Question

A 23-year-old woman presents with fatigue, weight gain, cold intolerance and constipation. TSH is 18 mIU/L (elevated) with free T4 8 pmol/L (low). She is not pregnant. According to Canadian thyroid management recommendations, what is the most appropriate treatment?

Accepted Answer

Start levothyroxine at a full replacement dose and titrate to normalise TSH.

Answer

No treatment; repeat thyroid function tests in 12 months.

Answer

Treat with liothyronine (T3) monotherapy.

Answer

Begin combination levothyroxine and liothyronine therapy.

Answer

Advise iodine supplementation alone without hormone replacement.

Practice question

A 23-year-old woman presents with fatigue, weight gain, cold intolerance and constipation. TSH is 18 mIU/L (elevated) with free T4 8 pmol/L (low). She is not pregnant. According to Canadian thyroid management recommendations, what is the most appropriate treatment?