Which of the following statements regarding treatment of hypothyroidism in a patient with Ischemic hea disease is true -
In patients with known ischemic hea disease, thyroid hormone replacement using levothyroxine should be introduced at low dose and increased very slowly. The staing dose of levothyroxine is 12.5-25 mg/d with similar increments every 2-3 months until TSH is normalized. Exacerbation of myocardial ischemia, MI and sudden death are recognised complications of levothyroxine replacement, even using doses as low as 25 mg/day. Coronary angioplasty or bypass surgery may be required if angina is exacerbated by levothyroxine replacement therapy. Reference : page 2293 Harrison's Principles of Internal Medicine 19th edition and page 744 Davidson's Principles and practice of Medicine 22nd edition
Low dose of Levothyroxine
Normal dose of Levothyroxine
Do not use Levothyroxine
Use thyroid extract
Endocrinology