A 45-year-old woman presents with fatigue, weight gain, cold intolerance and constipation for several months. TSH is 14 mIU/L (elevated) and free T4 i...

Question

A 45-year-old woman presents with fatigue, weight gain, cold intolerance and constipation for several months. TSH is 14 mIU/L (elevated) and free T4 is at the lower limit of normal. She has positive anti-TPO antibodies. According to thyroid management guidelines, what is the most appropriate next step?

Accepted Answer

Start levothyroxine replacement therapy

Answer

Observe without treatment and repeat tests in one year

Answer

Order thyroid ultrasound and no treatment

Answer

Treat with anti-thyroid drugs

Answer

Advise iodine supplementation only

ca-mccqe1 MCQ (SBA): Subclinical hypothyroidism - treatment threshold