Adult Hypothyroidism: Starting Levothyroxine — free guideline decision tool
This tool guides starting levothyroxine in adult hypothyroidism by type (overt/subclinical/central), TSH, and cardiac/pregnancy status, including a starting strategy and weight-based dose estimate.
Open guideline tool →Guideline-based
Implements the decision logic from published clinical guidelines.
Runs in your browser
No installation. Enter the patient's values and get a guideline recommendation instantly.
Data stays local
Nothing is uploaded. Results are for licensed clinicians only.
Common questions
What does Adult Hypothyroidism: Starting Levothyroxine do?
Use to decide whether to replace and how to start: overt and central hypothyroidism need replacement, subclinical disease is treated at TSH ≥ 10 or with high-risk features, and starting dose is tailored to age/cardiac status and pregnancy.
How is the result calculated?
Overt/central → replace (central: assess adrenal function first, monitor FT4). Subclinical: TSH ≥ 10 → treat; TSH < 10 with pregnancy/symptoms/TPOAb/CV risk → consider. Full dose ~1.6 μg/kg/d (~1.0 if elderly/cardiac; +30–50% in pregnancy).
Is this a substitute for clinical judgement?
No. All results are decision-support only, for licensed clinicians. They must be individualized to the whole patient and the latest guideline version.
Run Adult Hypothyroidism: Starting Levothyroxine now
This tool guides starting levothyroxine in adult hypothyroidism by type (overt/subclinical/central), TSH, and cardiac/pregnancy status, including a starting strategy and weight-based dose estimate.
Open guideline tool →For licensed clinicians. Not a substitute for clinical judgement.