Lynchburg Journal of Medical Science

Lynchburg Journal of Medical Science


Family Medicine


Dr. Tom Colletti


Treating patients with hypothyroidism not well controlled with the standard treatment of levothyroxine tablets can be challenging due to unknown underlying conditions that can decrease absorption. Clinicians should be aware of the varying causes of treatment-refractory hypothyroidism. An appropriate work-up, treatment of the underlying condition, and understanding the appropriate use and availability of alternative levothyroxine formulations can improve patient outcome, safety, and satisfaction. This article focuses on a patient with a history of treatment-refractory hypothyroidism with frequent dose changes of levothyroxine tablets and desiccated thyroid with continued symptoms and elevated Thyroid Stimulating Hormone (TSH).


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