Related Experiment Video

Updated: Feb 27, 2026

Transoral Endoscopic Thyroidectomy Vestibular Approach for Thyroid Lobectomy
05:12

Transoral Endoscopic Thyroidectomy Vestibular Approach for Thyroid Lobectomy

Published on: May 12, 2023

5.1K

TARGETED LEVOTHYROXINE THERAPY FOR TREATMENT OF CONGENITAL HYPOTHYROIDISM

Melissa J Schoelwer, Wanzhu Tu, Junyi Zhou

    Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
    |July 7, 2017
    PubMed

    Insights

    Targeted levothyroxine (LT4) dosing for congenital hypothyroidism (CH) based on thyroid anatomy did not reduce overall dose adjustments. Infants with athyreosis required fewer undertreatment adjustments but more overtreatment adjustments with this approach.

    Area of Science:

    • Pediatric Endocrinology
    • Neonatal Care
    • Thyroid Disorders

    Background:

    • Congenital hypothyroidism (CH) requires lifelong levothyroxine (LT4) therapy.
    • Initial LT4 dosing strategies vary, impacting treatment efficacy.
    • Optimizing LT4 dosage in infants is crucial for normal development.

    Purpose of the Study:

    • To investigate if initial LT4 doses guided by thyroid gland anatomy in infants with CH reduce dose adjustments within the first six months.
    • To compare dose adjustments between infants receiving anatomy-based LT4 dosing and those receiving empirical dosing.

    Main Methods:

    • Prospective, historical case-controlled study involving newborns diagnosed with CH.
    • Thyroid ultrasound determined initial LT4 dosage: 15 mcg/kg (athyreosis), 12 mcg/kg (dysgenetic), 10 mcg/kg (normal).
    • Matched study participants with historical controls based on sex and thyroid anatomy, recording dose adjustments over six months.

    Main Results:

    • No significant difference in overall LT4 dose adjustments between the anatomy-based group and controls.
    • Infants with athyreosis in the study group had significantly fewer adjustments for undertreatment (P=.03).
    • Infants with athyreosis in the study group had significantly more adjustments for overtreatment (P=.006).

    Conclusions:

    • Anatomy-guided LT4 dosing does not decrease the overall frequency of dose adjustments in infants with CH.
    • The 15 mcg/kg/day dose for athyreosis may exceed actual thyroid hormone needs in these infants.
    • Further refinement of LT4 dosing strategies for CH is warranted.
    Abstract

    More Related Videos

    Pre-clinical Evaluation of Tyrosine Kinase Inhibitors for Treatment of Acute Leukemia10:49

    Pre-clinical Evaluation of Tyrosine Kinase Inhibitors for Treatment of Acute Leukemia

    Published on: September 18, 2013

    18.7K
    Minimal Invasive Resection of Large Retrosternal Thyroid Goiter04:09

    Minimal Invasive Resection of Large Retrosternal Thyroid Goiter

    Published on: September 20, 2024

    1.0K

    Related Concept Videos

    Synthesis and Regulation of Thyroid Hormones01:20

    Synthesis and Regulation of Thyroid Hormones

    Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
    Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The...
    8.3K
    Functions of Thyroid Hormones01:18

    Functions of Thyroid Hormones

    The thyroid hormone (TH) plays a pivotal role in the intricate orchestration of physiological processes, exerting profound effects on development, metabolism, and homeostasis throughout different life stages.
    TH is indispensable for the normal development and maturation of the skeletal, muscular, and nervous systems during fetal and childhood growth. It facilitates bone mineral turnover and regulates protein synthesis in developing tissues, contributing significantly to overall growth and...
    6.0K
    Targeted Cancer Therapies02:57

    Targeted Cancer Therapies

    The targeted cancer therapies, also known as “molecular targeted therapies,” take advantage of the molecular and genetic differences between the cancer cells and the normal cells. It needs a thorough understanding of the cancer cells to develop drugs that can target specific molecular aspects that drive the growth, progression, and spread of cancer cells without affecting the growth and survival of other normal cells in the body.
    There are several types of targeted therapies against...
    9.0K
    Pharmacogenetics of Drug Targets: β₂-Adrenergic Receptors, Apo E, Thymidylate Synthase01:11

    Pharmacogenetics of Drug Targets: β₂-Adrenergic Receptors, Apo E, Thymidylate Synthase

    Genetic polymorphisms in drug targets have emerged as critical determinants of interindividual variability in drug response and toxicity. Pharmacogenomic investigations increasingly focus on identifying these variations to personalize and optimize therapeutic interventions. A drug target may be a receptor, enzyme, or signaling protein involved in pharmacologic responses or disease-related pathways. While early pharmacogenetic studies focused primarily on drug metabolism, current research...
    51
    The Thyroid Gland01:23

    The Thyroid Gland

    The thyroid gland is a small, butterfly-shaped gland located in the neck and covers the anterior surface of the trachea. The gland has two lateral lobes connected by a thin tissue mass called the isthmus. Internally, each lobe comprises many small spherical structures known as thyroid follicles, surrounded by a network of blood vessels.
    The follicles have a central cavity lined by simple cuboidal to squamous epithelial cells called follicular cells. These cells produce the glycoprotein...
    8.0K
    Drug Dosing: Infants and Children01:29

    Drug Dosing: Infants and Children

    Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
    407