Question

A 42-year-old woman presents with tiredness, weight gain and feeling cold. Examination shows dry skin and bradycardia. Thyroid function tests show TSH 18 mIU/L (reference 0.4-4.0) and free T4 7 pmol/L (reference 10-20). What is the most appropriate management?

Accepted Answer

Start levothyroxine and review thyroid function in 6-8 weeks

Answer

Repeat thyroid function tests in 12 months without treatment

Answer

Prescribe liothyronine alone

Answer

Refer urgently for thyroidectomy

Answer

Start beta blockers alone for symptomatic relief

Practice question

A 42-year-old woman presents with tiredness, weight gain and feeling cold. Examination shows dry skin and bradycardia. Thyroid function tests show TSH 18 mIU/L (reference 0.4-4.0) and free T4 7 pmol/L (reference 10-20). What is the most appropriate management?