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Once your doctor has found your specific synthroid dose, it is important to have lab tests done, as ordered by your doctor, at least once a year.

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Frequency not reportedPalpitationstachycardiahypertensionarrhythmiasincreased pulse and blood pressureheart failureanginamyocardial infarctioncardiac arrestRef]

The patient should be monitored closely to avoid undertreatment or overtreatmentUndertreatment may have deleterious effects on intellectual development and linear growthOvertreatment has been associated with craniosynostosis in infantsand may adversely affect the tempo of brain maturation and accelerate the bone age with resultant premature closure of the epiphyses and compromised adult stature.

The presence of concomitant medical conditions should be considered in certain clinical circumstances andif presentappropriately treatedsee PRECAUTIONS

Occasionallychronic autoimmune thyroiditis may occur in association with other autoimmune disorders such as adrenal insufficiencypernicious anemiaand insulin-dependent diabetes mellitusPatients with concomitant adrenal insufficiency should be treated with replacement glucocorticoids prior to initiation of treatment with levothyroxine sodiumFailure to do so may precipitate an acute adrenal crisis when thyroid hormone therapy is initiateddue to increased metabolic clearance of glucocorticoids by thyroid hormonePatients with diabetes mellitus may require upward adjustments of their antidiabetic therapeutic regimens when treated with levothyroxinesee DRUG INTERACTIONS

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