T4 Dosing Precision: The Art & Science of Thyroid Optimization

[Anabolix]

⚖️ T4 Dosing Precision: The Art & Science of Thyroid Optimization
Why "One-Size-Fits-All" Fails With Levothyroxine​

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🧪 The Gold Standard: Weight-Based Initiation
The universally accepted starting dose is:

• 1.6 mcg/kg/day for healthy adults
• Example: 70kg person → 112mcg/day
• Always adjusted for:
  → Lean body mass (not total weight)
  → Residual thyroid function (TSH levels)
  → Cardiac risk factors

Pro Tip: Take fasting with water only - coffee reduces absorption by 30%

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👵 Special Population Protocols

Population	Dose Adjustment	Rationale
Elderly/Frail	25-50mcg/day starting	• Slower metabolism • Cardiac sensitivity • Higher fracture risk
Pregnancy	+20-30% increase needed	• ↑ Thyroid-binding globulin • Fetal brain development demands
Post-Bariatric Surgery	May require 2-3x higher doses	• Malabsorption issues • Altered gut pH

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⚠️ Critical Dose Modifiers

1. Medications That Reduce Absorption:
   → Calcium carbonate (30% reduction)
   → Iron sulfate (40% reduction)
   → PPIs (28% reduction)
   Solution: Dose 4+ hours apart
2. Conditions Requiring Higher Doses:
   → Celiac disease
   → H. pylori infection
   → Lactose intolerance
3. Lifestyle Factors:
   → Vegan diets often need +15% dose
   → Heavy exercise may increase needs

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🔄 Lifelong Adjustment Guide

When to Reassess	Expected Change
Every 10 years after age 50	+5-15mcg likely needed

Weight change ±10kg
±12-25mcg adjustment

Starting/stopping estrogen
±20-30mcg change

Monitoring is Key: Get TSH tested every 6-8 weeks post-dose change, then annually when stable

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💬 Discussion Starters:
1. What dosing strategy worked best for you?
2. Have you experienced absorption issues with other meds?
3. How often do you retest your thyroid levels?

🔬 DOWNLOAD OUR T4 DOSING CALCULATOR​