Case Reports of Three Hypothyroid Patients Requiring Very High Doses of Levothyroxine

Chukwuma Ekpebegh


Majority of hypothyroid patients achieve and maintain euthyroidism on doses of levothyroxine in the range of 100 to 200 ug per day. This is a report of three patients with hypothyroidism requiring 300 - 450 ug of levothyroxine daily to be euthyroid. These comprised one case of central and two cases of primary hypothyroidism. Contributory factors to high doses of levothyroxine in the patients include use of efavirenz in one patient, morbid obesity and cimetidine therapy in another patient and sodium valproate treatment in the third patient. High doses of levothyroxine may be required to achieve euthyroidism in patients receiving efavirenz, sodium valproate and cimetidine.

J Med Cases. 2014;5(8):452-454


Levothyroxine; High doses; Hypothyroidism; Efavirenz; Cimetidine; Sodium valproate; Obesity

Full Text: HTML PDF

Browse  Journals  


Journal of Clinical Medicine Research

Journal of Endocrinology and Metabolism

Journal of Clinical Gynecology and Obstetrics


World Journal of Oncology

Gastroenterology Research

Journal of Hematology


Journal of Medical Cases

Journal of Current Surgery

Clinical Infection and Immunity


Cardiology Research

World Journal of Nephrology and Urology

Cellular and Molecular Medicine Research


Journal of Neurology Research

International Journal of Clinical Pediatrics



Journal of Medical Cases, monthly, ISSN 1923-4155 (print), 1923-4163 (online), published by Elmer Press Inc.                     
The content of this site is intended for health care professionals.
This is an open-access journal distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, which permits unrestricted
non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Creative Commons Attribution license (Attribution-NonCommercial 4.0 International CC-BY-NC 4.0)

This journal follows the International Committee of Medical Journal Editors (ICMJE) recommendations for manuscripts submitted to biomedical journals,
the Committee on Publication Ethics (COPE) guidelines, and the Principles of Transparency and Best Practice in Scholarly Publishing.

website:   editorial contact:
Address: 9225 Leslie Street, Suite 201, Richmond Hill, Ontario, L4B 3H6, Canada

© Elmer Press Inc. All Rights Reserved.

Disclaimer: The views and opinions expressed in the published articles are those of the authors and do not necessarily reflect the views or opinions of the editors and Elmer Press Inc. This website is provided for medical research and informational purposes only and does not constitute any medical advice or professional services. The information provided in this journal should not be used for diagnosis and treatment, those seeking medical advice should always consult with a licensed physician.