A 26-year-old client admitted for a simple goiter is prescribed levothyroxine. Which symptom indicates the dosage is too high?

A 26-year-old client admitted for a simple goiter is prescribed levothyroxine. Which symptom indicates the dosage is too high?

• A. Lethargy and lack of appetite.
• B. Palpitations and shortness of breath.
• C. Bradycardia and constipation.
• D. Muscle cramps and dry, flushed skin.

Answer: (B)

Excess thyroid hormone from levothyroxine speeds up the body's metabolism and heart activity. The most telling sign of an overdose is the heart going into overdrive, which shows up as palpitations and shortness of breath from the increased heart rate and workload. These symptoms reflect a hyperthyroid-like state caused by too much hormone. Lethargy and decreased appetite align with under-treatment rather than over-treatment, while bradycardia and constipation point to too little thyroid hormone. Muscle cramps with dry, flushed skin aren’t the classic pattern of excess thyroid hormone, so they’re less consistent with an overdose. The combination that fits the idea of too much hormone best is palpitations with shortness of breath. If this occurs, clinicians typically reassess the dose and monitor thyroid levels to achieve a euthyroid state.

Excess thyroid hormone from levothyroxine speeds up the body's metabolism and heart activity. The most telling sign of an overdose is the heart going into overdrive, which shows up as palpitations and shortness of breath from the increased heart rate and workload. These symptoms reflect a hyperthyroid-like state caused by too much hormone.

Lethargy and decreased appetite align with under-treatment rather than over-treatment, while bradycardia and constipation point to too little thyroid hormone. Muscle cramps with dry, flushed skin aren’t the classic pattern of excess thyroid hormone, so they’re less consistent with an overdose. The combination that fits the idea of too much hormone best is palpitations with shortness of breath. If this occurs, clinicians typically reassess the dose and monitor thyroid levels to achieve a euthyroid state.