We all know to check the weight of paediatric patients regularly and dose-adjust medicines accordingly. A recent case report in JAMA Internal Medicine presents the case of a 62-year-old male with hypothyroidism amongst other co-morbidities, who was admitted with atrial fibrillation secondary to thyrotoxicosis.

In the preceding six months, he had lost about 40 kg in weight (132 kg to 93 kg) with the aid of tirzepatide. His dose of levothyroxine was never adjusted based on his reducing weight, with resultant toxic levels of levothyroxine.

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