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About

Levothyroxine dosing requires high precision due to the drug's narrow therapeutic index. The American Thyroid Association (ATA) recommends weight-based estimation for initiating therapy in hypothyroidism. However, a standard calculation often fails for special populations. The elderly and those with cardiac history require significantly lower starting coefficients to prevent thyrotoxicosis or arrhythmias, while pregnant patients often require increased dosages to support fetal development.

This tool synthesizes lean body mass estimates and specific condition multipliers to recommend a starting daily dose. It matches the calculated value to the nearest commercially available tablet strength (color-coded by industry standard), reducing the cognitive load of manually adjusting theoretical numbers to pharmacy reality.

thyroid endocrinology levothyroxine hypothyroidism TSH

Formulas

The calculator uses condition-specific coefficients (k) applied to the patient's weight.

Dosedaily = Weightkg × k

{
1.6 Healthy Adult0.5 Elderly/Cardiac2.0 Pediatric/Pregnancy

The result is then snapped to the nearest valid set element S where S = {25, 50, 75, 88, 100, 112, 125, 137, 150, 175, 200}.

Reference Data

Tablet StrengthStandard ColorCoeff: AdultCoeff: Elderly
25 mcgOrange1.6 mcg/kg0.5 mcg/kg
50 mcgWhite1.6 mcg/kg0.5 mcg/kg
75 mcgViolet1.6 mcg/kgTitrate
88 mcgOlive1.6 mcg/kgTitrate
100 mcgYellow1.6 mcg/kgTitrate
112 mcgRose1.6 mcg/kgTitrate
125 mcgBrown1.6 mcg/kgTitrate
137 mcgTurquoise1.6 mcg/kgTitrate

Frequently Asked Questions

88 mcg helps bridge the large gap between 75 mcg and 100 mcg. Thyroid replacement often requires fine-tuning, and a 25 mcg jump can be too aggressive, causing symptoms of hyperthyroidism.
Absolutely not. This calculator provides an *initial* starting dose estimate. The actual maintenance dose must be titrated based on TSH and Free T4 blood tests taken 6-8 weeks after initiation.
Thyroid hormone increases heart rate and oxygen demand. In patients with cardiac issues, starting at a full replacement dose (1.6 mcg/kg) can precipitate angina or arrhythmia. The standard of care is "start low, go slow" (often 12.5-25 mcg).