The DOI matches its Crossref record; 1 of the 1 references it cites were found in a registry or an index.
Levothyroxine Therapy in Patients with Thyroid Disease
Abstract
PURPOSE: To review the indications for and the proper monitoring of levothyroxine therapy in patients with thyroid disease. DATA SOURCES: Relevant English language articles published from 1966 to 1992 were identified through a MEDLINE search and manual searches of both identified articles and selected endocrinology texts. STUDY SELECTION: Studies, case reports, and review articles that contained data on the pathophysiologic aspects of relevant thyroid disorders and on the pharmacologic aspects of, indications for, and administration of levothyroxine therapy. DATA EXTRACTION: Data on the epidemiology, clinical manifestations, complications, and treatment of thyroid disorders were analyzed with respect to patient selection, methods, diagnostic criteria, and conclusions. These data were used to develop a rational approach to the management of such patients. RESULTS OF DATA SYNTHESIS: Levothyroxine is a reliable and commonly prescribed drug to treat thyroid disease, but excessive dosage may have adverse effects. In patients with hypothyroidism, levothyroxine is used as replacement therapy. For most patients, therapy can be initiated with a full replacement dosage (1.6 micrograms/kg body weight), which is usually 75 to 100 micrograms/day for women and 100 to 150 micrograms/d for men. The goal is to normalize the serum thyroid-stimulating hormone concentration. Levothyroxine is also used to suppress the serum thyroid-stimulating hormone concentration. A trial of thyroid-stimulating hormone suppressive therapy is indicated for most patients with benign solitary nonfunctioning thyroid nodules and for those with a history of thyroid cancer. Levothyroxine in non-thyroid-stimulating hormone-suppressive doses may also be indicated for patients with nontoxic multinodular goiter and for certain patients after lobectomy for benign thyroid nodules. CONCLUSIONS: With proper patient monitoring, levothyroxine replacement therapy should be effective, inexpensive, and free of complications. Recommendations for thyroid-stimulating hormone suppression with levothyroxine are based on risk-benefit considerations of the biologic characteristics of the thyroid disorder and the individual patient.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“Based on body weight, hypothyroid patients with minimal endogenous thyroid function require LT4 doses of 1.6-1.8 l g/kg of actual body weight (38,47,212,213,215-217,226,227), although some studies estimate higher doses of 2.0-2.1 l g/kg for some patient groups (212,213,226).”
From Guidelines for the Treatment of Hypothyroidism: Prepared by the American Thyroid Association Task Force on Thyroid Hormone Replacement (2014) · cites this paper as [47]
In the citing paper
“Most studies examining this issue were retrospective chart reviews (47,212-224), but some studies were prospective (38,225-229).”
From Guidelines for the Treatment of Hypothyroidism: Prepared by the American Thyroid Association Task Force on Thyroid Hormone Replacement (2014) · cites this paper as [47]
In the citing paper
“Despite this, studies show that for many people levothyroxine dosage is not adjusted as they age because either monitoring for thyroid dysfunction may be not be carried out or indicated dose adjustments identified by monitoring may not be implemented.9 10 11 12 13 14”
From Levothyroxine dose and risk of fractures in older adults: nested case-control study (2011) · cites this paper as [9]
In the citing paper
“While the optimal levothyroxine dose for adults is 1.6-1.8 µg/kg/day,1 9”
From Levothyroxine dose and risk of fractures in older adults: nested case-control study (2011) · cites this paper as [9]
Citations
Cites
The publisher hasn’t deposited this paper’s reference list.
Cited by
Sorted by citations
Jonklaas, J., Bianco, A. C., Bauer, A. J., Burman, K. D., Cappola, A. R., Celi, F. S., Cooper, D. S., Kim, B. W., Peeters, R. P., Rosenthal, M. S., et al. (2014) · Thyroid® · doi:10.1089/thy.2014.0028 · Cited by 1,928
“The goals of LT4 replacement in primary hypothyroidism are to achieve a state of euthyroidism and normalization of the circulating levels of TSH and thyroid hormones (47,48).”
DeGroot, L. J., Abalovich, M., Alexander, E. K., Amino, N., Barbour, L. A., Cobin, R. H., Eastman, C. J., Lazarus, J. H., Luton, D., Mandel, S. J., et al. (2012) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2011-2803 · Cited by 1,885
Self-citationGarber, J. R., Cobin, R. H., Gharib, H., Hennessey, J. V., Klein, I., Mechanick, J. I., Pessah-Pollack, R., Singer, P. A., & Woeber, K. A. (2012) · Endocrine Practice · doi:10.4158/ep12280.gl · Cited by 1,567
Garber, J. R., Cobin, R. H., Gharib, H., Hennessey, J. V., Klein, I., Mechanick, J. I., Pessah-Pollack, R., Singer, P. A., & Woeber for the American Association, K. A. (2012) · Thyroid · doi:10.1089/thy.2012.0205 · Cited by 1,053
Abalovich, M., Amino, N., Barbour, L. A., Cobin, R. H., DeGroot, L. J., Glinoer, D., Mandel, S. J., & Stagnaro‐Green, A. (2007) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2007-0141 · Cited by 934
Self-citation
Metadata
- Authors
- Mandel, S. J., Brent, G. A., & Larsen, P. R.
- Affiliations
- Brigham and Women's Hospital (US)
- Corresponding author
- Mandel, Susan J.
- Venue
- Annals of Internal Medicine
- Publisher
- American College of Physicians
- Published
- 1993-09-15
- Volume
- 119
- Issue
- 6
- Pages
- 492-502
- ISSN
- 0003-4819 (ISSN-L)
- 1539-3704
- OpenAlex
- W2017578266
- Cited by
- 324
- References
- 0
- Citations by year
- 2025: 2 · 2024: 4 · 2023: 8 · 2022: 4 · 2021: 11 · 2020: 9 · 2019: 5 · 2018: 6 · 2017: 9 · 2016: 15 · 2015: 12 · 2014: 13 · 2013: 16 · 2012: 14
- FWCI
- 8.38
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r01dk043714-09)
- National Institute of Diabetes and Digestive and Kidney Diseases (1 R01 DK 43714, R01DK036256, T32DK007529)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Cancer Diagnosis and Treatment
- Keywords
- levothyroxine, thyroid dysfunction, hypothyroidism, thyroid-stimulating hormone, TSH suppression therapy, thyroid hormone replacement, thyroid nodules, multinodular goiter, thyroid cancer, lobectomy, drug dosing, adverse effects
- MeSH terms
- Female, Humans, Male, Pituitary Gland, Thyroid Diseases, Thyroid Gland, Thyroid Hormones, Thyrotropin, Thyroxine
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
How to cite
Cite CoChat for the checks on this page, and the paper for its own findings.
- This page
- CoChat. (2026). Citation check: Levothyroxine Therapy in Patients with Thyroid Disease. https://app.cochat.ai/papers/10.7326/0003-4819-119-6-199309150-00009
- The paper
- Mandel, S. J., Brent, G. A., & Larsen, P. R. (1993). Levothyroxine Therapy in Patients with Thyroid Disease. Annals of Internal Medicine. https://doi.org/10.7326/0003-4819-119-6-199309150-00009
