Pediatric Hypothyroidism Medication

Updated: Dec 20, 2016
  • Author: Sunil Kumar Sinha, MD; Chief Editor: Sasigarn A Bowden, MD  more...
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Medication Summary

Levothyroxine is generally considered to be the treatment of choice for patients with hypothyroidism.


Thyroid Hormone

Class Summary

Levothyroxine is the preferred form of thyroid hormone replacement in all patients with hypothyroidism. Rarely, patients with congenital hypothyroidism display a "reset thyrostat" (ie, the serum TSH is not suppressed to reference range even with supraphysiologic replacement of levothyroxine). The primary therapeutic goal in patients with congenital hypothyroidism is to maintain the free serum T4 level within the high end of the reference range without resulting in symptoms of hyperthyroidism.

Thyroid hormones only should be used as replacement therapy in children with hypothyroidism. In active form, thyroid hormone influences growth and maturation of tissues, metabolism, and development. It does not enhance final adult height in euthyroid children.

Levothyroxine (Levothroid, Levoxyl, Synthroid, Thyquidity)

Synthetic drug identical to human T4. Adjust dose on basis of total T4 and TSH (if primary hypothyroidism) or free T4 (if secondary or tertiary hypothyroidism); target range is normal total or free T4, with TSH < 5 mcU/mL. Use a single brand to avoid variations in potency between brands. Several commercial preparations are available and share equal efficacy, despite different potency. With age, dose decreases on a weight basis, although daily dose approximates 100 mcg/m2, IV dose is approximately 40-50% of the PO dose.