Monitoring of Hypothyroidism

Symptomatic improvement occurs in 2-3 weeks with the use of levothyroxine, but it takes around 6 weeks to bring TSH levels to normal. TSH monitoring is done every six weekly with the change of levothyroxine dose. Once TSH comes within range, thyroid profile test is conducted once yearly. The use of hormone replacement therapy and oral contraceptives raises the total T4 levels, so free T4 is also measured if the patient is taking any of these medicines. The usual dose of levothyroxine is 100-200 micrograms daily.