#208 Hypothyroidism Master Class with Susan Mandel MD - How to dominate the diagnosis and management
The Curbsiders Internal Medicine Podcast
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How to Start Treatment for Hypothyroidism
For older patients and generally people will say over the age of 65 or 70 we don't generally start with a full replacement dose. Unless for example you just took out their thyroid so their thyroid levels were normal yesterday and now their thyroid is gone and you're putting them on it. You would start with 25 to 50 micrograms if they're healthy 50 might be fine but for example if they have a history of coronary artery disease you might start with 25 because that will increase your MVO2 and you don't want to precipitate the angina. Your target can be a TSH in the high normal range 4 to 5 to 6 and someone who's over 70 which could be
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