Bechtol, L.D.; Warner, W.L.
November 1969
Angiology;Nov1969, Vol. 20 Issue 10, p565
Academic Journal
Sodium dextrothyroxine, in daily doses of 2 to 8 mg, is effective in lowering elevated serum cholesterol in both hypothyroid and euthyroid patients. This effect is somewhat greater in hypothyroid than in euthyroid patients, and is sustained for at least three years of therapy and beyond. The drug, when administered in a proper dosage schedule, is useful for the treatment of hypothyroidism is cardiac patients who cannot tolerate other types of thyroid medication. The side effects attributable to the drug are, for the most part, caused by increased metabolism. Adverse effects are more commonly seen in patients with hypothyroidism and/or coronary artery disease than in euthyroid patients without cardiac disease. Adverse change in cardiac status is not a significant problem in noncardiac patients, whether euthyroid or hypothyroid. In cardiac patients, such changes can be minimized by proper patient selection and attention to dosage schedules. Although not observed in very elderly patients, the mortality rate of D-thyroxine-treated patients is no higher than anticipated, especially in the noncardiac group, and may be lower than expected. Since the significant side effects are largely metabolic and appear to be dose related, it seems advisable to initiate therapy at low dosage levels (1 or 2 mg daily) and to increase the dose gradually until the desirable therapeutic range is reached. The maximum dose is dependent on individual patient tolerance, which may vary with thyroid and cardiac status and probably should be limited to 8 mg daily.


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