Question

A 58-year-old woman complains of tiredness, weight gain and cold intolerance. TSH is elevated and free T₄ is low. She is diagnosed with primary hypothyroidism and has no cardiovascular disease. According to UK guidance, what is the most appropriate initial treatment?

Accepted Answer

Levothyroxine 75–100 micrograms once daily, with TSH checked after 6–8 weeks.

Answer

Levothyroxine 25 micrograms once daily, titrating every 6 months.

Answer

Liothyronine 10 micrograms twice daily.

Answer

Carbimazole 20 mg once daily.

Answer

No treatment is needed if asymptomatic.

Practice question

A 58-year-old woman complains of tiredness, weight gain and cold intolerance. TSH is elevated and free T₄ is low. She is diagnosed with primary hypothyroidism and has no cardiovascular disease. According to UK guidance, what is the most appropriate initial treatment?