Question

A 35-year-old woman presents with lethargy, weight gain and cold intolerance. Examination reveals dry skin and delayed ankle jerk relaxation. TSH is 12 mIU/L (reference 0.4-4.0) and free T4 is low. She is not pregnant. According to best practice, what is the most appropriate initial management?

Accepted Answer

Commence levothyroxine and titrate to normalise TSH

Answer

Commence liothyronine monotherapy and repeat TSH in 6 months

Answer

Commence carbimazole and beta blocker

Answer

Observe and repeat thyroid function tests in 12 months

Answer

Refer for urgent thyroidectomy

Practice question

A 35-year-old woman presents with lethargy, weight gain and cold intolerance. Examination reveals dry skin and delayed ankle jerk relaxation. TSH is 12 mIU/L (reference 0.4-4.0) and free T4 is low. She is not pregnant. According to best practice, what is the most appropriate initial management?