BACKGROUND: Weight-based postoperative @entity1955 ( @entity2016 ) dosing often fails to appropriately dose overweight and underweight @entity1 . Previously, we created an @entity2016 -dosing algorithm based on BMI. We hypothesize that more @entity1 will achieve euthyroidism at their postoperative visit with the use of the protocol. STUDY DESIGN: A prospective evaluation was performed of our previously published BMI-based @entity2016 dosing. All adults who underwent thyroidectomy for benign disease between January 1, 2011 and December 31, 2013 were included; the new protocol was implemented in October 2012. Serum TSH was measured for all @entity1 6 to 8 weeks postoperatively, and adjustments were based on TSH. RESULTS: Three hundred and thirty @entity1 were included, with 54% undergoing thyroidectomy after institution of the protocol. The groups were well matched. Before protocol implementation, @entity2016 was dosed solely by weight and 25% of @entity1 were euthyroid at initial follow-up. After the protocol, 39% of @entity1 were euthyroid (p  = 0.01). The percentage of @entity1 who were given too high a dose of @entity2016 remained the same (46% vs 42%), and there was a significant reduction in the number of @entity1 who were given too little (29% vs 19%; p  =  0.05). The effect was most profound in @entity1 with low and normal BMI, and there were slight differences between sexes. CONCLUSIONS: Although correct initial dosing of @entity2016 remains challenging, this dosing protocol that we developed and implemented has improved @entity1 care by increasing the number of @entity1 who achieve euthyroidism at the first postoperative visit. We have made a change to our original protocol to incorporate sex differences into the calculation.

Prospective Intervention of a Novel XXXX Dosing Protocol Based on Body Mass Index after Thyroidectomy.

@entity1 :: ('9606', 'Species') :: ['patient', 'patients'] @entity1955 :: ('MESH:D013974', 'Chemical') :: ['levothyroxine'] @entity2016 :: ('CHEBI:18332', 'Chemical') :: ['LT4']
@entity1955 :: (MESH:D013974,Chemical) :: ['Levothyroxine']
