Question

A 47-year-old woman presents with tiredness, weight gain, constipation and dry skin. Examination shows bradycardia and periorbital puffiness. Blood tests show TSH 18 mU/L (0.4–4.0) and free T4 7 pmol/L (10–24). What is the most appropriate initial management?

Accepted Answer

Start Levothyroxine and repeat thyroid function tests in 6–8 weeks

Answer

Start Carbimazole and arrange urgent endocrinology review

Answer

Repeat thyroid function tests in 6 months without treatment

Answer

Start Propranolol and observe

Answer

Arrange thyroid ultrasound before treatment

Practice question

A 47-year-old woman presents with tiredness, weight gain, constipation and dry skin. Examination shows bradycardia and periorbital puffiness. Blood tests show TSH 18 mU/L (0.4–4.0) and free T4 7 pmol/L (10–24). What is the most appropriate initial management?