Levothyroxine Weight-Based Dosing

Calculate suggested starting or maintenance doses for levothyroxine using guideline-based mcg/kg targets. Always confirm with thyroid function tests.

Full replacement ~1.6 mcg/kg/day.

Enter 0 if patient is levothyroxine-naïve.

Dose Suggestion

Calculated dose

112 mcg/day

Weight: 70.0 kg • 1.6 mcg/kg.

Rounded tablet strength

112 mcg/day

Starting dose. Recheck TSH in 6–8 weeks.

Adjust doses in 12.5–25 mcg increments every 6–8 weeks to reach target TSH. In elderly or cardiac patients, start lower (12.5–25 mcg/day) despite calculated weight-based dose.

How to Use This Calculator

1

Select the clinical scenario

Different populations need different mcg/kg targets to avoid over-treatment.

2

Enter weight and current dose

The calculator suggests a target and compares it with current therapy.

3

Round to available strengths

Levothyroxine tablets come in specific strengths—round to the nearest feasible option.

Formula

Daily dose (mcg) = weight (kg) × mcg/kg (1.6 mcg/kg healthy adults).

Derived from ATA/AACE hypothyroidism guidelines and Endocrine Society recommendations.

Frequently Asked Questions

How often should TSH be monitored?

Check TSH 6–8 weeks after dose changes, then every 6–12 months once stable.

Should I use actual or ideal body weight?

Use actual weight unless BMI >30; in obesity consider lean body weight (IBW + 0.2 × (actual − IBW)).

What about pregnancy?

Increase dose by ~30% at confirmation (take 2 extra tablets weekly) and monitor TSH monthly.

Can doses vary during the week?

Yes. Average weekly dose matters; use pill boxes or alternate daily doses as needed.

What medications interfere with absorption?

Calcium, iron, PPIs, sucralfate, soy. Separate by at least 4 hours.