Question

A 30-year-old woman presents with new-onset fatigue, cold intolerance, and weight gain. Examination shows dry skin and delayed relaxation of deep tendon reflexes. TSH is 12 mIU/L (elevated) and free T4 is low. Anti-thyroid peroxidase antibodies are positive. What is the most appropriate management?

Accepted Answer

Start levothyroxine replacement to normalise TSH

Answer

Observe without treatment and repeat TSH in 12 months

Answer

Start propylthiouracil

Answer

Order thyroid uptake scan and withhold treatment until results are available

Answer

Treat with radioiodine ablation

Practice question

A 30-year-old woman presents with new-onset fatigue, cold intolerance, and weight gain. Examination shows dry skin and delayed relaxation of deep tendon reflexes. TSH is 12 mIU/L (elevated) and free T4 is low. Anti-thyroid peroxidase antibodies are positive. What is the most appropriate management?