Day
Date
What to do
0
(Day:)
Date:
Have baseline TSH and Thyroglobulin drawn if not done in the past 60 days. Stop L-thyroxine medication beginning on day 0
7
(Day:)
Date:
One week after stopping L-thyroxine, begin Cytomel 25 or 37.5 mcg per day (Circle one dose) for 2 weeks
21
(Day:)
Date:
Stop Cytomel
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