1276 Precision medicine in hypothyroidism: an engineering approach to individualized levothyroxine dosing

This chapter presents an innovative engineering approach to precision medicine in the treatment of hypothyroidism. By leveraging mathematical modeling of the hypothalamic- pituitary-thyroid (HPT) axis, a novel algorithm, PzeroT, is developed for individualized optimization of levothyroxine dosing. The chapter explores the HPT axis physiology and pathology and the current state-of-the-art in hypothyroidism treatment. The core contribution lies in implementing a compartmental model of the HPT axis, which is the foundation for the PzeroT algorithm. This model-based approach enables the prediction of the optimal levothyroxine dose tailored to individual patient characteristics. The chapter further validates the PzeroT algorithm using real patient case studies, demonstrating its potential to improve hypothyroidism management by reducing treatment times and enhancing dose accuracy compared to standard clinical practices. This work, at the intersection of chemical engineering and medicine, exemplifies how engineering principles can advance precision medicine and paves the way for more personalized and effective treatment of thyroid disorders.