Question

A 38-year-old woman presents with fatigue, cold intolerance and weight gain. TSH is 10 mIU/L (elevated) and free T4 is within the reference range. She is otherwise healthy, not pregnant and has no goitre. Anti-thyroid peroxidase antibodies are positive. What is the most appropriate management?

Accepted Answer

Start levothyroxine because she has subclinical hypothyroidism and positive antibodies

Answer

Reassure; no treatment or follow-up is required

Answer

Start levothyroxine only if she becomes symptomatic

Answer

Arrange urgent radioactive iodine ablation

Answer

Start liothyronine (T3) monotherapy

Practice question

A 38-year-old woman presents with fatigue, cold intolerance and weight gain. TSH is 10 mIU/L (elevated) and free T4 is within the reference range. She is otherwise healthy, not pregnant and has no goitre. Anti-thyroid peroxidase antibodies are positive. What is the most appropriate management?