Selection and Precautions for Hypothyroidism Treatment Thyroid News At the 14th National Conference on Endocrinology (CSE), Prof. Shi Yongquan from the Department of Endocrinology, Shanghai Changzheng Hospital gave a presentation on “Thyroid Hormone Therapy: Selection and Precautions for Hypothyroidism Treatment Drugs”. Treatment of cretinism Initially, oral T3 5ug every 8 hours and L-T4 25ug/d were given, and L-T4 was increased to 37.5ug/d after 3 days, and T3 was changed to 2.5ug every 8 hours after 6 days. Over the course of treatment, L-T4 is gradually increased to 50ug/d or more, while T3 is gradually reduced to discontinuation. Based on current clinical studies and national guidelines, L-T4 is the drug of choice for the treatment of adult hypothyroidism. The starting dose of treatment for primary hypothyroidism depends on the patient’s age, weight and cardiac status. If the patient is an adult patient <50 years of age with no previous history of heart disease, the full replacement dose can be reached as soon as possible; if the patient is older than 50 years of age or has a history of heart disease, gradual increments are required to reach equilibrium. Replacement therapy During replacement therapy, dose adjustment requires adequate biochemical evaluation, taking into account the improvement of clinical symptoms, relevant comorbidities and other potential causes, and regular monitoring of nail function during replacement therapy, with a testing period of not less than two weeks. Considerations for replacement therapy 1. gender differences: the dosage for men is greater than that for women 2. age differences: the dosage requirement for elderly patients is reduced 3. TSH <2.5mIU/L needs to be controlled before pregnancy 4. sex hormones can affect the treatment of female hypothyroidism The treatment of subclinical hypothyroidism is still controversial. It is generally believed that most subclinical hypothyroidism needs to be treated. For elderly patients or patients with combined cardiovascular disease, control goals need to be set and followed up regularly, and menopausal women must pay attention to the prevention of osteoporosis during treatment.