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The p K a of carboxylic acids is ~5, and the p K a of phenol is ~10

A detailed thyroid history is essential, including diagnosis date, current levothyroxine dosage, recent TSH and free T4 levels, presence of thyroid nodules, history of thyroid surgery or radioactive iodine treatment, and any family history of thyroid cancer or MEN 2 syndrome

Patients who consistently follow their prescribed protocol along with proper exercise and healthy eating habits may begin seeing results within 30 days [15]

Thus, patients who are known to be intermediate or poor metabolizers may ultimately require lower doses of phenytoin to maintain similar steady-state concentrations compared to normal metabolizers