Practice question

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A 45-year-old woman presents with fatigue, weight gain, and cold intolerance. On examination, she has dry skin and bradycardia (55 bpm). Blood tests reveal: TSH 8.5 mU/L (0.4-4.0), Free T4 10 pmol/L (12-22). Thyroid peroxidase antibodies (TPOAb) are positive. What is the most appropriate management?

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