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What Is Levothyroxine?

Levothyroxine sodium is a prescription synthetic form of thyroxine, also called T4. Current tablet labeling includes thyroid hormone replacement for primary, secondary, or tertiary congenital or acquired hypothyroidism in adults and children, including neonates. It is also used with surgery and radioiodine for thyroid-stimulating hormone suppression in selected well-differentiated thyroid cancer.

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What Is Levothyroxine?

Levothyroxine sodium is a prescription synthetic form of thyroxine, also called T4. Current tablet labeling includes thyroid hormone replacement for primary, secondary, or tertiary congenital or acquired hypothyroidism in adults and children, including neonates. It is also used with surgery and radioiodine for thyroid-stimulating hormone suppression in selected well-differentiated thyroid cancer.

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How Does Levothyroxine Work?

Levothyroxine acts like endogenous thyroxine. T4 is converted in tissues to triiodothyronine, or T3, which binds thyroid hormone receptors and regulates metabolism, growth, development, and other physiologic processes.

Who Is Treated With Levothyroxine?

Levothyroxine is used in adults and pediatric patients with congenital or acquired hypothyroidism and in selected patients requiring thyroid-stimulating hormone suppression for well-differentiated thyroid cancer. It is not indicated for suppression of benign thyroid nodules or nontoxic diffuse goiter in iodine-sufficient patients.

How Is Levothyroxine Dosed?

Dosing is individualized according to age, body weight, cardiovascular status, pregnancy, laboratory results, and other medicines. A full replacement dose in otherwise healthy adults is about 1.6 mcg per kg once daily. Older adults and patients with underlying cardiac disease start lower and titrate more slowly. Tablets are taken once daily on an empty stomach 30 to 60 minutes before breakfast.

What Serious Risks Are Linked to Levothyroxine?

Levothyroxine carries a boxed warning that thyroid hormones are not used to treat obesity or for weight loss. Excess dosing can cause serious or life-threatening toxicity, including fast or irregular heart rhythms, angina, and other hyperthyroid effects. Treatment can also worsen blood glucose control and reduce bone mineral density with overtreatment. Uncorrected adrenal insufficiency is a contraindication.

Frequently Asked Questions About Levothyroxine

What conditions does levothyroxine treat?

Levothyroxine replaces thyroid hormone in hypothyroidism and is also used for thyroid-stimulating hormone suppression in selected well-differentiated thyroid cancer.

What is a common full replacement dose in a healthy adult?

A common full replacement dose is about 1.6 mcg per kg once daily, with individual adjustment based on laboratory and clinical findings.

When should levothyroxine tablets be taken?

Tablets are taken once daily on an empty stomach, 30 to 60 minutes before breakfast.

Can levothyroxine be used for weight loss?

No. Levothyroxine carries a boxed warning against use for obesity or weight loss.

References

DailyMed - LEVOTHYROXINE SODIUM tablet. https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=741a8b30-86e1-4f37-917a-73265a82ee07. Date Accessed October 12, 2026.

Levothyroxine. MedlinePlus. https://www.medlineplus.gov/druginfo/meds/a682461.html. Date Accessed October 12, 2026.

Levothyroxine. PubChem. https://pubchem.ncbi.nlm.nih.gov/compound/levothyroxine. Date Accessed October 12, 2026.

Levothyroxine. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK539808/. Date Accessed October 12, 2026.

Thyroid Hormone. LiverTox. https://www.ncbi.nlm.nih.gov/books/NBK548497/. Date Accessed October 12, 2026.