A 35-year-old woman presents with lethargy, weight gain and cold intolerance. TSH is 18 mIU/L and free T4 is low. She has no cardiac disease and is no...

Question

A 35-year-old woman presents with lethargy, weight gain and cold intolerance. TSH is 18 mIU/L and free T4 is low. She has no cardiac disease and is not pregnant. What is the most appropriate initial dosing strategy for levothyroxine?

Accepted Answer

Start 1.6 micrograms/kg/day (approximately 100 micrograms daily) and titrate according to TSH

Answer

Start 25 micrograms daily and increase by 25 micrograms every 6 months

Answer

Start 50 micrograms daily and maintain this dose long term

Answer

Start 200 micrograms daily for 1 week then reduce

Answer

Do not start treatment until TSH exceeds 30 mIU/L

au-amc MCQ (SBA): Primary hypothyroidism

A 35-year-old woman presents with lethargy, weight gain and cold intolerance. TSH is 18 mIU/L and free T4 is low. She has no cardiac disease and is not pregnant. What is the most appropriate initial dosing strategy for levothyroxine?