Barw Barw Medical Journal 2960-1959 2025 11 18 Exploring the Efficacy of Once and Twice Weekly Thyroxine Dosing: A Promising Approach for Hypothyroidism Management 14 20 10.58742/bmj.v4i1.211 eng Abdulwahid M. Salih Department of Head & Neck Surgery, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq. a.salih@smartglobalholding.co.uk Aso S. Muhialdeen Kscien Organization for Scientific Research (Middle East Office), Hamdi Street, Sulaymaniyah, Iraq. asomuhialdeen@gmail.com Mohsin M. Ahmed Sulaymaniyah Teaching Hospital, Zanko Street, Sulaymaniyah, Iraq. mohsinahmed@gmail.com Hardi M. Zahir Department of Head & Neck Surgery, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq. hardizahir@gmail.com Yadgar A. Saeed Department of Head & Neck Surgery, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq. yadgarsaeed@gmail.com Saeed H. Ali Department of Head & Neck Surgery, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq. saeedali@gmail.com Hiwa O. Baba Department of General Surgery, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq. Hiwababa1@gmail.com Shaho F. Ahmed Department of Endocrinology, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq. shahoahmed@gmail.com Muhammed Bag A. Ali Smart Health Tower (Raparin Branch), Karux Street, Ranya, Sulaymaniyah, Iraq. muhamadbagali@gmail.com Hunar A. Hassan Kscien Organization for Scientific Research (Middle East Office), Hamdi Street, Sulaymaniyah, Iraq. hunarhassan@gmail.com Shko H. Hassan Department of Head & Neck Surgery, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq. shkohasan@gmail.com Marwan N Hassan Kscien Organization for Scientific Research (Middle East Office), Hamdi Street, Sulaymaniyah, Iraq. marwanhasan@gmail.com Swara H. Abdullah Department of Medicine, Shar Hospital, Malik Mahmud Ring Road, Sulaymaniyah, Iraq. swaraabdullah@gmail.com 2025 09 07 Introduction Hypothyroidism is a common endocrine disorder, in which the management involves daily intake of thyroxine. However, adherence to a daily medication regimen poses a substantial challenge for many patients. The current study aims to assess the efficacy of once and twice-weekly thyroxine regimen for the management of hypothyroidism. Methods This was a single-center cohort study involving hypothyroid patients that was conducted over three years. In this study, standard daily, once and twice-weekly thyroxine dosing regimens were used to treat the patients. The effectiveness of the three dosage regimens was ascertained by whether the patients achieved a euthyroid state after six months of therapy. Results In total, 328 hypothyroid cases due to thyroiditis were included in this study. The average age of the cases was 42.7 years (14-92). Before thyroxine therapy, in the standard daily regimen group, the median level of TSH was 15.4 μIU/mL (IQR 23.1), in the once-weekly regimen group, the level was 9.2 μIU/mL (IQR 6.8), and in the twice-weekly regimen group, the level was 9.1 μIU/mL (IQR 7.3). After thyroxine intake and upon follow-up after 6 months, the TSH level decreased to 4.0 μIU/mL (IQR 3.7), 4.5 μIU/mL (IQR 4.9) and 4.2 μIU/mL (IQR 5.1) in the standard daily, once- and twice-weekly regimen groups, respectively. Conclusion Once and twice weekly thyroxine shows promise as strategies for managing hypothyroidism. However, variability in patients in response to weekly thyroxine needs to be taken into account.