31-60mg up to 1 grain

Oral administration (capsule or tablet) on an empty stomach, 30–60 minutes before the first meal.

• Swallow with water; do not crush or chew.
• Maintain at least 4-hour separation from calcium, iron, antacids, and bile acid sequestrants.

The 31–60 mg range spans from the first dose-step above the starting 30 mg dose up to the 1-grain (60 mg) level, which is the lower end of maintenance dosing for many patients:

• Typical titration increases are 15 mg every 2–3 weeks from the starting dose.
• 60 mg (1 grain) may be a sufficient maintenance dose for smaller adults, children transitioning to adult dosing, or patients with partial residual thyroid function.
• Reassess TSH, free T4, and free T3 at 4–6 weeks after reaching each new dose.
• All dosing is prescribed individually by the clinician.

• Levothyroxine (T4): Undergoes deiodination to T3 peripherally; T3 binds TRα/TRβ receptors and regulates thyroid-responsive gene transcription governing metabolic rate, thermogenesis, and cardiovascular function.
• Liothyronine (T3): Directly and rapidly binds nuclear thyroid hormone receptors with high affinity, producing immediate thyromimetic effects without dependence on peripheral conversion.

Doses in the 31–60 mg range represent the transition from initiation to early maintenance thyroid hormone therapy. Clinical use includes:

• Continuing titration in patients recently initiated on thyroid hormone replacement.
• Maintenance dosing in smaller adults, patients with partial thyroid function, or those with higher cardiovascular sensitivity requiring slower titration.
• Monitoring TSH and free thyroid hormones every 4–6 weeks during active titration; annually when stable.
• Watch for signs of overcorrection (palpitations, tremor, excessive weight loss) at the upper end of this range.

Contraindications:

• Untreated adrenal insufficiency.
• Active thyrotoxicosis.
• Acute myocardial infarction.
• Hypersensitivity to ingredients.

Warnings & Precautions:

• Monitor cardiac status, especially in older adults and those with known cardiovascular disease.
• Hold biotin supplements ≥48 hours before thyroid function lab draws.

Drug Interactions:

• Warfarin: thyroid hormones potentiate anticoagulant effect; monitor INR closely during dose changes.
• Calcium, iron, antacids, PPIs: impair absorption; maintain 4-hour separation.

Common Side Effects: Palpitations, tachycardia, tremor, sweating, heat intolerance, weight loss, insomnia, diarrhea at supratherapeutic doses.

Store at controlled room temperature (15–25°C), protected from light and moisture. Keep container tightly closed. Keep out of reach of children. Use before the beyond-use date labeled by Genesis Compounding.

What does the '31–60 mg' range mean?

This indicates that the preparation is prescribed within this dose range; the exact strength is specified by your prescriber. One grain equals 60 mg; this range covers half-grain to full-grain territory and represents initiation-to-early-maintenance dosing.

Is 60 mg a full maintenance dose?

For some patients — particularly those with smaller body size or partial thyroid function — 60 mg (1 grain) may be a sufficient maintenance dose. Most adults require 60–120 mg/day. Your prescriber will determine the appropriate dose based on your labs and symptoms.

When are labs checked?

TSH, free T4, and free T3 should be checked 4–6 weeks after initiating or changing this dose. Remember to avoid biotin supplements for at least 48 hours before any thyroid blood test.

Is this preparation FDA-approved?

No. This is a patient-specific, 503A compounded preparation from Genesis Compounding and is not FDA-approved as a finished drug product.

Can I take this with my other morning medications?

Thyroid hormone should be taken separately from calcium, iron, antacids, and many other medications. Consult your prescriber or pharmacist for a complete list of separation requirements.