blood and acts as a prohormone of the more active thyroid hormone, triiodothyronine (T 3). [1]
When pregnant, a woman with a low-functioning thyroid will also need to increase her dosage of thyroid hormone. [16] One exception is that thyroid hormones may aggravate heart conditions, especially in older patients; therefore, doctors may start these patients on a lower dose and work up to a larger one to avoid risk of heart attack. [17]
In starvation or severe somatic stress, deiodinase type 1 is inhibited which lowers circulating levels of T 3 (due to it being the main source of peripherally converted T 3 from T 4 in the plasma), causing a decrease in the metabolic rate. [3]
Blood free thyroxine and TSH levels are monitored to help determine whether the dose is adequate. This is done 4–8 weeks after the start of treatment or a change in levothyroxine dose. Once the adequate replacement dose has been established, the tests can be repeated after 6 and then 12 months, unless there is a change in symptoms. [8]
The sum activity of peripheral deiodinases (G D, also referred to as deiodination capacity, total deiodinase activity or, if calculated from levels of thyroid hormones, as SPINA-GD [a]) is the maximum amount of triiodothyronine produced per time-unit under conditions of substrate saturation. [1]