Question

A 35-year-old woman presents with weight gain, fatigue, cold intolerance and constipation over 6 months. Examination shows dry skin and mild periorbital puffiness. Her thyroid function tests show TSH 12 mIU/L (0.4-4.0) and free T4 8 pmol/L (10-20). What is the most appropriate next step?

Accepted Answer

Start levothyroxine and titrate to normalise TSH

Answer

Reassure and repeat thyroid function tests in 12 months

Answer

Start carbimazole and beta blocker

Answer

Arrange urgent thyroid ultrasound to exclude malignancy

Answer

Start liothyronine (T3) alone

Practice question

A 35-year-old woman presents with weight gain, fatigue, cold intolerance and constipation over 6 months. Examination shows dry skin and mild periorbital puffiness. Her thyroid function tests show TSH 12 mIU/L (0.4-4.0) and free T4 8 pmol/L (10-20). What is the most appropriate next step?