A member asked:

Should methimazole be dosed on tsh or ft4, t4, t3, (liothyronine) ft3 levels?

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Dr. Joseph Mathews answered

Specializes in Internal Medicine - Endocrinology

All of the above: Methimazole is a thionimide that inhibits the formation of thyroid hormone it is important to measure tsh, ft4 ; ft3 (liothyronine) levels to have a better idea of the physiology causing the hyperthyroidism, ie is it subclinical hyperthyroidism, t3 (liothyronine) preferential secretion, or severe thyrotoxicosis. The TSH can be very suppressed with only minimally elevated t4/t3 (liothyronine) which would not need as high a dose.

Answered 10/23/2017

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